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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The development of a metastasis is dependent on an interplay between host factors and intrinsic characteristics of malignant tumor cells. The process of metastasis is highly selective, and the metastatic lesion represents the end point of many destructive events that only a few cells can survive. Neoplasms, which are predominantly heterogeneous, contain a variety of subpopulations of cells with differing metastatic potential. Furthermore, metastatic cell variants have been shown to preexist in murine neoplasms of old and recent origin. The possible existence of highly metastatic variant cells within a primary tumor suggests that we no longer should consider a neoplasm to be a uniform entity. Efforts to design effective therapeutic agents and procedures against malignant tumors should be directed toward the few but fatal metastatic subpopulations of cells.
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PMID:Tumor heterogeneity and the biology of cancer invasion and metastasis. 35 78

28 patients with ovarian immature teratoma were studied pathologically. Neoplasms with other germ cell elements were excluded. The ages ranged from 11 to 38. 71% were women under 25 years. Each primary tumor and metastatic lesion was graded histologically according to the criteria of Norris. Of these 28 cases, 11 were grade I; 11 grade II; and 6 grade III. The study showed that the stage of primary tumor is closely related to the prognosis. The likelihood of recurrence and metastasis could be determined by the grade of the primary tumor. The recurrence rate of grade I, II, and III were 0%, 44% and 100%, respectively. It also showed that the addition of hysterectomy and contralateral adnexectomy for grades II and III lesions did not improve the survival. One patient had been operated for 3 times to remove recurrences in the abdominal cavity and liver in a period of 25 months. The first and second recurrent tumors were grade III, but the third one was grade II showing that the immature teratoma tends to mature, but this conversion needs time. The authors support the opinion that repeated operations to remove the recurrences may improve the survival.
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PMID:[Pathologic study and prognostic factors in 28 patients with ovarian immature teratoma]. 321 82

During the first 10 years of the Mayo Lung Project, 68 roentgenographically inapparent ("occult") lung cancers were localized and apparently completely resected. A pathologic classification was developed based on depth of tumor infiltration. The five categories were (1) in situ carcinoma confined to surface epithelium or ducts of mucous glands or acini (23 cancers), (2) intramucosal invasion not greater than 0.1 cm from mucosal surface (12 cancers), (3) invasion to bronchial cartilages (11 cancers), (4) invasion to full thickness of bronchial wall (10 cancers), and (5) extrabronchial invasion (12 cancers). Multicentricity of lung cancer was studied in 54 patients, none of whom had a history of cancer of the respiratory tract, and all of whom had had "complete" surgical resection of the initial occult lung cancer (or cancers). Neoplasms that were initially multicentric occurred in 4 patients, and a subsequent primary lung cancer developed in 11. The rate of detection of second primary lesions was 42 per 1,000 person-years of observation. A high incidence of unresectable cancers and a low survival rate were noted among patients who had a subsequent primary tumor. These findings were primarily attributable to invasiveness of the subsequent primary cancer or to respiratory insufficiency that resulted from obstructive lung disease or previous pulmonary resection. Because of the high risk of development of a second primary cancer after initial surgical resection, it is important to treat the initial occult cancer as conservatively as possible consistent with "cure."
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PMID:Roentgenographically occult lung cancer: pathologic findings and frequency of multicentricity during a 10-year period. 673 13

Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. Neoplasms are extremely rare. We report a case of carcinoid tumor of Meckel's diverticulum in a patient with acute abdominal pain. So far, 111 cases have been reported. Review of the literature reveals that carcinoids are the most common malignant tumors of Meckel's diverticulum. Two thirds of the patients remain asymptomatic. Metastases are seen in 25% at diagnosis. The probability of metastases depends on the size of the primary tumor. Because of the early metastases rate even in small tumors, aggressive surgical management is justified.
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PMID:[Carcinoid tumor in Meckel's diverticulum: case presentation and review of the literature]. 928 35

Neoplasms are derived from normal tissues of the body by cellular transformation. Tumors often represent a less differentiated or an undifferentiated version of the histology of the neoplasms original tissue. Primary tumor(s) may spread by direct extension or by metastasis. For the purpose of this review, second primary tumors will be defined to exclude metastatic lesions or recurrences from an original primary tumor. Second primary tumors arise in several different clinical situations that basically are the result of either inherited or acquired genetic mutations. Second primary tumors may develop soon or very late after treatment of the first primary tumor and may reflect an underlying genetic or immunologic defect in the patient, treatment related genetic damage, or environmental exposure to carcinogens. With the greater success of modern chemotherapy and radiotherapy in achieving long-term remissions in many patients, second primary tumors are a rapidly developing disease-category. This paper will review the clinical circumstances associated with a significantly higher incidence of second primary tumors in patients with an initial primary tumor.
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PMID:The etiology of second primary neoplasms. 957 31

