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

Bronchial adenomas are a histologically and clinically diverse group of respiratory tract neoplasms arising from mucous glands and ducts of the tracheobronchial tree. They represent 1% of pulmonary malignancies. The traditional concept of a single, histologically benign form is challenged and the malignant potential of these tumors is stressed. Three main cell types with their characteristic histopathologic and clinical features are discussed: carcinoid, adenoid cystic carcinoma, and mucoepidermoid carcinoma. A case of bronchial carcinoid with hepatic metastases is reported, emphasizing the malignant potential of this controversial group of tumors. The appropriate diagnostic evaluation is outlined and aggressive surgical management is stressed. Chemotherapy and radiation therapy which are reserved mainly for palliation do not add to overall five year survival rates.
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PMID:Bronchial adenoma: a malignant misnomer. 51 20

Experience in the management of 146 consecutive patients with non-seminomatous tumours of the testis has led to a plan of management based on retroperitoneal lymph node dissection as the primary treatment modality, with use of adjuvant therapy dependent on pathological findings. Chemotherapy has proved to be the most important adjuvant with postoperative radiation therapy reserved only for patients with extensive retroperitoneal metastatic disease. 3-year crude survival for patients with all stages of disease was 78% and in those in whom the disease was confined to below the diaphragm the survival rate was 85%.
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PMID:Advances in the management of non-seminomatous germinal tumours of the testis. 56 69

The authors report two new observations of ureteral metastases from prostatic cancers and review the 17 already published cases. The relative rarity might well be only apparent, in relation with the delay in the exploration of the first observations. The diagnostic criteria are less clinical and radiological than anatomo-pathological, the metastases contrasting themselves with ureteral invasion by direct propagation. The anatomical status shows no predominance between tumoral or infiltrating forms, nor of any particular site on the ureter, while noting a relative frequence of bilateral involvement. The therapeutic approach is dependant upon these factors. The prognostic is reserved, at the cost of a segmental ureteral resection or a nephro-ureterectomy.
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PMID:[Ureteral metastases from prostatic cancers. 2 cases. Review of the literature]. 74 53

Lymphoma of the stomach may exist as a primary lesion or as a manifestation of generalized or systemic lymphoma. The primary lesions constitute approximately 3 per cent of all malignant lesions of the stomach and outnumber all other types of non-epithelial malignant lesions. The cause is not known. Gross characteristics often resemble carcinoma, and like carcinoma, the primary lesion may affect other structures by direct extension, may seed to peritoneal surfaces, may metastasize to lymph nodes near or far, and may be borne by the blood to liver, lung or bone. Diagnosis begins with clinical suspicion by the physician, is supported by the results of roentogenographic and gastroscopic studies, and is finally established by a positive study of biopsy specimens obtained with or without laparotomy. Improvements in both gastroscopic instruments and their use promise to increase greatly the accuracy of preoperative diagnosis. Pseudolymphoma of the stomach, a rare type of inflammatory lesion, may, on occasion, offer a difficult differential diagnosis from that of lymphoma. The clinical approach to the lesion, whether the diagnosis is histologically proved or not, is the same as for suspected carcinoma. A laparotomy is usually necessary to determine the possibility of surgical cure, unless distant spread or systemic involvement can be established by other means, such as a distant lymph node containing the disease or a positive needle biopsy of the liver. When a cure seems possible, resection is favored by most surgeons, even though it entails total gastrectomy or multiple organ resection. Opinion is divided as to whether or not a curative resection should be followed routinely by irradiation, although irradiation is generally favored by palliation of lesions not amenable to resection. Transgastroscopic biopsy and gastroscopic follow-up study may permit radiation to be tested as the only form of treatment of favorable lesions. At the present time, chemotherapy should be reserved for lesions not controlled by operation or irradiation. Stage for stage, the outlook for lymphoma of the stomach is about twice as favorable as that for carcinoma. No generally accepted classification of lymphoma exists as yet. Correlations between prognosis and microscopic characteristics are not close, except for the generally favorable outlook for lymphocytic lymphoma.
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PMID:An interpretive review of lymphoma of the stomach. 77 84

