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

The clinicopathologic, immunohistochemical, and flow cytometric characteristics of 34 cases of mammary carcinoma with metaplasia were compared with those of 20 cases of pure sarcoma of the breast. All 20 of the latter tumors showed the pattern of malignant fibrous histiocytoma. There were 20 cases of carcinoma with mesenchymal metaplasia, 7 cases of carcinoma with mixed epithelial (squamous) and mesenchymal metaplasia, and 7 cases of carcinoma with epithelial metaplasia (four mixed ductal/squamous and three pure squamous cell carcinomas). No patient with pure sarcoma had lymph node metastases develop; all nodal metastases were found in patients who had carcinoma with metaplasia, although in one case the carcinomatous component was seen only within a lymph node metastasis. Epithelial antigens were found not only within the epithelial elements of all cases of carcinoma, but also within the apparent mesenchymal elements of 44% of the carcinomas showing divergent differentiation. Flow cytometric analysis of eight cases of carcinoma with mesenchymal metaplasia showed aneuploidy/tetraploidy in six neoplasms. For patient management purposes, the distinction of pure sarcoma from carcinoma with metaplasia is important, but additional subclassification of carcinoma with metaplasia is of greater biologic than clinical interest.
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PMID:Carcinomas with metaplasia and sarcomas of the breast. 174 99

The authors assessed the impact of two cycles of preoperative chemotherapy (POCT) with intraarterial cisplatin (120 mg/m2) and continuous intravenous doxorubicin hydrochloride (Adriamycin; 20 mg/m2/day x 3 days) on the decision to perform a limb-sparing procedure (LSP) or amputation in 22 patients with high-grade bone sarcomas of the extremities. The tumor types were osteosarcoma (17), malignant fibrous histiocytoma (three), leiomyosarcoma (one), and malignant schwannoma (one). Surgical stages were IIA (three), IIB (17), and IIIB (two). The prechemotherapy surgical options chosen were 12 amputations (55% of patients) and ten LSPs (45%). The initial decisions to amputate were based on a combination of the following: improper biopsy (five cases), large tumors (ten) and those with neurovascular encroachment (six), and pathological fracture (one). Following chemotherapy, 18 LSPs (81%) and four amputations (19%) were performed. Nine of 12 patients (75%) initially deemed unresectable were converted to LSP. The median tumor response (necrosis; range, 0%-100%) was 70%; ten of 22 specimens had necrosis greater than 95%. Median tumor necrosis for the patients treated by amputation and LSPs was 45% and 88%, respectively. Following surgery, all patients received four additional cycles of cisplatin and doxorubicin. The median follow-up period is 30 months; six patients have developed metastatic disease, with a median disease-free interval of 16.6 months. The rate of local tumor control is 95% (21 of 22 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of two cycles of preoperative chemotherapy with intraarterial cisplatin and intravenous doxorubicin on the choice of surgical procedure for high-grade bone sarcomas of the extremities. 188 42

Seventeen cases of soft tissue sarcoma (STS) developing in the pleural cavity were collected from Japanese hospitals, and their clinical and pathologic findings summarized. Eight of the 17 patients had a 15-year to 50-year (mean, 28.8) history of chronic pleural inflammatory disease (pleuritis, pyothorax, and pulmonary tuberculosis) before the onset of the pleural sarcoma. Histologically, malignant fibrous histiocytoma was the most common tumor type (11 cases), followed by angiosarcoma (four). The age at diagnosis of the sarcoma ranged from 15 to 74 years (mean, 58); the male-to-female ratio was 3.3:1. In the eight cases of sarcoma associated with chronic pleural inflammatory disease, male preponderance was more marked (7:1). The commonest presenting symptom was chest pain. A mass could be detected by chest roentgenograms in 13 patients and computed tomographic scans in 15 patients. No patient had distant metastases at first admission. Thirteen patients were treated by surgery, chemotherapy, and/or radiation therapy. Thirteen of the 17 patients died 1 to 87 months (mean, 14.2) after therapy for STS. The actuarial 1-year survival rate was 38.5%. These findings suggest that long-standing pleural inflammation might be an etiologic factor for development of pleural STS.
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PMID:Soft tissue sarcoma of the pleural cavity. 189 56

