Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphangiography was performed on 23 patients with malignancy in non-descended testicles, 14 of whom had seminomatous and 9 non-seminomatous tumors. Lymph node metastases were shown by lymphangiography in 8 patients: 3 in lumbar nodes, 1 in iliac nodes alone and 4 in lumbar and iliac lymph nodes. Microscopic metastases were shown in lumbar nodes at retroperitoneal lymph node dissection in 2 patients when the lymphangiograms were negative. Iliac lymph node metastases are rare in testicular tumors but may be seen in tumors of non-descended testicles, alone or in combination with lumbar metastatic disease. This information is extremely important for the radiologist as well as the clinician in the management of patients.
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PMID:Lymphangiography in patients with malignancy in a non-descended testicle. 2 11

Of 402 patients with cancers of the oral cavity, oropharynx, and supraglottic larynx treated at Stanford between 1957 and 1972, 164 had clinically uninvolved cervical lymph nodes prior to the initiation of radiation therapy. Lymph node metastases developed later in 38 per cent of patients with primary oral cavity carcinomas who were treated with interstitial radium implants alone. No late cervical lymph node involvement was found in those patients who received high dose external irradiation to at least the primary site and first echelon lymph nodes. Lymph node failures were ultimately noted in 20 of the 140 patients (14 per cent), who received partial or complete neck irradiation, but 18 of these occurred in patients with uncontrolled primary lesions, suggesting that re-seeding of cervical lymph nodes had taken place rather than failure of the initial irradiation to control subclinical metastases. Our present policy is to treat the primary lesion and adjacent lymph nodes with high dose megavoltage techniques, combined with interstitial irradiation if possible. Bilateral supplemental inferior neck radiation ports are added for patients with advanced primary neoplasms and for those with clinically involved cervical lymph nodes. All other patients undergoing radiation therapy for stage T1 primary lesions and clinically negative necks also receive ipsilateral low neck irradiation. In addition, cervical lymph nodes are electively irradiated when the primary lesion has been resected. When these policies are adopted, the incidence of cervical lymph node failures is extremely low in patients whose primary sites remain controlled, and morbidity from the cervical radiation fields is negligible.
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PMID:Irradiation of clinically uninvolved cervical lymph nodes. 81 1

With a uniform pathohistological technique of investigation the frequency of histological verified lymph node metastases in tumor nephrectomy depends on the surgical approach. Lymph node metastases were seen twice (6%) in 33 cases of lumbar nephrectomy, 22 times (17%) in 132 cases of abdomino-paracolic operations without systematic lymphadenectomy, 11 times (37%) in 30 abdomino-transplical nephrectomies with systematic lymphadenectomy. Primarily, one can expect lymph node metastases in case of infiltration of capsula adiposa, macroscopic invasion of veins, histologic grade 3 of malignancy, and/or if the tumor exceeds a size of 10 cm. Metastases are also possible in not enlarged and macroscopic normal lymph nodes. Without systematic dissection of the regional abdominal lymph nodes unknown regional lymph node metastases are likely to remain. Therefore, the treatment of choice in renal cell cancer is abdominal transplical nephrectomy with systematic lymphadenomectomy.
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PMID:[Regional lymph node metastases in renal cell cancer. Morphologic findings and clinical consequences (authors transl)]. 89 37

In three new cases of sweat gland carcinoma that we observed within recent years, the sites were the axilla, back, and arm. Axillary lymph node dissections were performed in two of the patients and the nodes were normal. Preoperative diagnoses were hydroadenitis, squamous cell carcinoma of the skin, and pyogenic granuloma. In one patient who was followed up for four years, there has been no recurrence; the follow-up period for the other two has been short. Sweat gland carcinoma is an uncommon neoplasm that occurs mostly in the older age groups. It may be very slow growing and is extremely difficult to diagnose preoperatively. Lymph node metastases are frequent and overall survival is poor. Prognosis is related to histologic cell type and presence or absence of lymph node metastases. Treatment by wide local excision of the lesion and primary regional node dissection is recommended.
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PMID:Sweat gland carcinoma. Current concepts of surgical management. 94

Records of 792 patients with differentiated thyroid carcinoma seen at the Lahey Clinic Foundation over a 40-year period were analyzed; 631 patients had a minimum followup period of 15 years. Differentiated types currently constitute nearly 90% of thyroid carcinomas. The clinical presentation has improved substantially through the years, and the results of treatment generally have improved. The per cent of patients with primarily incurable and locally unresectable disease or distant metastases has decreased from 7% before 1950 to 1% currently, and this group resulted in almost one third of the total fatalities and one half of fatalities within the first 5 years after treatment. Clear relationships were demonstrated between older age, men, extraglandular extension, blood vessel invasion, major capsular involvement, multifocal disease, and higher mortality rates. Lymph node metastases were found to exert a protective effect in all categories of disease analyzed, and this effect was directly related to the number of lymph node metastases present such that no deaths occurred in those patients who had more than 10 node metastases. Surgical treatment recommended is subtotal thyroidectomy for patients at high risk of death from disease as defined by combinations of age, sex, and extraglandular extension. Patients at low risk or with small carcinomas can be treated satisfactorily by lobectomy. Lymph node resections should be of a limited type or a modified neck dissection and should be performed only therapeutically. No improvement, as judged by mortality or recurrence rates, could be demonstrated by the use of radio therapy after surgery, and its use should be discouraged. Thyroid hormone administered for suppression of endogenous thyroid-stimulating hormone production improved mortality rates significantly in patients with papillary and mixed forms of carcinoma in all age groups but did not affect survival in patients with follicular carcinoma of the thyroid.20
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PMID:Changing clinical, pathologic, therapeutic, and survival patterns in differentiated thyroid carcinoma. 98 23

