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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because of the high cure rate of localized anal cancers from combined modality treatment, there is little that is known for the treatment of patients who progress to have metastatic disease. Treatments currently used are based on activity demonstrated in other cancers with similar histology. Cetuximab, a molecular-targeted therapy, is an antibody directed against epidermal growth factor receptor that has demonstrated anticancer activity in several cancers. We report a female patient with refractory anal cancer who achieved an excellent response to the combination of cetuximab and irinotecan after having failed single-agent irinotecan.
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PMID:Evidence of clinical activity for cetuximab combined with irinotecan in a patient with refractory anal canal squamous-cell carcinoma: report of a case. 1725 87

Distant extrapelvic metastases appear in approximately in 10% of the patients with squamous cell anal cancer (SCAC) and survival depends on the treatment strategy. Exact staging leads to optimal planning of multimodality therapy and the adequate evaluation of treatment response can improve the prognosis of the disease. Diagnosis and staging of SCAC are commonly performed using contrast-enhanced computerized tomography(CT) and interpretation of the findings for tumor biological behavior. F18-fluoro-2 deoxy-D glucose positron emission tomography((18)F-FDG PET) reveals aspects of tumor function and allows metabolic measurements. Combined PET/CT scans permit exact localization with anatomical criteria of the hypermetabolic (18)F-FDG avid malignant lesions. We present a patient with SCAC in whom, according to PET/CT findings, the initial stage was changed from II (T2N0M0) to III A (T2N2M0). Radiation therapy (RT) and chemotherapy achieved a good therapeutic response but early follow up revealed new paraaortic lymph node (LN) metastases, as well as an uncommon left supraclavicular LN metastasis from the same primary carcinoma. The disease was restaged as stage IV (T2N2M1) and radiation therapy was substituted by chemotherapy.
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PMID:Impact of PET/CT on initial staging, restaging and treatment management of anal cancer: a clinical case with literature review. 1730 88

We report a case of anal cancer with iris metastasis and summarize the iris metastasis literature. A 69 years old woman with a history of anal cancer presented with a visual field loss. Slit lamp examination showed a pink ovular mass on the iris of the left eye which was typical of iris metastasis. Because of worse prognosis of metastatic cancer and any ocular complications, the patient was treated by radiotherapy which allowed a clinical improvement. A review of medical records was performed to assess the clinical presentation, diagnosis and treatment. Anal carcinoma can metastasize to the iris. Radiotherapy allows a good local control of tumour but the prognosis depends on systemic disease which is generally bad.
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PMID:Unusual iris metastasis from anal cancer: a case report. 1829 34

Anal squamous cell carcinoma and its precursor lesions are increasing in incidence in the United States and Europe. This trend predates human immunodeficiency virus/acquired immune deficiency syndrome and has been associated with persistent high-risk human papilloma virus (HPV) genotype infection, previous lower genital tract dysplasia/carcinoma, high frequency anoreceptive intercourse, heavy cigarette smoking, immunosuppression in solid organ transplant and immune disorders, and human immunodeficiency virus seropositivity. Screening protocols for at-risk patients are under active investigation and pathologists are often asked to assess anal canal and perianal biopsies for the presence of dysplasia and/or invasive carcinoma. Because underdiagnosis and overdiagnosis of anal cancer and precancer may lead to inappropriate treatment, it is important for the pathologist to be aware of current screening strategies, specific risk lesions, and the role of pathology in initial diagnosis and evaluation of anal biopsy and/or resection specimens. Standardized histologic criteria and uniform terminology should be used for reporting all anal canal and perianal squamous intraepithelial lesions. HPV subtyping, anal cytology, and recently identified biomarkers, such as p16 and Becton Dickinson ProEx C may provide additional information in problematic cases, but it is important to be aware of the limitations of these assays. HPV has been linked to all the major histologic subtypes of anal carcinoma (eg, basaloid, cloacogenic, transitional, etc.) and this association is strongest for anal canal lesions. With the possible exception of the microcystic pattern, histologic subtype does not seem to predict prognosis; and anal squamous cell carcinomas should be classified as either keratinizing or nonkeratinizing. Poorly differentiated squamous cell carcinomas have a worse prognosis and should be distinguished from poorly differentiated adenocarcinoma, melanoma, and neuroendocrine tumors. Very well differentiated squamous cell carcinoma with pushing margins (so-called giant condyloma of Buschke and Lowenstein) should be classified as verrucous carcinoma; this tumor shows aggressive local infiltration but does not metastasize. As all anal condylomata may harbor foci of high-grade dysplasia or invasive carcinoma, careful sectioning and complete histologic examination is required.
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PMID:Diagnostic problems in anal pathology. 1872

Metastasis to the regional lymph nodes is an important prognostic factor in colorectal cancer, and nodal evaluation is essential for accurate staging. In colorectal cancer, the aim of evaluating sentinel lymph nodes (SLNs) is the selection of patients for adjuvant therapy and the detection of aberrant lymphatic drainage patterns, leading to modification of the initial therapeutic plan. In a review of the literature, tracer, technique, tumor-related factors (location and size of tumor, T stage, status of lymph node metastasis), neoadjuvant chemoradiation therapy, and body mass index were important factors in the accurate diagnosis of SLNs in colorectal cancer. In recent multicenter SLN trials, ultrastaging has been possible in 10-38% of NO colon cancer patients. Most recently, the trial conducted by Bilchik et al., which investigated the prognostic significance of micrometastases in SLNs in colon cancer patients, found that all NO colon cancer patients with recurrence had positive SLN findings after reverse transcriptase-polymerase chain reaction (RT-PCR)-ultrastaging, whereas none of those with negative SLN findings in immunohistologic staining had recurrence, and there was only a significant correlation between recurrence and molecular markers in RT-PCR. However, further prospective multicenter trials are warranted to evaluate the ultimate clinical relevance of SLN diagnosis in colorectal cancer including anal cancer.
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PMID:[Current status of sentinel lymph node-based nodal ultrastaging in colorectal cancer]. 1934 97

