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

Parotid gland is an unusual metastasis site. Metastatic lesions very often represent spread from adjacent regions of lymphatic drainage; nevertheless direct involvement or hematogenous spread can occur. Head and neck cutaneous tumors are the most common primary: in a overlooking of more than 800 cases, cutaneous squamous cell carcinomas and melanomas represent about 80%. Parotid metastasis from extra-cutaneous head and neck tumors and distant primary are uncommon: in our review we found respectively 66 and 87 reports. In our experience, from 1968 to 1991, we observed 38 patients with metastatic involvement of the parotid gland. The primary were located as follows: 24 cutaneous head and neck tumors (15 SCC, 7 melanomas, 2 BCC), 10 extra-cutaneous supra-clavicular tumors (9 carcinomas, 1 adenocarcinoma), 4 distant primary (2 renal cell carcinomas, 2 lung tumors). In 14 patients was performed a parotidectomy, in 10 cases associated to a neck dissection and in 4 cases followed by post-operative radiotherapy. Exclusive radiotherapy and chemotherapy were performed respectively in 14 and 4 cases, in 6 patients the only planned treatment was a symptomatic therapy. After 1, 3 and 5 years follow-up the overall survival was respectively of 71.4%, 30.4% and 11.8%; better results were observed in cutaneous primary (86.3%, 42.8% and 20%). To conclude, parotid metastases represent a not uniform clinical entity. Cutaneous SCC, BCC and melanoma can be successfully treated by surgery and/or radiotherapy. As non-cutaneous secondary parotid tumors have a poor prognosis, treatment must be related to condition of generalized disease.
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PMID:[Parotid metastases: a review of the literature and case reports]. 826 1

Cutaneous squamous cell carcinoma has a relatively low metastatic rate (0.5% to 16%), but patients with the disease should always be evaluated for possible regional nodal involvement. We reviewed the records of 37 patients with metastatic disease among the 388 patients with head and neck cutaneous squamous cell carcinoma who were treated at New York University Medical Center between 1961 and 1992. In this group of patients the most common primary sit was the cheek or preauricular region and the most common metastatic site was the level I neck lymph nodes. Seven patients (18%) had metastases at initial presentation. Among the remaining patients the average time to the development of metastases was 19 months. Nineteen patients (51%) had recurrence at the primary site before metastasis; 11 (30%) developed metastases with control of the primary tumor. Analysis of the records of 31 patients treated for cure revealed that 13 were treated by surgery, 2 by radiation therapy, and 16 by a combination of surgery and radiation therapy. During the mean follow-up period of 49 months, 11 (35%) of these 31 patients died of their disease. Recurrence of the primary tumor appeared to increase the risk for nodal and distant metastases.
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PMID:Metastatic cutaneous squamous cell carcinoma of the head and neck region. 858 45

Keratoacanthoma of the skin and well-differentiated squamous cell carcinoma are two cutaneous neoplasms that most often occur in sun-exposed sites of light-skinned persons. It is often difficult to distinguish these two from each other either clinically or histologically. The view that these two cutaneous neoplasms are part of the same disease entity is not new. We reviewed 150 patients with these two diseases in an effort to see whether any specific criteria for diagnosis and treatment could be achieved. It is our hypothesis that they are not separate diseases but within the spectrum of the same disease. Keratoacanthoma may be some sort of aborted malignancy or hyperplastic premalignant lesion within the squamous cell carcinoma spectrum. The incidence of metastases from squamous cell carcinoma of the skin may be as high as 3%. We do not have the courage to wait 3 months to see if a potentially invasive and metastatic neoplasm is indeed involutional. Incision biopsy may be wrought with significant histopathological inconsistencies. We believe that early, complete excision is the treatment of choice for all skin neoplasms thought to be keratoacanthoma.
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PMID:Keratoacanthoma: is it a real entity? 960 Apr 29

Cutaneous squamous cell carcinoma is the most common metastatic skin cancer. The importance of early recognition and thorough treatment of premalignant lesions as well as the recognition of risk factors of the neoplasms that are most likely to metastasize must also be emphasized. A retrospective study of 126 patients, treated for primary squamous cell carcinoma of the face, was undertaken over a 7-year period. An attempt is made to define the major therapeutic modalities chosen, taking into consideration the specific anatomic location.
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PMID:[Squamous cell carcinoma of the face: therapeutic approach]. 1002 94

The guidelines of the International Union against Cancer are generally used to assess malignancy of squamous cell carcinoma of the skin. Beside TNM-staging, histological grading is performed. This system has been extended by a selection of histological parameters which were studied with respect to prognosis, based on a review of 184 patients with squamous cell carcinoma. An increased malignancy was found in carcinomas with the following features: clinical diameter greater than 2 cm, low degree of keratinization, high degree of cellular polymorphism, high mitotic index and high tumor thickness index (metastases only from tumor thickness 2.4 mm and subcutaneous infiltration), desmoplasia and ulceration. Consideration of histological tumor parameters improved prognosis assessment. Multivariate analyses with large case series are necessary to determine ranks of the prognostic factors. Therefore, the data analysis of all centers that contribute to the carcinoma registry will make a precise definition of high- and low-risk carcinomas possible and can thus influence therapy and follow-up procedures.
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PMID:[Histological and clinical prognostic factors in squamous cell carcinoma of the skin. A contribution to the multicenter carcinoma study of the association of surgical and oncological dermatology]. 1042 9

