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

In a prospective observational study including 34 patients with carcinoma of the ampulla of Vater, postoperative morbidity, mortality, and long-term survival were analyzed to determine the surgical procedure of choice. Surgically related postoperative complications were observed in 35.4% of patients after pancreatic resection. No patient died within the first 30 days postoperatively, and in-hospital mortality was 3%. Lymph node metastases were associated only with moderate or undifferentiated tumors larger than 0.6 cm in diameter that infiltrated beyond the ampulla of Vater. The median follow-up time was 4.3 years. The 5-year survival rate for the 31 patients undergoing radical resection was 62.7%. Multivariate analysis (including the covariates depth of tumor infiltration, lymph node metastases, and the ratio of metastatic to dissected lymph nodes) demonstrated that only this ratio exerted an independent influence on the prognosis (p = 0.001). The present series demonstrates that radical resection of ampullary cancer is the procedure of choice even in elderly patients. The most important factor influencing the survival rate is the extent of the lymph node dissection. The histopathologic investigation of our pancreatoduodenectomy specimens demonstrates clearly that local excision of ampullary cancer may be indicated only in high risk patients with a pT1, well differentiated tumor smaller than 0.6 cm in diameter.
 ...
PMID:Clinicopathologic study for the assessment of resection for ampullary carcinoma. 914 68

Having observed 2 cases of lymphoepithelioma-like carcinoma of the lung in a 49-year-old female and in a 66-year-old male patient, we present a review on this entity, which was described for the first time in 1987. Essentially this neoplasm has the same histological appearance as a Schmincke-Regaud tumor, but it is possible that a certain morphological variety exists. In the differential diagnosis, a metastasis of a Schmincke-Regaud tumor and a malignant lymphoma should be considered. Including our 2 cases, a total of 30 cases have been reported: 14 male patients aged between 33 and 73 years and 12 female patients between 38 and 70 years; in 4 cases there was no reference to sex or age. Most of the patients were Asians, mainly Chinese. These tumors presented with nearly the same frequency in both lungs. They mostly appeared as peripheral coin lesions in the chest X-ray study. Lymph node metastases were found in approximately 25% of the cases. Hematogenous metastases seldom occurred and were observed almost only in the skeletal system. In most cases a lobectomy was performed. At present, no exact assertion is possible regarding the prognosis. An association with an Epstein-Barr virus infection was observed in the Asian patients, but not in the Caucasian patients.
 ...
PMID:[Lymphoepithelioma-like lung carcinomas]. 924 73

Increased glucose metabolism by malignant tissue can be visualized with positron emission tomography (PET), using the radiolabeled glucose analogue F-18 fluorodeoxyglucose (FDG). Depending on the criteria of image interpretation FDG-PET allows detection of breast cancer with a sensitivity of 68% to 94% and a specificity of 84% to 97%. However, sensitivity to visualize small tumors (< 1 cm) is limited. Positron emission tomography demonstrates tumor involvement of regional lymph nodes with high accuracy, predominantly in patients with advanced breast cancer. The sensitivity for the detection of axillary lymph node metastases was 79% with a corresponding specificity of 96%. Lymph node metastases could not be identified in four of six patients with small primary breast cancer (stage pT1), resulting in a sensitivity of only 33% in these patients. By visualizing primary tumors and metastases in one imaging procedure, PET imaging may allow the effective staging of breast cancer patients. Further studies are needed to define the role of scintigraphic techniques for the diagnostic work-up in patients.
 ...
PMID:[Possible uses of positron emission tomography in breast carcinoma]. 927 7