Anal cancer is an uncommon tumor with an incidence of about one case per 100,000 in most countries. Its incidence seems to be increasing because of exposure to human immunodeficiency virus (HIV) and human papillomavirus (HPV). Traditional pretreatment evaluations include physical examination and CT imaging of the pelvis. Current treatment guidelines include fluorodeoxyglucose positron emission tomography integrated with computed tomography (FDG-PET/CT) as part of the standard pretreatment workup of patients diagnosed with anal cancer. At diagnosis, FDG-PET/CT is used to evaluate primary tumor size, lymph node status and to evaluate for distant metastases. FDG-PET/CT can also be used for radiation therapy treatment planning by clearly defining sites of metabolically active tumor. Posttherapy FDG-PET/CT to determine response to therapy is highly predictive of long-term clinical outcomes. This imaging modality can also be used to evaluate sites of recurrent disease. FDG-PET/CT is an imaging modality which greatly affects the management of patients with anal cancer.
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PMID:FDG-PET/CT: new horizons in anal cancer. 1939 79

Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60-year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms.
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PMID:Small cell carcinoma of the anus: a case report. 2007 82

Carcinoma of the anal canal is a relatively rare cancer with a low propensity for metastasis. A literature review identifies two cases of brain metastases from anal cancer. The authors present the case of a 63-year-old female with poorly differentiated squamous cell carcinoma of the anal canal who presented with a solitary dural-based enhancing lesion of the right parietal area. The patient underwent craniectomy and tumor resection. Histopathology confirmed the cerebral lesion to be a poorly differentiated squamous cell carcinoma, consistent with the known primary tumor of the anal canal. Although exceptionally rare, the presence of a cerebral lesion in a patient with carcinoma of the anal canal should raise the possibility of metastatic disease. Treatment decisions in patients with newly diagnosed dural-based enhancing lesions and known anal cancer should bear in mind the possibility of metastatic disease.
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PMID:Anal cancer with cerebral metastasis: a case report. 2044 May 37

Although anal cancer is a rare disease, its incidence is increasing in men and women worldwide. The most important risk factors are behaviors that predispose individuals to human papillomavirus (HPV) infection or immunosuppression. Anal cancer is generally preceded by high-grade anal intraepithelial neoplasia (HGAIN), which is most prevalent in human immunodeficiency virus (HIV)-positive men who have sex with men. There is a general consensus that high-risk individuals may benefit from screening. Meta-analysis suggests that 80% of anal cancers could be avoided by vaccination against HPV 16/18. Nearly half of all patients with anal cancer present with rectal bleeding. Pain or sensation of a rectal mass is experienced in 30% of patients, whereas 20% have no tumor-specific symptoms. According to the Surveillance Epidemiology and End Results (SEER) database, 50% of patients with anal cancer have disease localized to the anus, 29% have regional lymph node involvement or direct spread beyond the primary, and 12% have metastatic disease, while 9% have an unknown stage. Clinical staging of anal carcinoma requires a digital rectal exam and a computed tomography scan of the chest, abdomen, and pelvis. Suspicious inguinal lymph nodes should be subject to pathologic confirmation by fine-needle aspiration. The 5-year relative survival rates are 80.1% for localized anal cancer, 60.7% for regional disease, and 29.4% for metastatic disease. Part 2 of this two-part review will address the treatment of anal cancer, highlighting studies of chemoradiation.
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PMID:Management of anal cancer in 2010. Part 1: Overview, screening, and diagnosis. 2046 50

A 72-year-old man underwent sigmoidectomy for sigmoid colon cancer in January 1999. Histopathological examination revealed a moderately differentiated adenocarcinoma, tub 2, SS, ly2, v2, N1, H0, P0, M0, Stage IIIa, cur A. In March 2001, he complained of an anal bleeding and underwent colonoscopy. It showed a submucosal tumor 15 mm in diameter at the anal canal and the biopsy indicated a moderately differentiated adenocarcinoma. This tumor was suspected of metastasis from sigmoid colon cancer and transanal resection was performed in May 2001. Histopathological examination revealed a moderately differentiated adenocarcinoma, which was the same histological type as primary sigmoid colon cancer, tub 2, A, ly2, v2, RM0. The diagnosis of anal metastasis was made on the basis of three points. First, tumor was covered with anal epithelium. Secondly, there were severe lymphatic and venous involvements. Thirdly, there were no findings of other primary anal cancer. By removing anal canal metastases twice, inguinal lymph node metastases three times and lung metastases in each time, he survived for 11 years after a primary surgery. We reported here because it was a very interesting and rare case that the patient was cancer-free after surgeries as many as seven times.
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PMID:[A case of anal metastasis from sigmoid colon cancer in a long-term survivor who had repeated local excisions]. 2122 47


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