Synovial sarcoma (SS), an aggressive neoplasm accounting for up to 14% of soft tissue sarcomas, was recently recognized as a primary tumor in the lung and pleura. SS is characterized by the chromosomal translocation t(X;18)(SYT-SSX) found in more than 95% of the tumors. We report a cooperative study from the French Sarcoma Group and the Mesopath Group on 40 t(X;18)(SYT-SSX)-positive primary intrathoracic SS. There were 22 males and 18 females, whose age ranged from 16 to 79 years (median, 47 years). Neoplasms were mostly circumscribed and of large size (median, 7.5 cm; range, 2-16 cm). Thirty-nine tumors were monophasic SS, including 24 (60%) monophasic fibrous and 15 (37.5%) poorly differentiated cases, and one lesion was a biphasic SS. A larger proportion of poorly differentiated tumors were observed among intrathoracic SS as compared with soft tissue SS. Immunohistochemically, 90% of the cases reacted with at least one epithelial marker. CD34 was focally expressed in 3 cases. SYT-SSX1 fusion transcripts were detected in 22 cases (56.4%) and SYT-SSX2 fusion transcripts in 17 cases. Median and 5-year disease-specific survival in 33 patients was 50 months and 31.6%. Median and 5-year disease-free survival was 24 months and 20.9%. Patient sex, age, tumor size, histologic subtype, grade, and SYS-SSX fusion type had no significant impact on outcome. In conclusion, intrathoracic SS are rare but aggressive tumors with poor prognosis. In this unusual location, the detection of SYT-SSX fusion transcripts is a valuable diagnostic adjunct.
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PMID:Primary intrathoracic synovial sarcoma: a clinicopathologic study of 40 t(X;18)-positive cases from the French Sarcoma Group and the Mesopath Group. 1572 2

Neoplasms of the hand are not common. Giant cell tumor of tendon sheath (GCTTS) is the most common primary tumor of the hand. Many different theories have recently been proposed as to whether GCTTS is a neoplasm or a localized reactive process. We believe the evidence supports a neoplastic origin. Although the origin is still not proved, the presentation, diagnosis, and treatment of GCTTS have been clear for a long time.
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PMID:Giant cell tumor of tendon sheath. 1582 13

Head and neck masses represent a common clinical entity in children. In general, these masses are classified as developmental, inflammatory, or neoplastic. Having a working knowledge of lesions within this region and conducting a thorough history and physical examination generally enables the clinician to facilitate an appropriate workup and establish a diagnosis. The differential diagnosis is broad, and expeditiously distinguishing benign from malignant masses is critical for instituting a timely multidisciplinary approach to the management of malignant lesions. Neoplasms of the head and neck account for approximately 5% of all childhood malignancies. A diagnosis of malignancy may represent a primary tumor or metastatic foci to cervical nodes. In this review, we discuss the general approach to evaluating suspicious masses and adenopathy in the head and neck region and summarize the most common malignant neoplasms of the head and neck with regard to their incidence, clinical presentation, diagnostic evaluation, staging, and management. Thyroid, parathyroid, and salivary gland tumors are discussed elsewhere in this issue of Seminars in Pediatric Surgery.
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PMID:Malignant neoplasms of the head and neck. 1661 12

Neoplasms from almost every tissue have been reported to metastasize to the pituitary. Gastric carcinoma is a rare cause of metastases in pituitary gland. Gastric carcinoma will be the primary tumor in less than 2% of patients with pituitary gland metastases. We report the case of a 60-years old white man with liver metastasis from gastric cancer with fair presentation symptoms of pituitary gland metastasis. Basal endocrinological work-up showed corticotroph, gonadotroph, somatotroph and thyrotroph cell insufficiency; serum PRL was elevated and no deficit of the ADH level was observed. Despite the hormonal deficits the patient did not report any specific symptom. After diagnosis the patient began thyroid and adrenal-replacement therapy and was referred to Radiotherapy Unit for treatment on the sellar and pituitary gland region.
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PMID:Gastric cancer metastatic to the pituitary gland: a case report. 1755 75

Neoplasms arising in accessory lacrimal glands are rare. We describe a 33-year-old man with adenocarcinoma arising in the left lower eyelid accessory lacrimal gland. Microscopic evaluation demonstrated an infiltrative neoplasm composed of mildly to moderately pleomorphic cells with abundant eosinophilic cytoplasm and focal intracytoplasmic vacuoles, arranged predominantly in ductules. Foci of luminal and intracytoplasmic eosinophilic secretory material and occasional mucin were noted. An in situ component was identified in the gland of Wolfring. Though perineural invasion was present, high-grade nuclear features, brisk mitotic activity, and comedonecrosis were not identified. Immunohistochemical studies were notable for immunoreactivity of the tumor cells for CK7, carcinoembryonic antigen, BRST-2, androgen receptors, and HER2/neu (2+). The neoplastic cells were negative for CK20, estrogen and progesterone receptors, S-100, p63, calponin, thyroid transcription factor-1, and prostate-specific antigen. Fluorescence in situ hybridization studies for ETV6 and MAML2 rearrangements and for HER2/neu amplification were negative. Because of the absence of unifying morphologic, immunophenotypic, and molecular genetic findings, the diagnosis of adenocarcinoma, not otherwise specified, was rendered. The patient underwent comprehensive oncologic workup, which was negative for another primary tumor and metastases. He remains disease free with a follow-up of 4 years. This case illustrates the challenges encountered in applying salivary gland tumor classification to the accessory lacrimal gland neoplasm.
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PMID:Adenocarcinoma, Not Otherwise Specified, Arising in Accessory Lacrimal Gland: A Diagnostic Challenge. 3032 83


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