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)

We report eight cases of epithelioid angiosarcoma arising in deep, usually intramuscular soft tissue. All the patients were men (mean age, 58). All the lesions arose in a limb or limb girdle. Cardinal morphologic features were the diffuse, sheetlike growth pattern, with only focally apparent vascular differentiation, and epithelioid tumor cells with a degree of intracytoplasmic vacuolation/lumen formation. Immunohistochemically, all eight cases coexpressed keratin as well as endothelial markers. In three cases, endothelial differentiation was confirmed ultrastructurally. Clinically, deep-seated epithelioid angiosarcomas are high-grade neoplasms that rapidly develop metastases. These findings expand the range of recognized epithelioid endothelial tumors and provide further evidence of keratin expression by such lesions. The presence of intracytoplasmic lumina/vacuoles (sometimes containing red blood cells) combined with the characteristic reticulin pattern and striking positivity for Factor VIII-RAg provide the clearest means of distinction from an epithelial metastasis.
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PMID:Epithelioid angiosarcoma of deep soft tissue: a distinctive tumor readily mistaken for an epithelial neoplasm. 171 76

Epithelioid hemangioendothelioma is a very rare tumour of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. Confirmation of its endothelial origin is achieved by positive staining for Factor VIII-related antigen or by the demonstration of Weibel-Palade bodies by electron microscopy. We report two cases of primary epithelioid hemangioendothelioma of the liver that occurred in our center in the last ten years. The first patient is a 21 year old woman who presented with a right upper quadrant pain and an echographic finding of multiple hepatic lesions suggestive of metastases. The second patient is a 32 year old woman operated on for a cerebral glioma, in whom an abdominal CT scan, performed in view of radiotherapy, revealed multiple hepatic lesions, originally interpreted as being metastatic. In both cases, diagnosis was made based on the histologic examination of biopsies have been adopted in each case: the first patient has undergone successful liver transplantation. In the second patient an attentive surveillance appeared to be the best option, due to the presence of a previous cerebral glioma.
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PMID:Epithelioid hemangioendothelioma of the liver: report of two cases. 174 18

This study was conducted to elucidate the factors related with liver metastases, to clarify the significance of blood vessel invasion and then to predict liver metastases from these findings. Patients examined were 102 cases which underwent gastrectomy and were followed-up for more than 5 years or until death at our department. Two new staining methods were applied in this study; Victoria blue + hematoxylin eosin double staining for elastic fiber and Factor VIII related antigen for vascular endothelium. Significant differences in qualitative frequency of blood vessel invasion, the number of lymph node metastases, and the depth of invasion were found in those patients with liver metastases, as compared with 5 year survivors. Quantitative analysis of blood vessel invasion revealed significant importance of blood vessel invasions in the submucosa, in the forms of complete thrombus, wall invasion and partial thrombus, in the diameters of 0.01-0.1 mm and 0.1-1.0 mm. Applying discrimination coefficients of linear discrimination analysis, prediction of liver metastases was possible with 81.8% sensitivity, 85.3% specificity, and 83.6% accuracy. Liver metastases can be predicted from the qualitative and quantitative analyses of blood vessel invasion in the primary tumors by elastic fiber staining.
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PMID:[Significance of blood vessel invasion in gastric carcinoma--prediction of liver metastases from the blood vessel invasion in the primary tumors]. 194 58

Primary tumor of the aorta is extremely rare. An instance of aortic intimal sarcoma, namely fibromyxosarcoma, which extended from the beginning of the descending aorta to 7 cm above the abdominal bifurcation, with clinical evidence of acutely occurring hypertension, arterial embolism of the lower extremities, renal infarction, and aortic occlusion in a 50-year-old male is reported. The tumor was limited to the intima and composed of spindle-shaped tumor cells with abundant myxoid extracellular matrices. The tumor cells were negative for Factor VIII, Desmin, or Myoglobin, but were positive for Vimentin or Factor XIIIa in immunoperoxidase studies. An electron microscopic examination revealed a large amount of rough endoplasmic reticulum in the cytoplasm. Parenchymal metastases were observed in both the lungs and thoracic vertebrae. A review of literature on the clinical and pathological aspects of the tumor was made.
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PMID:A case of aortic intimal sarcoma manifested with acutely occurring hypertension and aortic occlusion. 258 79