We reviewed 21 patients more than 16 years old who were seen with a diagnosis of paratesticular sarcoma from 1958 to 1987. Of the patients 14 presented with primary disease and 7 with recurrent disease. The survival of the primarily treated patients was 58% at 5 years, calculated by the product limit method. Of the 14 patients with primary disease 13 had grade 3/4 or 4/4 sarcoma and 13 of 14 underwent initial radical orchiectomy. In addition, 6 of the 14 patients underwent an adjuvant operation or radiotherapy to the groin, or groin and scrotum, and none had local relapse. Some patients also had chemotherapy. Three patients underwent adjuvant retroperitoneal node dissection and 2 had microscopically positive nodes. All 3 patients remain without relapse. Six patients had relapse: 2 locally, 2 in the retroperitoneal nodes and 2 with distant metastases. Only 1 patient (with scrotal recurrence) was salvaged. Of the 7 patients referred with recurrent disease none was salvaged. In this series there is a 2 of 14 (14%) risk of local failure and a 4 of 14 (28%) risk of retroperitoneal relapse after radical orchiectomy. Since salvage has not proved successful, patients with rhabdomyosarcoma, intermediate or high grade malignant fibrous histiocytoma, or fibrosarcoma should be considered for adjuvant retroperitoneal node dissection. All patients should undergo adjuvant dissection or irradiation of the ipsilateral pelvic and groin nodes, and scrotum.
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PMID:Adult paratesticular sarcomas: a review of 21 cases. 190 46

Between June 1985 and March 1990, 25 patients with primary malignant bone tumors, including 15 cases of osteogenic sarcoma, two cases of periosteal osteogenic sarcoma, six cases of chondrosarcoma, and two cases of malignant fibrous histiocytoma, were treated with limb-salvage procedures. Fourteen patients underwent limb salvage operations with tumor prosthesis arthroplasty, 6 with resection-arthrodesis, 4 with wide resection, and 1 with autoclaved autograft. Pre- and/or post-operative chemotherapy with or without radiotherapy was combined with these limb salvage operations. The average follow-up period was 25.2 months (6 to 52 months) since diagnosis. The estimated 3.5-year survival rate of the total 25 patients was 39.5% based on the Kaplan-Meier survival plot. In the 15 cases of osteogenic sarcoma, the estimated Kaplan-Meier 34-month survival rate was 46.2%. Seventeen patients who were followed up for more than 1 year were grouped by functional grading: 11 (65%) were excellent; 3 (18%) good; 2 fair (12%); and 1 poor. Complications occurred in 4 patients, 1 had a local recurrence, 2 had superficial wound infections, and 1 a loosening of the femoral stem. Metastases were shown in 15 case, and the most common location was the lung.
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PMID:Limb-salvage operations in primary malignant tumors of the bone--interim report. 196 35

We evaluated 17 children with primary intracranial neoplasms for subarachnoid metastatic disease (SAMD) using myelography with computed tomographic follow-up (Myelo + CT) and cerebrospinal fluid (CSF) histopathologic examination, as well as magnetic resonance imaging with gadolinium DTPA (MRI + Gd), between December 1988 and December 1989. There were 12 boys, and the median age was 5.7 years (range, 0.8 to 21.8 years). Tumor histology included 8 primitive neuroectodermal tumors (PNETs), 3 ependymomas, 2 low-grade astrocytomas, 1 anaplastic astrocytoma, 1 glioblastoma multiforme, 1 atypical rhabdoid tumor, and 1 malignant fibrous histiocytoma. Thirteen tumors originated in the posterior fossa, 2 were supratentorial, and 2 were in the spinal cord. The median interval between the 2 diagnostic tests was 2 days. MRI + Gd was positive in 11 (65%), Myelo + CT in 8 (47%), and CSF in 5 (29%) cases. MRI + Gd was superior in delineating spinal cord nodules and "sugar coating" whereas Myelo + CT more readily revealed nerve root sleeve filling defects. There was no case in which Myelo + CT was positive that MRI + Gd did not reveal SAMD. MRI + Gd is a safe, noninvasive test that should be used as the initial imaging modality for the presence of SAMD.
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PMID:Comparison of myelography with CT follow-up versus gadolinium MRI for subarachnoid metastatic disease in children. 198 95

