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

We examined two cases of proliferating pilar cysts of the inguinal region. One of the cases showed a transformation to epidermoid carcinoma and, despite surgical resection, the patient died by means of distant generalized metastases. The diagnosis of proliferating pilar cyst should be made in pilar cysts with epithelial proliferation that shows well-defined borders and abundant keratinization despite cytologic atypia and mitotic activity. The diagnosis of carcinoma in proliferating pilar cysts should be reserved for lesions showing poorly defined borders and clear-cut infiltrative properties with cytologic evidence of malignancy.
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PMID:Proliferating pilar (trichilemmal) cyst. Report of two cases, one with carcinomatous transformation and one with distant metastases. 654 21

Eleven patients with extraskeletal Ewing's sarcoma (EES) were treated with combined modality therapy at the National Cancer Institute. The diagnosis of EES was reserved for lesions that were identical to Ewing's sarcoma of bone by light and electron microscopy. Diagnostic work-up to rule out a skeletal primary included bone scan, localized views of adjacent bone, and bone tomography. Seven patients presented with an extremity primary and four patients had a truncal primary. No patients had evidence of metastases at presentation. Patients were treated with combined modality therapy consisting of high-dose local irradiation and vincristine, actinomycin D, and cyclophosphamide chemotherapy following a biopsy or local excision. No attempt was made to excise widely the primary tumor mass. Gross tumors generally responded rapidly to the combined modality treatment. Of 11 patients, seven (64%) remain disease free, with a follow-up of three to seven years from completion of therapy. Long-term local control was established in nine of 11 patients (82%). Autopsy findings on two patients with local failure showed no tumor involvement of adjacent bone. Attempts at gross resections by radical surgical procedures do not routinely appear to be necessary in light of the high local control rates with high-dose irradiation.
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PMID:Extraskeletal Ewing's sarcoma: results of combined modality treatment. 1877 7

The approach to primary operable, or potentially curable breast cancer is a controversial field of oncology and is subject to a number of ongoing clinical experiments in many centers. This report discusses the recommended treatment for patients with this disease who are evaluated at the Breast Service of Memorial Sloan-Kettering Cancer Center. The most widely practiced treatment is modified radical mastectomy, with radical mastectomy reserved for patients having more advanced lesions. Modified radical mastectomy is defined as total mastectomy plus axillary lymph node dissection either with preservation of the pectoralis minor muscle or its removal. The latter allows a more thorough axillary dissection and is preferred for patients with invasive carcinomas. In either case, axillary node sampling is not advocated and will miss a significant percentage of axillary metastases. In patients with negative axillary lymph nodes, who are not candidates for adjuvant systemic therapy, breast reconstruction is possible within a few months of mastectomy. For patients with involved axillary nodes, trials of adjuvant chemotherapy (perhaps with antiestrogen therapy for estrogen-receptor positive primary tumors) seem to offer the best hope for improved survival. With available follow-up of such trials to date, there seems little doubt that at a minimum, such treatment prolongs disease-free interval. The role of adjuvant radiation therapy is more controversial, and the difficulty in combining this with chemotherapy is apparent.
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PMID:Surgical management of primary breast cancer. 685 May 32

On the basis of three selected cases (one with clinically occult follicular and two with metastatic papillary carcinoma) the necessity of a comprehensive therapeutic concept even in highly differentiated thyroid cancer is stressed. Thyroid tissue and regional metastases should be eliminated by surgery, followed by radioiodine therapy in any event. Radiation teletherapy should be reserved to patients with invasive tumor growth exceeding the organ capsule, with lymph node metastases, and with massive angioinvasive growth.
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PMID:Should treatment of highly differentiated thyroid carcinoma be conservative? 686 76

The diagnosis of hepatic metastases is the responsibility of the diagnostic radiologist. In a comparison of the screening techniques, scintigraphy, sonography, and computed tomography, CT is the best single examination to determine the presence and extent of a hepatic mass. Hepatic angiography is now reserved for problem solving and in preparation for therapeutic management. Superselective catheterization is imperative and can be accomplished in 95%. Transcatheter management by hepatic artery infusion and embolization is feasible because the blood supply to hepatic metastases originates almost exclusively from the hepatic artery (90-95%), while the normal liver parenchyma has a dual supply--hepatic artery (25%) and portal vein (75%). This treatment delivered to the hepatic artery selectively effects the neoplasm. In the event of multiple hepatic (45%) arteries, occlusion of the aberrant artery with a steel coil redistributes flow through a single artery to facilitate infusion. The median survival from the time of the initiation of hepatic artery infusion for the treatment of metastatic colorectal carcinoma is 8 months and 15 months when the infusion is associated with occlusion. The median survival of 11.5 months is observed from the time of hepatic artery embolization which usually is done after failure of all other therapeutic modalities.
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PMID:The radiologic diagnosis and management of hepatic metastases. 707 24

