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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of yolk sac tumor of the testis are presented. The patients were 17 months and 24 months old. The children were inflicted with painless swelling of their left scrotal content. alpha-Fetoprotein levels were elevated at presentation but decreased within normal limits after orchiectomy. Chest X-rays and CT scans were negative. The cases were diagnosed as stage I. Fifty six cases of testicular yolk sac tumor in children have been reported in Japan since 1981. There were no recurrent stage I cases. One patient with stage II and 3 patients with stage III died despite chemotherapy, while three children with stage II or stage III disease survived more than 36 months after a positive response to chemotherapy. We conclude that prepubertal stage I yolk sac tumor is treated best initially by orchiectomy alone. Aggressive chemotherapy has a major role in salvage of stage II or stage III patients.
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PMID:[Yolk sac tumor of the testis in children: report of two cases]. 152 21

We present four cases of infantile cerebellar neoplasms composed of cells with large vesicular nuclei with prominent nucleoli. All four cases were strongly immunoreactive for synaptophysin, and one case showed immunoreactivity for neurofilaments. Filter hybridization for N-myc and c-myc oncogenes showed a 27-fold c-myc amplification in one case. The cytogenetic analysis in this case showed Double-Minutes and isochromosome 17q. An intracerebral xenograft in nude mice obtained from one such tumor showed a similar morphology to that of the original tumor as well as strong immunoreactivity for synaptophysin and neurofilaments. All the neoplasms were characterized by highly aggressive behavior leading to early cerebrospinal fluid dissemination despite radiotherapy and chemotherapy. We conclude that large-cell medulloblastoma represents a distinct and more aggressive variant of medulloblastoma that requires more aggressive therapy.
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PMID:Large-cell medulloblastomas. A distinct variant with highly aggressive behavior. 153 Jan 8

The histopathologic criteria most useful for grading of mucoepidermoid carcinomas are controversial. To identify those histologic features most important in the grading of intraoral mucoepidermoid carcinomas, 143 cases of this disease with clinicopathologic correlations were studied. Twelve histopathologic features of each tumor and their clinical presentation were correlated with patient outcome. Seven patients died of disease, 5 had regional metastases only, 10 had recurrences only, and 121 had no additional problems. Clinical features suggesting aggressive behavior were short duration, presence of clinical symptoms, and location of tumor in the tongue and floor of the mouth. The histopathologic features that indicated high-grade behavior were an intracystic component of less than 20%, four or more mitotic figures per ten high-power fields, neural invasion, necrosis, and cellular anaplasia. The simultaneous assessment of these features showed improved prognostic correlation over individual parameters. A quantitative grading system was devised using these features. Tumors with a point score of 0 to 4 were considered low grade, and none of 122 patients with scores in this range died of their tumor, although 9 had recurrences only and 3 had regional metastases. Point scores of 7 or above indicated highly aggressive behavior. Six of ten patients with these high scores died of tumor. Most of these six patients had recurrences and regional metastases, and all had distant metastases. Two other patients had regional metastases only. Scores of 5 to 6 were considered intermediate between low-grade and high-grade scores because only 1 of 13 patients with these scores died of disease. Three of the five patients with regional metastasis had low-grade tumors, indicating the inability of the grading system to identify them. Nonetheless, with an average follow-up on these patients of 10 years after treatment of the metastasis, no patient had additional problems. The relative objectivity of our proposed grading system for intraoral mucoepidermoid carcinomas may help achieve more accurate and consistent grading of these rare tumors.
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PMID:Mucoepidermoid carcinoma of intraoral salivary glands. Evaluation and application of grading criteria in 143 cases. 154 11

Biologic aggressive behavior in adenocarcinoma of the prostate is proposed to be a direct function of cancer volume. In an autopsy series, distant metastasis was found only in cancers that had both volume greater than 5 cc and areas of poor differentiation (Gleason grades 4 and 5). In subsequent study of over 200 radical prostatectomy specimens, cancers were found to originate both in the peripheral zone (PZ) and in the normally small anteromedial transition zone (TZ) where benign nodular hyperplasia also develops. Anatomic TZ and PZ cancers were nearly equivalent to clinical stage A and B cancers, respectively. Transition zone cancers showed much less capsule penetration and seminal vesicle invasion than PZ cancers of comparable volume because the TZ boundary provided a barrier to cancer spread through the PZ. In PZ carcinomas, capsule penetration depended largely on facilitated spread along perineural spaces, and its distribution was determined by the location of superior and inferior nerve pedicles. Capsule penetration, seminal vesicle invasion, and positive surgical margins were all strongly correlated with cancer volume. Tumors smaller than 4 cc had all morphologic variables favorable; tumors larger than 12 cc tended to have all variables unfavorable. Lymph node metastasis in radical prostatectomy cases was most strongly predicted by a combination of cancer volume plus percentage of high-grade tumor. Cancers with more than 3.2 cc of grade 4 and/or 5 component showed a 100-fold increase in proportion of cases with nodal spread.
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PMID:Cancer volume and site of origin of adenocarcinoma in the prostate: relationship to local and distant spread. 155 36

The presentation and management of a patient with liver metastasis from a 0.6 cm carcinoid tumor of the appendix is presented. This is the first documented case of distant metastasis from a carcinoid of the appendix less than 1 cm in size. Histopathologic, immunohistochemical, and electron microscopic studies support the appendiceal carcinoid as being the primary neoplasm. Invasion of the mesoappendix was the only finding to suggest potentially aggressive behavior. We reviewed the literature and found 414 previously reported cases that provided complete information regarding tumor size, mesoappendiceal invasion, and presence of metastasis. For the entire group the frequency of metastasis was related to tumor size greater than 2 cm (p less than 0.0001) and invasion of the mesoappendix (p less than 0.0001). After dividing the group based on size, mesoappendiceal invasion was related to metastasis in those tumors less than 2 cm in size (p less than 0.0001) but not in tumors larger than 2 cm (p = 0.1538).
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PMID:Distant metastasis from a carcinoid tumor of the appendix less than one centimeter in size. 848 83