Breast cancer is a chronic disease, often generalized at the time of diagnosis. Present treatments are efficient only if the tumor is still localized so that results are relatively disappointing. Careful clinical appraisal will define the chances of a disabling treatment and the limits of a curative treatment. Systematic histologic study of axillary nodes completes the clinical examination, is a reliable measure of the risk of dissemination at the time of treatment and indicates the necessity for complementary chemotherapy. The main choices of treatment for initial stages are presented. Radical mastectomy, according to the literature appears best as it adds a precise diagnosis to a safe result. Mastectomy without resection of the pectoralis major is a cosmetic alternative with statistical and experimental soundness. Complementary prophylactic irradiation for radical mastectomy should be reserved for high risk of local recurrence and for control of metastases to the internal mammary nodes.
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PMID:[The problem of the treatment of the operable breast cancer (author's transl)]. 91 92

Anal bleeding and pain were the symptoms in half of 53 patients with carcinoma within and around the area of the anus treated from 1950 to 1974. Twenty-seven carcinomas were exclusively located in the anal canal and six, in the perianal skin. Vaginal invasion was present in 13 of the women. There were 39 squamous cell carcinomas and nine basaloid cell carcinomas. More than 37 of the patients had an abdominoperineal resection as part of the treatment. The resection margins were positive for carcinomas in 11 patients. Radiation as the primary treatment was used only once. Palpably enlarged inguinal lymph nodes were treated by subsequent radical groin dissection. The crude over-all survival rate was 42 per cent; the adjusted five year survival rate was 38 per cent. Significant correlates of death were symptoms for longer than six months' duration bleeding, inguinal adenopathy and presence of hemorrhoids. In general, abdominoperineal resection is the operation of choice for carcinoma of the anal verge or anal canal. Inguinal lymphadenectomy at a later time should be reserved for patients with signs of metastases to the inguinal nodes.
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PMID:Appraisal of the treatment of carcinoma of the anus and anal canal. 92 54

To develop a plan of management based on the clinical and pathologic stage of the tumor the results of treatment of 96 consecutive patients with non-seminomatous testis tumors have been analyzed. There were no exclusions and all patients were treated, including 17 with advanced stage C disease. All patients underwent retroperitoneal lymph node dissection as primary treatment but the judicious use of adjuvant therapeutic modalities improved survival in all stages of disease. Chemotherapy was the most important adjuvant and postoperative radiation therapy was reserved for patients with extensive retroperitoneal metastatic disease. Results indicate that a modified unilateral thoracoabdominal retroperitoneal lymph node dissection can effectively remove the retroperitoneal nodes. Of 57 patients 50 with stage A or B tumor survived after lymph node dissection without radiation therapy. Compared to an operation alone prophylactic adjuvant chemotherapy improved survival from 82 to 93 per cent for patients with minimal disease (stage A or B1). Postoperative irradiation therapy combined with cyclic chemotherapy improved survival for patients with advanced retroperitoneal disease compared to an operation and radiation alone or an operation and chemotherapy alone. An aggressive approach that combined operation with chemotherapy, radiation therapy or both, has salvaged 8 of 17 patients with disseminated metastatic disease (stage C). The over-all survival rate for these 96 patients is 78 per cent. A plan of management has evolved, which is based on retroperitoneal lymph node dissection followed by the judicious use of adjuvant chemotherapy and radiation therapy as determined by pathologic findings.
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PMID:Non-seminomatous testis tumors: a plan of management based in 96 patients to improve survival in all stages by combine therapeutic modalities. 94 52

