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

Endocrine pancreatic tumors are slowly growing neuroendocrine neoplasms with a malignant potential which may cause symptoms such as hypoglycemia, multiple ulcers, diarrhea, flush, hyperglycemia and skin rash. A prospective study was performed on 84 patients with endocrine pancreatic tumors. In 59 patients (70%) the tumors were malignant. Of the 84 patients, 23 had insulinomas, 25 gastrinomas, 20 nonfunctioning tumors, 14 the WDHA syndrome, 1 somatostatinoma and 1 glucagonoma. The median age at diagnosis was 53 years and the median delay from first symptom to diagnosis was 2 years. The most common site of the pancreatic primary tumor was the tail (41%), and metastases were most frequently located in the liver (60%) and lymph nodes (44%). Plasma chromogranin A + B was elevated in 94%, serum pancreatic polypeptide (PP) in 74%, plasma neurotensin in 67% and serum gastrin in 62%. Serum HCG-alpha and -beta subunits were elevated in 41 and 30% respectively, all except 3 having a verified malignant tumor. The median survival from first symptom and diagnosis was 14.2 and 8.7 years respectively. Patients with MEN-1 had a significantly better survival from diagnosis than sporadic cases (median 15.1 versus 5.8 years). Patients who received interferon after failing chemotherapy had a significantly better survival than those given chemotherapy alone (5-year survival 65 and 50% respectively).
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PMID:Neuroendocrine pancreatic tumors. Clinical findings in a prospective study of 84 patients. 247 25

Cancers of unknown origin represent approximately 5% of all cancers and are therefore as frequent as some solid tumors such as gastric or pancreatic cancers. The diagnosis of cancer of unknown origin should be based on a detailed pathological examination including immunohistochemical techniques and electron microscopy; hormonal receptors should also be measured. Besides detailed medical history and physical examination, only a few additional tests should be carried out: routine chemistry including the assay of HCG, alphafoetoprotein and specific antigen of the prostate, chest X-ray, thyroid scan, mammography and abdominal CT scan. Other tests are generally not of sufficient specificity and sensitivity. Unknown primary tumors arising in the cervical area are frequently squamous cell carcinomas corresponding to occult primary tumors of the upper aerodigestive mucosae and are efficiently treated by cervicofacial radiotherapy or lymph node dissection. Women presenting with axillary lymph nodes with no obvious primary tumor should be treated according to the guidelines used for breast cancer. The patients with inguinal lymph nodes of unknown origin are usually treated with radiation therapy. The syndrome of germinal tumors of extragonadic origin corresponds to cases of undifferentiated or poorly differentiated carcinomas in patients under 50 years of age and with one of the following characteristics: involvement of the median organs, lung involvement, lymph node involvement or increase of alphafoetoprotein or HCG. The therapeutic approach recommended for these patients consists of the chemotherapeutic combination used for testicular cancer. For all other patients, the prognosis remains poor. Patients with local symptoms may be treated by radiation therapy; others may receive a combination of fluorouracil, doxorubicin and mitomycin.
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PMID:[Diagnosis and treatment of unknown primary tumors]. 269 83

Radioimmunoscintigraphy was performed in 52 patients with a variety of malignant tumors (colorectal, melanoma, lung, testicular, ovarian, bladder, carcinoid). Respective antibodies or their F(ab')2 fragments against CEA (n = 23), melanoma antigen 225.28 S (n = 18), TPA (n = 4), beta HCG (n = 5) and HMFG2 (n = 2) were selected by immunohistochemistry of the primary tumor. Most patients were suspected of recurrence or of hitherto unknown distant or local metastases. Overall accuracy was 61% (32/52). False negatives amounted to 33% (17/52). Useful additional clinical information-not available by CT, ultrasonics or serum levels of tumor markers-was obtained in 17 out of 52 patients (= 33%). From these results it seems obvious that antibodies used for radioimmunoscintigraphy should be selected on the basis of immunohistochemistry.
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PMID:Clinical results of immunoscintigraphy in a variety of malignant tumors with special reference to immunohistochemistry. 354 Aug 57

