Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-six patients with apparent stage I nonseminomatous germ cell tumor (NSGCT) of the testis were treated by inguinal orchidectomy and intensive follow-up only. Assessment included measurement of serum alpha fetoprotein (alpha FP) and beta human chorionic gonadotropin (beta HCG) (tumor markers) and chest x-ray monthly for 1 year, then twice monthly for 1 year, with computed tomographic (CT) scans of abdomen and chest repeated three times monthly for the first year and six times monthly for the second year. Median follow-up was 36 months (range, 14 to 92 months). Relapse occurred in 12 patients (33.3%) at a median of 7 months (range, 2 to 28 months). Elevated markers were of limited importance in relapse detection, confirming the need for close clinical and radiological follow-up. Of nine histological factors examined in the primary tumor only the presence of lymphatic invasion was associated with a significantly higher relapse rate. All patients were treated at relapse with cisplatin-based chemotherapy. Four underwent surgery in addition, two before and two after chemotherapy. Eleven were rendered disease-free, but four had a second relapse. One patient has died, one is alive with disease, and ten are disease-free. Chemotherapy failed to cure six patients who had relapsed but bulk of disease was not a factor. Despite the good overall result reported here, optimal postorchidectomy management of apparent stage I disease remains to be defined.
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PMID:Disease relapse in patients with stage I nonseminomatous germ cell tumor of the testis on active surveillance. 245 19

An elevated serum level of human chorionic gonadotropin (HCG) in a patient whose primary tumor histologically appears to be a pure seminoma implies the presence of syncytiotrophoblastic giant cells either detectable by careful step sectioning of the primary tumor or present in metastatic disease. Inasmuch as the malignant potential and radioresponsiveness of syncytiotrophoblastic giant cells are unknown and the serum elevation of HCG may signal metastatic embryonal carcinoma, retroperitoneal lymph node dissection with adjuvant chemotherapy dependent on pathologic staging should be considered for patients with seminoma and postorchiectomy elevated HCG levels. An illustrative case is herein reported.
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PMID:Seminoma with elevated human chorionic gonadotropin. The case for retroperitoneal lymph node dissection. 258 Mar 84

To assess the biological significance of human chorionic gonadotropin (HCG) detection in large bowel carcinomas, we have studied immunohistochemically 50 colorectal carcinomas, 20 adenomas, 8 ulcerative colitis, and 10 normal colonic mucosae. The HCG-immunoreactive cells were found in 26 carcinomas (52%). Positivity was not detected in any normal mucosa or benign lesions. Cells containing HCG predominated in mucinous (80%) and poorly differentiated carcinomas (92%). No trophoblastic differentiation could be demonstrated in any tumor. Human chorionic gonadotropin was detected more frequently in carcinomas invading the entire bowel wall (67%) than in those confined to the submucosa or muscularis propria (30%). Fifteen of 19 cases (79%) with lymph node and/or hepatic metastases had HCG in the primary tumor, whereas only 9 of 23 cases (32%) without metastases showed HCG immunoreactivity. The eight patients with hepatic metastases had HCG in the primary tumor. Thus, the immunohistochemical detection of HCG in colorectal carcinomas may be a biological marker of prognostic significance.
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PMID:Human chorionic gonadotropin in colorectal carcinoma. An immunohistochemical study. 354 43

Choriocarcinoma is a malignant growth of trophoblastic cells characterized by the secretion of human chorionic gonadotropin. Primary choriocarcinoma arising in the placenta during a seemingly normal gestation is rare. Very few choriocarcinomas occurring simultaneously in mother and child have been reported so far. We describe an additional case of placental choriocarcinoma metastasizing to the newborn and showing many different cutaneous tumors. The primary tumor was found in the placenta. In the newborn, diagnosis was performed by skin biopsy only a few days after birth (by optic and electron microscopy). Immunohistochemical localization of human chorionic gonadotropin was performed by the immunoperoxidase technic with the use of monoclonal antibodies. This report describes an additional case and summarizes previously reported cases of placental choriocarcinoma metastasizing to the infant, as well as cases of skin metastases from malignant gestational trophoblastic disease.
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PMID:Infantile choriocarcinoma with cutaneous tumors. An additional case and review of the literature. 371 1

The current report describes a secondary malignancy developing in a retroperitoneal mature residual lesion 6 years after chemotherapeutic treatment of a disseminated nonseminomatous testicular tumor. The histologically malignant component was not present in the primary tumor and consisted of polygonal and fusiform cells with focal tubular formations, resembling primitive neuroectodermal tissue. Immunoperoxidase staining for alpha-fetoprotein and the beta-subunit of human chorionic gonadotropin remained negative, whereas focal positivity for S100 protein was observed. Neuron specific enolase positivity was equivocal. The DNA contents of both the mature components in the primary and the metastatic retroperitoneal tumor and in the various malignant components of the primary tumor, were in the hypotriploid range. In the malignant component of the retroperitoneal metastasis, a hypertriploid peak was observed. These findings suggest further clonal evolution in a phenotypically mature, genotypically abnormal residual metastatic tumor after chemotherapy. It is stressed that the mature appearance of the residual lesions may be deceiving and that these lesions are highly susceptible to resume malignant behavior.
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PMID:Histology and DNA contents of a secondary malignancy arising in a mature residual lesion six years after chemotherapy for a disseminated nonseminomatous testicular tumor. 371 20