The results of a specific type of prosthetic reconstruction of the knee (total replacement arthroplasty) after resection of a sarcoma of the proximal part of the tibia in sixteen patients were retrospectively reviewed. The diagnosis was stage-IIB osteogenic sarcoma in nine patients, stage-IIB malignant fibrous histiocytoma in three patients, and stage-IB sarcoma of various types in four patients. The length of tibial resection ranged from 100 to 257 millimeters. Of the eleven patients who were available for functional examination (mean duration of follow-up, sixty-three months), three patients had an excellent result, seven had a good result, and one had a fair result. Of the five patients who were not available for functional testing, one who was doing well was lost to follow-up at eighty months, one had died of metastases at sixteen months, and three had had a secondary amputation for infection or for loosening of the prosthesis.
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PMID:Prosthetic arthroplasty of the knee after resection of a sarcoma in the proximal end of the tibia. A report of sixteen cases. 199 23

Sarcomas arising in the major salivary glands are rare. This article presents the clinicopathologic features of 11 patients with primary sarcomas of the parotid gland (eight men and three women aged 7 to 75 years; mean age, 42 years). The 11 sarcomas were histologically typified as follows: three malignant fibrous histiocytomas and two each of neurosarcomas, rhabdomyosarcomas, fibrosarcomas, and osteosarcomas. Four patients experienced disease recurrences, and seven patients developed metastases. Seven patients died of their sarcomas, with a mean survival time of 30 months. Four patients were alive from 5 to 12 years (one each with angiomatoid malignant fibrous histiocytoma, embryonal rhabdomyosarcoma, fibrosarcoma, and neurosarcoma). Prognosis correlated with size of the neoplasm, type of sarcoma, and histologic grade. In this respect, salivary gland sarcomas behaved in identical fashion to their soft-tissue counterparts.
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PMID:Primary sarcomas of the major salivary glands. 199 70

Cases of malignant fibrous histiocytoma arising from the aorta are rare and have a dismal outlook despite treatment. The longest reported survival period following resection is only 28 months. A patient with malignant fibrous histiocytoma of the descending thoracic aorta was successfully treated with resection and reconstruction with a prosthetic graft. The patient developed metastatic disease eight months postoperatively. With aggressive triple regimen chemotherapy, complete remission has been obtained. The patient is alive and free of disease six years postoperatively.
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PMID:Malignant fibrous histiocytoma arising from descending thoracic aorta. 215 40

Primary sarcomas of the kidney in adults are rare. In the handful of published reports of all soft tissue sarcomas, DNA ploidy has correlated with histologic grade and outcome. This report presents the clinicopathologic and flow cytometric features of 17 cases of primary renal sarcoma (seven men and ten women, ages 28-69 years). Presenting symptoms included abdominal and back pain and hematuria. Stages at diagnosis were I, in three patients; II, five patients; III, two patients; and IV, two patients. Eight tumors were leiomyosarcoma, two malignant fibrous histiocytoma, one hemangiopericytoma, one fibrosarcoma, and five unclassified. Tumors measured 5.5 to 23 cm, seven contained marked nuclear pleomorphism, seven were extensively necrotic, and mitotic rate was 1 to 33 per 10 high-power fields. Seven tumors showed aneuploidy and five were diploid. Thirteen patients were dead of disease after a mean of 23 months and two were alive with known metastases at 29 and 33 months, respectively. Ploidy pattern and outcome or time to death were not correlated, but aneuploidy correlated with histologic grade, marked nuclear pleomorphism (P less than 0.05), extensive necrosis (p less than 0.01), and high mitotic rate (0.05 less than P less than 0.10). The authors conclude that although DNA ploidy does correlate with histologic grade, for primary renal sarcomas, whose prognosis in this series was extremely poor, it does not correlate with outcome.
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PMID:Primary sarcomas of the kidney. A clinicopathologic and DNA flow cytometric study of 17 cases. 215 1


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