Based on the increased glucose metabolism of malignant tissue, positron emission tomography (PET), using the radiolabeled glucose analog 18F-fluorodeoxyglucose (FDG), allows identification of breast cancer. Based on the criteria implemented in image interpretation, sensitivity of PET imaging ranged from 68% to 94% with a specificity between 84% and 97%. However, sensitivity for small tumors (< 1 cm) was found to be low. PET demonstrates tumor involvement of regional lymph nodes with high accuracy, predominantly in patients with advanced breast cancer. The sensitivity for the detection of axillary lymph node metastases was 79%, increasing to 94% in patients with primary breast tumors larger than 2 cm in diameter. Corresponding specificities were 96 and 100%, respectively. Lymph node metastases could not be identified in four of six patients with small primary breast cancers (stage pT1), resulting in a sensitivity of only 33% in these patients. By visualizing primary tumors and metastases in one imaging procedure, PET imaging may allow the effective staging of breast cancer patients. Response to treatment may be assessed at an earlier point than with imaging techniques currently used. Therefore, indications for PET studies in the future may be the evaluation of loco-regional lymph nodes, whole-body staging, diagnosis of local recurrence and therapy monitoring.
 ...
PMID:[Diagnosis of breast carcinoma and locoregional lymph nodes with positron emission tomography]. 942 20

We reviewed the management of 50 patients with cancer of the penis treated between November 1983 and April 1995 at Tygerberg Hospital. The mean patient age was 54 years. The race of the patient was mixed in 40, white in 8 and black in 2 cases. Serological tests were positive for syphilis in 8/18 (44%), and for human immunodeficiency virus (HIV) in 2/11 patients (18%) who were tested. Only 1 patient had been circumcised (at puberty). Penectomy was performed in 45 patients--partial amputation in 29 cases and radical penectomy in 20 (in 4 of these after previous partial penectomy with positive margins). Complications of penectomy occurred in 9 patients (20%). The histology of the primary lesion was squamous carcinoma in 46, verrucous carcinoma in 3 and melanoma in 1 patient. Differentiation of the tumour was good in 24, moderate in 15 and poor in 8; the grade was not recorded in 3 cases. The pathological T stage was Tis in 1 patient, T1 in 5, T2 in 24, T3 in 17 and T4 in 3 cases. Inguinal lymphadenectomy was performed in 34 patients at a median interval of 72 days after penectomy. Complications after lymphadenectomy occurred in 26 of the 34 patients (76%), but a second operation was required in only 5 cases (15%). In patients without clinically palpable inguinal nodes, cancer was present in 2/8 (25%) specimens. In patients with clinically palpable inguinal nodes, metastases were present in 16/29 (55%)--in 4/16 (25%) of nodes clinically thought to be infective, and in 12/13 (92%) of nodes considered to be malignant. Lymph node metastases were present in 0/2 patients with T1, in 5/19 (26%) with T2, in 12/15 (80%) with T3 and in 3/3 (100%) with T4 tumours. At a mean follow-up of 22 months in 39 patients 62% were alive without evidence of disease, 23% were alive with carcinoma and 15% were dead. Death and recurrence or metastases were significantly more common in patients with T3-4 compared with T1-2 tumours, and in those with N1-3 compared to NO disease, but tumour grade had no significant effect on outcome. Death and recurrence or metastases were also more common in cases where the surgical margin at penectomy was involved with tumour. In conclusion, our patients presented at a relatively young age with locally advanced tumours and a high incidence of inguinal lymph node metastases. In patients with locally advanced tumours we recommend ablative surgery with bilateral inguinal lymphadenectomy 6-8 weeks after penectomy. We avoid pelvic lymph node dissection, since this does not improve the prognosis, while increasing the risk of complications, especially lower limb oedema.
 ...
PMID:Cancer of the penis--a review of 50 patients. 1022 6

The aim of this study was to examine the efficacy of lymph node palpation versus high resolution lymph node sonography for the detection of lymph node metastases in patients with malignant melanoma. We retrospectively evaluated 2256 pairwise lymph node examinations of the cervical, axillary and inguinal region by palpation and sonography in 264 patients with resected melanomas greater than 0.75 mm of invasion thickness. Lymph node metastases occurred in 50 patients (19%) which were detected in 38 (76%) by both methods in agreement. In 7 cases (14%) palpation failed, in 3 cases (6%) sonography failed and in 2 cases both methods failed to identify metastases. The overall sensitivity of detecting metastatic disease was 82% for palpation and 90% for sonography which was statistically not different. The overall specificity by sonography (99%) was significantly better than for lymph node palpation (88%). Taking into account the results of this analysis, we conclude that patients with a negative result by lymph node palpation do not need further sonography for verification. However, any suspect result by palpation should be additionally evaluated by lymph node sonography in order to rule in or out metastatic disease.
 ...
PMID:Lymph node sonography versus palpation for detecting recurrent disease in patients with malignant melanoma. 947 Aug 37