Chondrosarcoma is rare in children. Only 12 patients with a diagnosis of chondrosarcoma were treated at Children's Hospital Medical Center in Boston during the period from 1957 to 1980. Pediatric chondrosarcoma has a relatively rapid onset, manifested by pain, a palpable mass and neurological symptoms with the lesion localized in the spinal column. The pelvis was the most frequent location. Ten patients had primary and two patients had secondary chondrosarcoma. Of the latter two, one developed chondrosarcoma in a preexisting osteochondroma and the other had irradiation for neuroblastoma. The poorest outcomes were in patients who had involvement of the pelvic girdle and spinal column. Grade 2 and 3 lesions had the worst prognoses with metastases occurring within 12 months. Eight patients died at the time of study, and the longest survival time was 80 months. If surgically feasible, the treatment is radical excision. Radiation therapy and chemotherapy should be reserved for recurrences or distant metastasis.
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PMID:Chondrosarcoma in children and adolescents. 708 77

Transposition of the contralateral submaxillary gland to the submental region is proposed as a method for preventing asialia following salivary gland irradiation during radiotherapy for oropharyngeal cancer. Good results were obtained in the majority of cases treated, salivary secretion being conserved, as confirmed by scintigraphy, but the method should be reserved for patients with oropharyngeal cancer without lymph node metastases on the contralateral side.
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PMID:[Prevention of post-irradiation xerostomia by submaxillary gland transposition]. 712 83

Metastases to the celio-mesenteric organs from malignant melanoma are studied retrospectively in 22 autopsied cases and in seven surgically treated patients. Metastatic disease to one or more celio-mesenteric organs was found in 86.3% of postmortem examinations: the liver was the most frequently involved organ, followed by the pancreas, peritoneum, small bowel, biliary tract spleen, colon and stomach, in that order. Surgery only resulted in long-term asymptomatic survival in those patients with a long relapse-free interval and a single metastasis. It is concluded that, apart from cases with intestinal obstruction or massive GI bleeding, resection should be reserved for patients with a relapse-free interval of at least 15 months and with a single "alimentary" metastasis. It is suggested that diagnosis of systemic spread at the asymptomatic stage would improve prognosis of stage IV malignant melanoma.
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PMID:Resection of metastases to the alimentary tract from malignant melanoma. 716 Sep 83

Cis-diamminated-dichloroplatinum is an effective drug in the treatment of testicular dysembryomas and choriocarcinomas. It may obtain results in cases resistant to combinations of drugs already known as being effective against such tumours. It is thus worthy of integration into treatment protocols for forms of these tumours with a poor or reserved prognosis (cases with metastases or lymph node involvement or with chorial participation).
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PMID:[Cis-diamminated-dichloroplatinum (CDDP) in the chemotherapy of testicular dysembryomas and choriocarcinomas (author's transl)]. 719

64% of all patients with newly diagnosed prostatic carcinoma present with metastases. Hormone application with or without orchiectomy appears to be the adequate form of primary treatment. The most common therapeutic modality is estrogen administration, which has, however distinct disadvantages: The patient is protected up to 5 years only, there is a 27% cardiovascular mortality, it induces a prolactin surge, and is immunosuppressive. Phase III-studies of the EORTC and VACURG have demonstrated that medroxyprogesterone acetate and cyproterone acetate parallel the effectiveness of estrogens. In a phase II-trial adjunctive bromocriptine was found to be necessary to suppress estrogen or antiandrogen induced hyperprolactinemia. The following concept is derived: In disseminated untreated prostatic cancer estrogens or antiandrogens in combination with bromocriptine or high dose injectable gestagens are effective means of primary treatment. Distinct clinical parameters determine the "hormone of first choice". Orchiectomy is reserved for patients with ureteral compression or progressing disease.
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PMID:[Hormone therapy of prostatic cancer (author's transl)]. 719 68


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