Histologic sections from 63 patients with infiltrating duct carcinoma of the breast were selected for study by immunohistochemical staining with antibody against human Factor VIII-related antigen. Of these 63, 30 had no lymph node metastases at the time of surgery, while 33 had axillary lymph node metastases. A positive correlation exists between the presence of vascular invasion and lymph node metastases. Sixty-nine percent of patients with lymph node metastases had vascular invasion while only 26% of patients without lymph node metastases showed evidence of invasion of blood vessels. The finding of vascular invasion by tumor in patients without axillary lymph node metastases at the time of mastectomy may explain the occurrence of disseminated disease years after treatment.
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PMID:Angioinvasion in breast carcinoma. An immunohistochemical study of factor VIII-related antigen. 303 95

The pathology of a rare case of primary diffuse angiosarcoma of the pericardium is reported. Grossly, the heart was entirely encased by the pericardial tumor, and the myocardium was only superficially invaded by the tumor. The tumor tissue extended directly to the mediastinum, where the great vessels were embedded in the tumor. A few minute distant metastases were found only in the bilateral lungs and pulmonary hilar lymph nodes. Microscopically, the tumor tissue was composed of malignant cells forming vascular channels admixed with solid areas. Histo- and immunohistochemically, no mesothelial characteristics were evident. Factor VIII-related antigen and Ulex europaeus I lectin were positive, implying that the tumor was of vascular origin. Grossly, and in part microscopically, this case resembled malignant diffuse mesothelioma, indicating that pericardial angiosarcoma may sometimes mimick malignant mesothelioma.
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PMID:An autopsy case of primary angiosarcoma of the pericardium mimicking malignant mesothelioma. 321 12

Carcinomas histologically resembling nasopharyngeal lymphoepithelioma have been identified in the salivary gland, thymus, tonsil, and uterine cervix. Five patients with similar tumors primary in the skin are described. The patients ranged in age from 50 to 81 yr. Four neoplasms were situated on the head, and one was located on the shoulder. Microscopically, they were concentrated in the mid- and deep dermis and lacked connections with epidermis. The pattern was of multiple nodules, smaller irregular islands, and cords. The uniform tumor cells had moderate amounts of lightly eosinophilic cytoplasm and vesicular nuclei with one or two prominent nucleoli. A lymphoid infiltrate was intimately associated with each neoplasm and obscured the malignant epithelium in one. Neither squamous nor glandular differentiation was present, but all tumors exhibited intracytoplasmic mucin. Immunohistochemistry was positive for cytokeratin (5 of 5; diffuse) and epithelial membrane antigen (4 of 5; 3 diffuse, 1 focal). Focal reactivity was also noted for carcinoembryonic antigen (1 of 5), neuron-specific enolase (1 of 5), and vimentin (1 of 5). S100 protein, leukocyte common antigen, Factor VIII-related antigen, prostate-specific antigen (males), Leu M1, and salivary amylase reactivity were absent. One patient developed local recurrence and metastases after 39 mo and was dead of disease at 57 mo. The remaining four were free of disease after 46, 27, 25, and 6 mo of follow-up. The diagnosis of lymphoepithelioma-like carcinoma of the skin is based on microscopic findings and exclusion of occult malignancy. The tumor can be confused with a lymphoid infiltrate and is differentiated from Merkel cell carcinoma primarily on cytologic grounds. The neoplasm may be of adnexal origin.
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PMID:Lymphoepithelioma-like carcinoma of the skin. 323 11