The clinicopathologic features of 32 metaplastic carcinomas with heterologous osteocartilaginous elements are reported. Each neoplasm consisted of invasive adenocarcinoma accompanied by a cartilaginous or osseous component. In 10 neoplasms, this consisted of cartilage and in 2 the heterologous element was osteoid or bone exclusively. The remaining 20 neoplasms contained a mixture of cartilaginous and osseous components. All patients were women; mean age was 56 years. Twenty-four patients were treated using mastectomy and eight by local excision. Twenty-six patients underwent axillary lymph node dissection. Lymph node metastases were detected in 6 of the 26 (23%) patients who underwent axillary dissection. Clinical follow-up was available for 29 of 32 patients (91%). Local recurrence or distant metastases developed in 6 patients (21%) within 2 years of initial treatment, and 4 of these patients died of metastatic carcinoma. The overall 5-year survival rate was 60%. When compared with control patients with infiltrating duct carcinoma, the group with metaplastic carcinoma tended to have a more favorable prognosis after adjustment for nodal status and tumor size. The prognosis of patients with metaplastic mammary carcinoma with heterologous osteocartilaginous elements is dependent on tumor stage at diagnosis. Immunohistochemical studies for 34BE12, p53, retinoblastoma protein, HER/2neu (polyclonal), epidermal growth factor receptor, and cyclin D1 were performed in 18 cases. Positive immunohistochemical staining was found as follows: 34BE12: n = 13 (72%); p53: n = 11 (61%); retinoblastoma protein: n = 12 (66%); HER2/neu: n = 2 (11%); epidermal growth factor receptor: n = 7 (38%); and cyclin Dm: n = 5 (28%). Positive staining for 34BE12 was observed in the carcinomatous component in 5 (38%) of the neoplasms, in the metaplastic component in 2 (15%), and in both elements in 6 (64%). A p53 staining was observed in the carcinomatous component exclusively in 4 (36%) of 11 p53-positive tumors. No disparity in p53 staining was noted between the epithelial and metaplastic elements in the other p53-positive tumors. Expression of these markers did not correlate with clinicopathologic features such as patient age, tumor size, tumor type, relative proportion of metaplastic elements, and axillary nodal status and was not predictive of disease-free survival.
 ...
PMID:Metaplastic carcinoma of the breast with osteocartilaginous heterologous elements. 950 Feb 19

To evaluate the efficacy of lymphangiography combined with fine needle aspiration biopsy and computer tomography (CT) for lymph node staging in clinically localized prostate cancer. Prospective evaluation of nodal involvement was carried out using standard bipedal lymphangiography combined with fine needle aspiration biopsy (FNAB) in 70 patients (aged 47 to 75 years, mean age 63 years) with apparently locally confined prostate cancer before intended radical prostatectomy. Sixty-four patients also underwent computer tomography. Seventeen withdrew the decision to undergo a radical prostatectomy, leaving 53 patients with pathologic examination of the lymph nodes eligible for analysis. Lymph node metastases were diagnosed in 8 patients (8/53 = 15.1%). Three were diagnosed preoperatively by FNAB, 3 peroperatively by lymph node dissection and frozen section biopsy and an additional 2 at the final pathologic assessment. The sensitivity, specificity, positive and negative predictive values for lymphangiography and lymphangiography combined with FNAB in predicting nodal disease, based on the analysis of the 53 patients with known pathologic results, were 0.63, 0.76, 0.31, 0.92 and 0.38, 1.00, 1.00, 0.90, respectively. The corresponding values for CT staging were 0.25, 0.98, 0.67 and 0.87, respectively. The efficacy of bipedal lymphangiography alone or combined with FNAB or CT alone for assessment of nodal metastases is too low to be worthwhile for lymph node staging in localized prostate cancer patients with expected low or intermediate probability of nodal disease.
 ...
PMID:Lymphangiography combined with biopsy and computer tomography to detect lymph node metastases in localized prostate cancer. 960 83