Malignant small round cell tumor of the abdomen is a newly described clinicopathologic entity. The features of this entity include a predilection for young men, predominant abdominopelvic location, and aggressive behavior. Pathologic analysis demonstrates a small-cell tumor unusually coexpressing desmin and keratin. This study describes CT characteristics in five patients with malignant small round cell tumor of the abdomen. All patients were young white men, 20-36 years old (mean, 28 years). In all five cases, CT scans revealed lobulated masses appearing to arise primarily from peritoneal surfaces and predominantly involving the peritoneal cavity of the abdomen (two cases) and pelvis (two cases); diffuse abdominopelvic involvement was noted in one case. The masses were centrally necrotic and enhanced inhomogeneously after administration of iodinated contrast material. Additional CT features included ascites (one case), calcifications in the dominant mass (one case), omental implants (two cases), hydronephrosis (four cases), anterior diaphragmatic lymphadenopathy (two cases), liver metastases (two cases), and retroperitoneal lymphadenopathy (two cases). CT findings of abdominal malignant small round cell tumor are nonspecific and mimic findings noted in other conditions, such as peritoneal carcinomatosis and leiomyosarcomatosis.
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PMID:Primary malignant small round cell tumor of the abdomen: CT findings in five cases. 156 62

219 metatarsal (MTP) and 69 metacarpal (MCP) capitulae obtained during surgery from patients with definite rheumatoid arthritis (RA) were histologically evaluated. This evaluation, focussing on primary pathways of joint destruction by tumor-like proliferated synovial cell masses revealed 3 pathways of aggression: Pathway A: In 15% aggression onto the articular cartilage only. Pathway B: In 49% direct invasion exclusively into the cortical bone. Pathway C: In 36% a "forceps-like" aggression, a combination of A and B in which the joint is attacked from both sides. In contrast to the hitherto conventional concepts, the findings of this study reveal a clear preference of the synovial aggression for the cortical bone rather than for the articular cartilage. The different concepts of joint destruction in RA are being discussed in the light of our findings. Thus, future pathogenetic considerations with regard to joint destruction in RA should take this fact into consideration.
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PMID:Pathways of destruction in metacarpal and metatarsal joints of patients with rheumatoid arthritis. 157 Apr 80

A high index of suspicion for penile cancer and a low threshold for biopsy of all penile lesions that do not respond to a short trial of conservative therapy are the primary requirements for early diagnosis and treatment of patients with penile cancer. Survival is related to stage; however, there is a considerable difference between clinical and pathologic stage. This discrepancy is attributable to the difficulty in determining corpora cavernosal invasion and inguinal lymph node metastases because of concomitant inflammatory changes and inaccuracies in diagnostic imaging modalities. Aggressive clinical staging may identify otherwise occult tumor and improve locoregional control and survival.
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PMID:Penile cancer. Clinical presentation, diagnosis, and staging. 157 15

The role of nutritional support in the management of the critically ill patient has been a topic of much concern and research. Malnutrition experienced by patients with cancer can be related to the nutritional status of the patient before the development of cancer, to the tumor itself, and to cancer therapy. Aggressive treatment may increase the degree of malnutrition, and the combination of the effects of therapy and progressive malnutrition may be a frequent cause of death. The use of intensive nutritional support for some patients may promote weight gain and positive nitrogen balance, increase tolerance of cancer therapy, and improve immune response. The benefits of nutritional support in the patient with cancer may outweigh concerns of nutrition effects on tumor growth. The choice of nutritional support is dependent on the availability of and access to a functioning gastrointestinal tract, comfort and compliance of the patient, the toxicity of drugs, and site of radiation therapy. Extended length of treatment, availability of care givers, and costs are also factors considered in delivering nutrients. Nutrition requirements, nutritional tolerance, and immune status should be monitored by the nurse. The nurse can function as coordinator for treatments and care as well as act as interpreter, teacher, and counselor to coordinate medical and nutritional management of the patient's illness into overall high-quality nursing care.
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PMID:Nutritional support of the patient with cancer. 157 77

Between 1965 and 1985, 194 of 1,113 patients (17.4 percent) with advanced carcinoma of the stomach who underwent gastric resection had Borrmann type IV carcinoma of the stomach, a macroscopically evident and diffusely spreading tumor. These patients tended to be younger and female and to have larger tumors that involved the entire stomach, as compared with patients with other types of carcinomas. Tissues were commonly undifferentiated, serosal invasion was prominent with infiltrative growth and high rates of metastasis to the lymph nodes and peritoneal dissemination were evident. In most instances, the disease was advanced; therefore, total gastrectomy was performed upon 82.0 percent of the patients and a palliative resection was done in 64.4 percent. The survival rate was lower than for patients with carcinoma of the stomach of other types (p less than 0.01). A multivariate analysis indicated that curative resection is an independent favorable prognostic event, while other factors are dependent covariates. Early detection of this carcinoma is crucial to extend survival time of patients with Borrmann type IV carcinoma of the stomach. Aggressive postoperative chemotherapy should be considered when a noncurative resection is done.
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PMID:Lower survival rate for patients with carcinoma of the stomach of Borrmann type IV after gastric resection. 162 Nov 94


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