Cutaneous squamous cell carcinoma (SCC) is a common cancer. Although most patients with primary cutaneous SCC have an excellent prognosis, for those with metastatic disease, the long-term prognosis is poor. The most common sites of metastasis are regional lymph nodes, lung, liver, brain, skin, and bone. However, metastatic soft tissue SCC from cutaneous lesions is extremely rare, with only two reported cases. We report a case in which the patient had a primary SCC lesion on his left palm in 1986. A second primary SCC on his left forearm was confirmed in 2001, with subsequent metastasis to the proximal muscles and bone invasion in spite of the initial wide excision.
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PMID:Intramuscular metastasis of cutaneous squamous cell carcinoma: a case report. 1279 49

Hypercalcemia is one of the most common paraneoplastic syndromes, where it may result from the presence of osteolytic metastases or from humoral effect of factors produced by tumor cells. One of such factors is the parathyroid hormone-related protein (PTH-rP). This protein is usually produced by solid tumors, especially by squamous cell carcinomas. In the case of squamous cell carcinoma of the skin hypercalcemia is very rare and symptomatic hypercalcemia is unusual. We present a case of acute hypercalcemic crisis as a consequence of overproduction of PTH-rP in a patient with spinocellular squamous cell carcinoma of the skin, which was proved by immunohistochemical staining of the tissue samples from the neoplastic lesion, metastases in bone and in lung, and also from kidney and liver.
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PMID:[Acute hypercalcaemic crisis in the course of PTH-rP producing squamous cell carcinoma of the skin--a case report]. 1652 24

Squamous cell carcinoma of the skin is common skin malignancy arising from malignant proliferation of the keratinocytes of the epidermis. Chronic exposure to ultraviolet radiation in sunlight is the most important risk factor for squamous cell carcinoma. Early diagnosis and appropriate treatment provide the best opportunity to cure cutaneous squamous cell carcinomas. Although it is locally invasive, squamous cell carcinomas usually remain localized and can be cured by a variety of techniques. Surgical excision is the most broadly used treatment for high-risk squamous cell carcinoma. It is well-tolerated, extremely effective, and the completeness of the procedure can be evaluated through histologic assessment of the specimen's margins. About 10 percent of squamous cell carcinomas in Japan spread to regional lymph nodes or more distant sites with a relatively poor outcome. Five-year cure rates are reported to be 85 to 80 percent for Japanese patients with squamous cell carcinomas, respectively. Recommendations for surgical margins vary depending upon the risk of local recurrence, especially; squamous cell carcinomas with perineural extension also need more extensive procedures. Patients with clinically enlarged lymph nodes may require radiographic imaging, fine needle aspiration, or lymph node biopsy. Depending upon the results of these tests, regional lymph node dissection may be done. Recently the sentinel lymph node biopsy technique is being evaluated for its ability to detect microscopic involvement in patients with high-risk patients who have no clinical evidence of lymph node metastasis. The occurrence of regional lymph node metastases places the patient at increased risk for the subsequent development of distant metastases. Distant metastases are associated with a markedly increased risk of disease-related mortality. Systemic chemotherapy has been to limited benefit in patients with disseminated squamous cell carcinoma patients. In Japanese patients with distant metastases, the five-year survival rate is about 10 percent. The ability of current chemotherapy protocols to increase the cure ratio in squamous cell carcinoma is still controversial.
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PMID:[Squamous cell carcinoma]. 1703 26

Cutaneous squamous cell carcinoma of the head and neck most often spreads via direct extension or through lymphatics to regional lymph nodes. This is a unique case of a cutaneous squamous cell carcinoma of the nasal dorsum with direct vascular invasion of the facial vein. This was initially incorrectly identified as a regional level Ib lymph node metastases, and the intervening venous structures were neither extirpated during an initial surgery nor recognized during subsequent radiation therapy. The patient then presented with a sizable recurrence in the right suborbital subcutaneous tissue region extending into the neck and internal jugular vein. During further resection, direct tumor invasion into the facial vein was pathologically confirmed. This unusual involvement is presented as the first documented report of regional spread via tumor thrombosis within the facial vein as demonstrated in the facial vein with a tumor thrombus, as demonstrated by computed tomography and microscopic findings.
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PMID:Regional spread of cutaneous squamous cell carcinoma of the face via facial vein tumor thrombus: a case report. 1914 5

Cutaneous SCC is the second most common skin cancer among whites. Most cases of primary cutaneous SCC are induced by UV radiation. Chronic sun exposure is the major risk factor, and favored locations include the head and neck and other sun-exposed areas. Moreover, it is important for the clinician to recognize other risk factors associated with this malignancy, including HPV infection, occupational exposures, various genodermatoses, scarring dermatoses, chronic wounds, and burn scars. The allogenic transplant population is at most risk for developing cutaneous SCC. For these patients, aggressive patient education, control of immunosuppression, and clinical surveillance should be the standard of care. Most patients who have primary SCC have an excellent prognosis, and treatment is usually straightforward. A substantial minority of these neoplasms, however, may recur or metastasize. Obtaining a complete history and performing a total-body skin examination can help to identify tumors at high risk for recurrence or metastasis in addition to those that may be more easily treated. For those individuals with metastatic disease, however, the long-term prognosis is guarded. Based on recent reports, in the future, there may be a role in SLNB for cutaneous SCC to diagnose subclinical metastasis accurately. Larger studies and better guidelines need to be developed before SLNB can be routinely used in the management of metastatic disease. Physicians should emphasize to their patients the benefits of sun avoidance and protection from sunlight, beginning in childhood, to minimize the risk for developing this potentially life-threatening neoplasm.
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PMID:Cutaneous squamous cell carcinoma. 1925 4


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