Four unusual cases of primary mammary mucinous cystadenocarcinoma composed predominantly of tall columnar cells with abundant intracytoplasmic mucin are reported; they were multicystic and appeared virtually identical to mucinous cystadenocarcinomas of the ovary and pancreas. Three of the women were white and one was black, they ranged in age from 49 to 67 years (average 58), and they had tumors that ranged from 0.8 to 19 cm in diameter. Microscopically, the tumors were characterized by cystic spaces lined by predominantly bland-appearing columnar mucinous cells with stratification, tufting, and papillary formations. Varying degrees of cytologic atypia were focally evident, with gradual loss of the intracytoplasmic mucin and transformation to an eosinophilic squamoid cell population. Multifocal invasion generally emanated from these eosinophilic, squamoid areas in all cases. All four tumors displayed immunoreactivity for MIB-1 (Ki-67) in a relatively high percentage of cells and failed to show immunoreactivity for estrogen receptors and progesterone receptors. All four stained positively with cytokeratin 7 (CK7) but were negative with cytokeratin 20 (CK20). Mastectomy and axillary lymph node dissection were performed in three cases and lumpectomy with lymph node dissection in the remaining case. Lymph node metastases, identified in only one patient, retained the distinctive morphology. Three of the patients are alive without evidence of disease 11, 22, and 24 months after the diagnosis; the fourth is a recent case. These tumors are a rare, clinicopathologically distinct type of primary breast carcinoma that should be distinguished from typical mucinous (colloid) carcinomas of the breast and, more importantly, metastases from other sites.
 ...
PMID:Mucinous cystadenocarcinoma of the breast. 963 Jan 76

The purpose of the present study was to define the indications and extension for the treatment of lymph nodes in clinically NO patients with primary malignant epithelial parotid tumors. A retrospective analysis was performed on 46 cases with such tumor out of 307 parotid neoplasms (246 benign, 61 malignant) consecutively treated from 1985 to 1994. Lymph node metastases were present only in the histotypes with a high degree of malignancy (overall incidence, 24%). Two patients (5%) showed occult metastases. No correlation was found between the size of the neoplasm and the incidence of lymph node metastases. However, the latter were significantly more common in locally highly aggressive neoplasms (class "a"), 8%; class "b" 43%; P = 0.006). Due to the small number of cases, it was not possible to correlate the incidence of occult metastases with neoplasm size or local extension. As regards topographic distribution of lymph node metastases, level II was always involved, level V was never involved, and level i.v was involved only when metastases were found in the upper levels. Occult metastases were found only at level II. Over a follow-up period of 2 to 10 years, no cases were seen with cervical recurrences. Although drawn from a limited series, the results are similar to the data generally reported in the literature, showing that lymph node metastases are rare in neoplasms with a low grade of malignancy whereas there is a significant increase in the incidence of metastatic lymph nodes and occult metastases when the grade of malignancy is high. In conclusion, in clinically NO patients, a suprahomohyoid neck dissection (levels I-II-III) is indicated only when the neoplasm shows a high grade of malignancy or when it is a class "b" malignancy. In the other cases, neck dissection is determined by the clinical evidence of metastasis and can be extended to the lower levels. Neck dissection can be avoided in NO patients whenever ultrasound and fine needle biopsy are both routinely used in the preoperative evaluation of the cervical lymph nodes.
 ...
PMID:[Indications for elective neck dissection in malignant epithelial parotid tumors]. 970 25


<< Previous 1 2 3 4 5 6 7 8 9 10