This paper presents the results of a retrospective clinical study of 250 cases of monocentric carcinoma of the mucosal surface of the cheek, i.e. all the primaries treated by radiotherapy at our Institute between January 1948 and December 1965. Neoplastic lesions found at follow-up were regarded as marginal recurrences if in the proximity of the treated area and as secondary tumors in other cases. From 1948 to 1957 conventional radium therapy was the usual treatment for the primary tumor whereas from 1958 to 1965 cobalt teletherapy was given most frequently. Surgery was reserved for lymph node metastases when present on clinical examination. In our experience radiotherapy is effective in cancers of the mucosal surface of the cheek, for it checked local spread in 50.9% of cases, however treated and regardless of initial clinical appearance, whereas in the T1-T2 cases the local failure rate dropped to 35.8%. The higher the T level the greater are the difficulties confronting radiotherapy; for more extensive lesions appropriate combination therapy (radiosurgical) in line with the well-defined rules explained in the text is useful. In our experience radiotherapy yields good long term results regardless of T level and even in the more unfavorable cases. Our study confirms the low rate of lymph spread of these carcinomas: over half of the patients were N0 before treatment; only 56.7% of the patients receiving surgical treatment on the neck had histologically positive lymph nodes; there were very few neck recurrences at follow-up; the presence of suspect or frankly metastatic nodes on clinical examination, being movable and homolateral (N1), did not worsen the prognosis. However, considering the techniques used for irradiation of the primary, some patients received a substantial dose to the neck; hence radiotherapy probably played its part in the low rate of neck metastases.
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PMID:[Results of radiotherapy in a series of 250 carcinomas of the mucosal surface of the cheek (author's transl)]. 103 Aug 65

The natural history of prostatic cancer is incompletely understood. Small cancers may have a very slow or rapid growthrate, and the majority are differentiated. Cells may leave the prostate by blood or lymph without penetrating capsule or invading the seminal vesicles. The predication of latency or of biologic activity in any givne case is impossible. Stage A cancer should be separated into A1 (focal) and A2 (diffuse). Stage A1 cancer that is low grade is best lfet alone. Stage A2 cancer and high grade cancer probably should be treated by megavoltage radiation. Stage B includes many cancers that are microscopically stage C. If this stage is separated into clinical stage B1 (tumors grossly involving less than one lobe), and B2 (tumors involving one lobe or more) the underestimation of microscopic extent in B1 will be less than in 10 per cent of the cases. In clinical stage B2 cancer, 50 per cent are microscopically stage C. Radical prostatectomy for cure should be limited to clinical B1 cases without distant spread. It is not a cure-all, but it provides the best 15-year survival rate more completely, more quickly, less expensively, and with fewer discomforts than other methods. The alternative options are no treatment, endocrine treatment, and radiation. The first is risky in many instances and may allow an ac-ive cancer to get out of control. The second rarely destroys all of the cells in the total cell population and gives one a false sense of security. The last should be reserved for cases well beyond stage B1, but without distant metastases, where its usefulness exceeds that of radical excision.
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PMID:The present status of radical prostatectomy for stages A and B prostatic cancer. 112 46

The problem of the malignant potential of neoplastic colonic polyps is being, in large measure, resolved by newly derived techniques. Now most polyps may be removed endoscopically using the fiberoptic colonoscope. The largest world experience is at the Beth Israel Medical Center in New York, where over 2000 polyps have been endoscopically removed without a single death and with but one complication requiring operative intervention. Laparotomy is now reserved for polyps not suitable for endoscopic resection or where a question of residual cancer exists. Experience with endoscopic resection has called for: 1) re-assessment of colonic polyps in terms of their malignant potential; and 2) clarification of the indications for laparotomy and bowel resection subsequent to or instead of endoscopic removal. Among all polypoid lesions 0.5 cm or greater in size in the Beth Israel series, a variety of pathologic types was encountered. If only the neoplastic polyps were considered, the incidence of "malignant change" was 10.5% for 855 polyps analyzed. There is, however, a need to clarify terminology and to differentiate between carcinoma in situ and invasive cancer whenever possible. Superficial cancers (carcinomas in situ) do not recur or metastasize and require no treatment other than polyp removal. When "invasive" cancer is present (4.5% of neoplastic polyps) or the lesion is a "polypoid carcinoma" each case must be individually evaluted. Criteria for diagnosis, gross morphological features suggesting cancerous change, and current management of "malignant" polyps are discussed. Colonoscopy is an important component of the followup program whether malignant polyps are resected endoscopically or by the transabdominal route.
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PMID:Endoscopic polypectomy. Therapeutic and clinicopathologic aspects. 115 28


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