Autopsy findings including immunohistochemical and ultrastructural study of intravascular bronchioloalveolar tumors (IVBAT) of the lung and liver which were incidentally found in a 68-year-old man were reported. The tumors presented as several, small nodular lesions in bilateral lungs and liver. Immunohistochemical study using the antibody against Factor VIII-related antigen and electron microscopic study suggested endothelial nature of both pulmonary and hepatic lesions. The study by using anti-estradiol antibody revealed the presence of estrogen in the cytoplasm of neoplastic cells, suggesting the possibility of the presence of estrogen receptors in the cells. Although the result is still preliminary, some role of estrogen in the development of IVBAT is suggested. The hepatic lesions have been thought to be metastases from the pulmonary IVBAT but the other possibilities such as primary hepatic or multicentric origin must be considered. Review of the previous reports of IVBAT disclosed several cases which were associated with liver involvement.
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PMID:Immunohistochemical and ultrastructural study of early lesions of intravascular bronchioloalveolar tumor with liver involvement. 393 36

Nine cases of aggressive angiomyxoma (AAM) of the pelvic soft parts were studied by light and electron microscopy and immunohistochemistry. The tumors were confined to the vulva, vagina, pelvic floor, and perineum in the seven women. The perineum and the para-anal region were involved in the two men. The patients ranged in age from 18 to 63 years. Aggressive angiomyxoma presented as a slowly growing, polypoid or cyst-like tumor. Six of the nine cases were followed up; all of the tumors recurred within nine to 84 months, and one recurred for the second time at 144 months. Recurrences were attributed to incomplete tumor excision. None of the six patients died or had metastases. The aggressive angiomyxomas had infiltrative borders and rubbery, white or soft, gelatinous cut surfaces. Histologically, the lesions were composed of stellate and spindle-shaped neoplastic cells embedded in a collagenous and hyaluronic acid-containing stroma. Nuclear atypia and mitoses were absent. Typically, the lesions had an important vascular component, often displaying medial hypertrophy and vascular grouping. Ultrastructurally, the neoplastic cells resembled fibroblasts rather than myofibroblasts. They showed strong immunoreactivity for actin but were negative for S-100 protein, Factor VIII, carcinoembryonic antigen, and keratin. The morphoimmunocytochemical characteristics of AAM cells favor a fibroblastic origin and differentiation. Aggressive angiomyxoma should be distinguished from the more common benign and malignant myxoid neoplasms or tumor-like conditions of the pelvic soft parts. Recurrence of AAM may be avoided by wide, local excision.
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PMID:Aggressive angiomyxoma of pelvic soft parts: a clinicopathologic study of nine cases. 399 39

The clinical, morphologic, and follow-up findings in 32 patients with a hitherto rarely reported tumor of the liver are reported. The study comprised 20 women (62.5 per cent) and 12 men (37.5 per cent) ranging in age from 19 to 86 years (average, 49.65 years). The tumors were discovered incidentally in four patients (12.5 per cent). Four patients (12.5 per cent) had jaundice attributable to the tumors; one of these patients experienced liver failure. One patient presented with an acutely painful abdomen due to hemoperitoneum. The remaining patients had nonspecific complaints. Grossly, the tumors were often multiple and involved both lobes of the liver. They were generally white and firm to hard. Microscopically, the neoplastic cells infiltrated sinusoids and intrahepatic veins of all sizes. Two types of tumor cells were identified--dendritic and epithelioid. Tumor cells were also vasoformative and synthesized Factor VIII-related antigen. Nine patients survived five years or longer. Two of these patients were alive five years, two nine years, one 12 years, and one 15 years after the onset of disease. Three patients died seven, ten, and 28 years, respectively, after the initial diagnosis. This vascular tumor has distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma. Although the prognosis is much more favorable than that for angiosarcoma, extrahepatic metastases occurred in nine of the patients (28 per cent) in this series. The biologic behavior of the tumor may be related in part to its matrix, which may show inflammation, dense sclerosis, and calcification.
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PMID:Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. 608 83


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