Risk factors, their interrelationship, and prognostic relevance for seminoma stage II disease have been examined. The size of the primary tumor was significantly correlated with the pT category, as was the presence of tumor invasion of small vessels. The pT category was correlated neither with clinical substage nor relapse rate. There was a poorer 3-year survival for anaplastic seminomas as compared to that of classical seminomas; the difference was not significant. The 5-year survival for seminomas rich in lymphocytes was better than those of poor lymphocytic infiltration, but this difference also was not significant. No difference in survival or relapse rate was found between HCG-producing and HCG-nonproducing seminomas.
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PMID:Testicular seminoma: histological findings and their prognostic significance for stage II disease. 368 35

Thirty patients with nonseminomatous testicular cancer and no evidence of metastases outside the retroperitoneum were evaluated for discrepancy between the clinical and pathologic stages and also for frequency of elevations of the serum levels of human chorionic gonadotropin (hCG) and alphafetoprotein (AFP). When marker-level data were not considered in the staging, the clinical and pathologic stages differed in 47% of the patients; the inclusion of marker data reduced the staging error to 37%. Seven of ten patients with clinical Stage I, pathologic Stage II disease had normal marker levels (false-negative results). However, there were no false-positive results: abnormal marker levels before retroperitoneal lymphadenectomy always signalled persistent tumor unless the level could be accounted for by the metabolic decay rate of marker produced by the primary tumor. Comparison of marker-level data from these patients with data from 48 patients with Stage III disease demonstrated increasing frequency of elevated marker levels with increasing stage (P less than 0.001). Serial determinations of HCG and AFP are helpful in clinical staging and are necessary in clinical management.
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PMID:Human chorionic gonadotropin and alphafetoprotein in the staging of nonseminomatous testicular cancer. 616 91

The extreme radiosensitivity of testicular seminomas plus recent advances in chemotherapy for nonseminomatous tumors and for advanced seminomas have made long term survival possible in the large majority of patients with testis cancer. Since choice of therapy is determined by tumor histology and extent of disease, accurate clinical staging is critical. Computed tomography (CT) of the abdomen and chest is the imaging procedure of choice for staging testis cancer. Clinical staging accuracy of 80 to 90% can be achieved using CT in combination with radioimmunoassays for beta-HCG and AFP. Ultrasonography (US), while less sensitive and specific than CT for determining nodal status, may be useful in thin patients with sparse retroperitoneal fat; in addition US may play an important role in detecting occult testicular neoplasms and in assessing primary tumor extent within the scrotum. Lymphangiography should be reserved for Stage I patients in whom elective treatment of the retroperitoneum is not planned. Follow-up should include serial radioimmunoassays for serum AFP and beta-HCG and periodic CT examinations of the abdomen and chest. Technical improvements in CT scanners and further experience with the use of tumor markers should help refine our ability to stage and manage patients with testicular tumors. In addition, nuclear magnetic resonance (NMR) imaging and radionuclide imaging following injection of radioactively labelled antibodies to AFP and beta-HCG are new techniques which offer great promise for the future.
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PMID:Testicular tumors: oncologic imaging and diagnosis. 620 Apr 63