A case of occult sclerosing thyroid carcinoma is reported. The primary requirement for diagnosis is that the cancer is less than 1.5 cm in diameter. In addition, a fibrosing component with varying degrees of sclerosis is present. Lymph node metastases are frequent and may appear as benign thyroid follicles. Occasional direct invasion or vascular invasion may occur. Distant metastases were not reported in the series reviewed. Adequate therapy would seem to be total thyroidectomy of the involved lobe and radical subtotal thyroidectomy of the opposite lobe with excision of all enlarged or involved lymph nodes.
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PMID:Occult sclerosing carcinoma of the thyroid. 101 81

In 117 women with breast cancer, breast size, tumour size, suspicion of malignancy and clinical stage (Columbia Clinical Classification) were assessed clinically by palpation. Tumour size, degree of differentiation, malignancy grading (Ackerman), co-existent cystic fibroadenosis and axillary node metastases were assessed histopathologically. Differentiation was also assessed cytologically. There was good agreement between clinical and pathological measurements of tumour size. Ackerman's histopathological grading of malignancy correlated with the other criteria better than some other systems of malignancy grading. A higher histopathological malignancy grade was found in larger tumours and older patients. There was no clear relationship between cytological and histopathological malignancy grading. Lymph node metastases occurred three times more often in large breasts than in small ones, in spite of relatively slight differences in tumour size. Cancers in breast with cystic fibroadenosis were smaller, less malignant histopathologically and had fewer lymph node metastases than cancers in breasts without cystic fibroadenosis. "Definite cancer" on palpation was more often associated with a highly malignant tumour than a less suspected palpatory finding.
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PMID:Clinical findings in relation to morphology in breast carcinoma. 118 80

A series of 117 patients operated on for thyroid carcinoma from 1969-1973 is compared with a previous series of 115 cases treated from 1956-1968, with the object of clarifying diagnostic aspects and indications for primary operation. In the group with papillary carcinomas there was a high peak of incidence among young patients both females and males aged 20 to 30 years. In the present series the incidence of metastases was less than in the previous series. Lymph node metastases in the neck were the only metastases in papillary and medullary carcinomas. The time interval between beginning of treatment and appearance of main symptoms had decreased noticeably. The pre- and peroperative diagnostic procedures employed made it possible to operate as the primary procedure in 78% of papillary, 100% medullary and 86% anaplastic tumours, but only in 52% of follicular carcinomas. The most common reason for diagnostic failure was that frozen section had not been performed during the primary operation. The value of both aspiration biopsy and frozen section was dependent on the histological type of the tumour; it was more reliable in papillary and anaplastic than in follicular carcinomas. The operability rate had not changed essentially, 94% of papillary and 85% of follicular, but only 24% of anaplastic primary tumours could be radically removed. The value of establishing a firm diagnosis is to be able to operate as a primary procedure in these tumours when less operative complications occur.
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PMID:Diagnostic aspects in 117 patients treated surgically for thyroid carcinoma. 126 3

One hundred consecutive radical hysterectomies performed in a Dutch oncology centre during a five and a half year period between 1984 and 1990, were analysed. The operations were performed in a uniform manner by the same three surgeons. Surgical mortality was nil. Mean operating time was 4 hours and mean blood loss amounted to 1200 ml. One patient developed a vesicovaginal fistula. Long lasting urinary symptoms occurred in 32% of patients, sex problems in 13%. The latter situation was encountered significantly more frequently when surgery was combined with radiotherapy. Eighty-two of the 100 patients had a primary cervical carcinoma and were analysed further. Distribution according to stage was as follows: stage IA: 3, IB: 64, IIA: 13, IIB: 2. Postoperative external and intracavitary pelvic radiation was given in 34 patients (41%). Three-year survival of these patients amounted to 86%. One-third of patients had a large primary tumour (diameter greater than 4 cm). Three-year survival rate in this subgroup of patients was 78%. Lymph node metastases were found in 14 patients (17%). Three-year survival rates for patients with and without lymph node metastases were 64% and 94%, respectively (p less than 0.0001). Results and complications of this series were compared with the current literature data and found to be comparable and sometimes even better than recent literature data. These findings may serve to advocate further centralisation of this kind of surgery in oncological centres in the Netherlands.
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PMID:[Morbidity and results of 100 radical hysterectomies performed in an oncology center]. 160 65

The fate of clonal lineages in tumor formation and metastasis has been studied by genotypic marking of cells from three separate tumor lines of different malignant potential. Marking was accomplished by random incorporation of the neomycin resistance gene and visualized by Southern blot analysis of integration sites. Primary tumors formed by polyclonal cell suspensions of all three cell lines injected s.c. usually remained polyclonal even at late stages of tumor growth and metastatic spread. Lung metastases were often clonal, but it was not unusual to find ones of polyclonal origin. Lymph node metastases were almost always polyclonal and remained so, as they grew large. Sometimes clones present in the original inoculum were absent in the primary. Other times clones visible in the metastases were undetectable in the corresponding primary tumor. Occasionally a single clone became dominant in the primary, and others were eliminated, but this was not a necessary prelude to the onset of invasive or metastatic behavior. It is concluded that there is considerable variation in the results obtained with various cell lines in different circumstances. Even clones which are underrepresented in the original inoculum or the primary tumor can acquire metastatic capability. Hence, progression of malignancy is not uniformly dependent on prior or concurrent extinction of other non- or less metastatic clones in the neoplasm, and the underlying mechanisms of invasion and metastasis can be separated from those which sometimes confer growth supremacy on a clone of tumor cells. The frequent continuing genetic heterogeneity of cells in a neoplasm has substantial implications for clinical treatment protocols.
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PMID:Fate of clonal lineages during neoplasia and metastasis studied with an incorporated genetic marker. 155 Nov 2


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