Choriocarcinoma was found in the lung of a 34-year-old woman. Examination of the patient's entire body, especially the genital tract, failed to disclose foci of choriocarcinoma other than that in the right lung. After surgery, the levels of human chorionic gonadotropin in the blood and the urine fell. It was concluded that the choriocarcinoma of the lung was, in fact, the primary tumor. The genesis of choriocarcinoma was also studied in ten patients who died after delivery or abortion. Autopsy disclosed trophoblasts in the pulmonary arteries in nine of these ten patients. These findings suggest that primary choriocarcinoma in women is due to pulmonary embolism caused by trophoblasts at the time of abortion or delivery.
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PMID:Primary choriocarcinoma of the lung. 384 Jul 68

Excluding patients with bulky stages II or III disease, 73 patients with nonseminomatous germ cell testicular tumors were evaluated between September 1979 and April 1983 for a protocol omitting retroperitoneal lymph node dissection. Patient eligibility required clinical stage I (T1 category) disease based upon normal post-orchiectomy serum tumor markers (alpha-fetoprotein, human chorionic gonadotropin and lactic dehydrogenase), chest x-ray, ipsilateral lymphangiography, and a computerized tomography scan of the abdomen and pelvis. Of the 73 patients 10 (14 per cent) were entered and followed for more than 2 years (3 had relapse within 7 months but were salvaged with retroperitoneal lymph node dissection and chemotherapy). Analysis of failures showed embryonal carcinoma in all 3 patients, with vascular invasion in the primary tumor in 1 and undetected spermatic cord involvement in 1, while 1 had a slower than expected decrease to normal of an elevated human chorionic gonadotropin level after orchiectomy. There were 63 patients (86 per cent) excluded from the protocol for various reasons: 2 (3 per cent) refused treatment, 16 (25 per cent) had suspicious or positive lymphangiography, 22 (40 per cent) had a positive CT scan, 6 (9 per cent) had elevated tumor markers, 3 (5 per cent) were less than 15 or more than 15 or more than 40 years old, 8 (13 per cent) had had a prior orchiopexy or scrotal violation, 4 (6 per cent) had extension to the spermatic cord and 2 (3 per cent) were unavailable for monthly followup. These 63 patients underwent retroperitoneal lymph node dissection, and 36 (57 per cent) had negative and 27 (43 per cent) had positive nodes (8 had stage N1, 10 stage N2A, 6 stage N2B and 3 stage N3 disease). Average interval from orchiectomy to final staging was 6 weeks. The results suggest that assessment of local tumor extent and potential sites of metastases via all available means are necessary in an effort to reduce the risk of tumor recurrence in patients who are followed expectantly.
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PMID:Selection of testicular tumor patients for omission of retroperitoneal lymph node dissection. 394 94

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

A one-year-five-month-old boy with hepatoblastoma producing both human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) is presented. Histologically, the primary tumor was mainly composed of well differentiated hepatoblastoma cells, with minor areas of poorly differentiated cells. Immunoperoxidase staining of the tumor for hCG and AFP showed that a few well differentiated, fetal type cells and multinucleated giant cells were positive for hCG, and AFP was never stained in the same cells. In areas where cells were poorly differentiated, positive reactions for either hCG or AFP were not observed. Electron microscopic studies revealed focal aggregates of cytoplasmic cored vesicles in some tumor cells, similar to secretory granules.
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PMID:Immunocytochemical identification of human chorionic gonadotropin- and alpha-fetoprotein-producing cells of hepatoblastoma associated with precocious puberty. 618 19

Possible relationships between histopathologic cell type and several clinical variables were examined in 253 patients with Stage III nonseminomatous germ cell tumors of the testis. No statistically significant associations were found between cell type and either the side of primary tumor or cryptorchidism. The presence of elements of choriocarcinoma was associated with the presence of retroperitoneal tumor (P less than 0.03) but no other association between cell type and site of metastasis was encountered. Elevated serum levels of human chorionic gonadotropin were found in patients with elements of choriocarcinoma but serum levels of alphafetoprotein, lactate dehydrogenase and carcinoembryonic antigen were not correlated with a specific cell type. No statistically significant association was found between cell type and either complete response to combined modality therapy or survival. These results would indicate that cell type is probably not an important prognostic variable in patients with Stage III nonseminomatous tumors of the testis.
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PMID:Interrelationships of histopathology and other clinical variables in patients with germ cell tumors of the testis. 618 28


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