Serum levels of HCG and SP-1 and tissue localization in the primary tumors of these markers were correlated in 41 patients with advanced-stage non-seminomatous germ cell tumors (NSGCT) of the testis. In patients' serum, as well as in the primary tumor tissue, SP-1 positivity was accompanied by a concordant HCG positivity, so that it is concluded that in our patient group SP-1 does not give important additional information with respect to marker positivity not yet provided by HCG. A good correlation was found between serum levels of HCG and SP-1 in advanced-stage disease and the cellular localization of these markers in the primary tumors. Elevated serum SP-1 levels, with concordant elevation of HCG serum levels, were found mainly in cases with a histological diagnosis of choriocarcinoma or an admixture of this component in the primary tumor. Moreover, in cases of choriocarcinoma the presence of SP-1 positive syncytiotrophoblastic cells was very much comparable with the presence of HCG-positive syncytiotrophoblastic cells, whereas in syncytial giant cells associated with embryonal carcinoma HCG-positivity clearly outnumbered SP-1-positivity. This indicates a higher specificity of SP-1 for choriocarcinoma and, therefore, serum levels of this marker may have an important prognostic impact in NSGCT patients with advanced-stage disease. Apart from positivity in syncytiotrophoblastic cells of choriocarcinoma and syncytial giant cells, HCG positivity was incidentally seen in mononuclear embryonal carcinoma cells.
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PMID:Non-seminomatous germ cell tumors of the testis. Immunohistochemical localization and serum levels of human chorionic gonadotropin (HCG) and pregnancy-specific beta-1 glycoprotein (SP-1); value of SP-1 as a tumor marker. 629 73

A case of a 47-year-old man with choriocarcinoma is reported. This case is quite unique in that the primary tumor presented in the submental region. Multiple remote metastases developed within a few weeks after the tumor extirpation, resulting in a fatal outcome. The neoplasm revealed the features of pure choriocarcinoma. By the immunoperoxidase method, it was demonstrated that both cyto- and syncytiotrophoblasts produced HCG.
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PMID:Primary nongestational choriocarcinoma of submental region. 654 16

Tissue specimens from the primary tumor and metastasis (histological examination: cystadenocarcinoma) of two postmenopausal women were cut into pieces and were incubated or superfused for 3- to 4-hr periods. The incubation and superfusion procedures were performed in the absence and presence of human chorionic gonadotropin (hCG, 10 IU/ml). After incubation, the medium concentrations of progesterone (P), testosterone (T), androstendione, and 17beta-estradiol (E2) were determined by radioimmunoassay, while after superfusion the medium concentrations of cyclic AMP (cAMP), P, T, and E2 were analyzed. HCG stimulated the production of cAMP in the superfused tissue of the first case and in the second case the addition of hCG to the incubation medium caused a significant drop in testosterone release by the primary tumor and in androstendione release by the metastasis. These results suggest that tissues from primary tumor and metastasis were capable of releasing steroids into the media, supporting the contention that tissue from epithelial ovarian cancers can produce and/or release steroids in its own right.
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PMID:Steroid release from two human epithelial ovarian tumors: evidence for an intrinsic production in vitro. 899 55

In mature and immature teratoma the treatment is surgical. The risk of recurrence can be estimated from the parameters primary site (with the coccygeal tumors being most at risk), histological grade of immaturity and completeness of the primary resection including the adjacent organ of origin (coccyx, ovary, testis etc.). In case of a microscopically complete tumor resection there is no role for adjuvant chemo- or radiotherapy irrespective of the histological grade of immaturity. Malignant germ-cell tumors (GCT) account for 2.9% of all malignant tumors of children younger than 15 years of age. More than half of the tumors occur at extragonadal sites such as the ovaries (26%), the coccygeal region (24%), the testes (18%) and the brain (18%) represent then primary sites. In patients with extensive tumor growth, metastatic disease or secreting intracranial tumors a delayed tumor resection after preoperative chemotherapy is preferable. In these patients malignant non-seminomatous GCT may be diagnosed clinically due to the increased serum or cerebrospinal fluid levels of the tumor markers AFP and/or beta-HCG. Current risk adapted treatment protocols containing cisplatinum allow long-term remissions in about 80% including patients with bulky or metastatic tumors. In the cisplatinum era the prognostic factors like histology, primary site of the tumor and initial tumor stage have partly lost their former impressive significance in infants and children. On the other hand the completeness of the primary tumor resection according to oncological standards has been established as the most powerful prognostic parameter superior to tumor marker levels or primary site of the tumor.
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PMID:Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. 1081 91


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