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)

18F-fluorodeoxyglucose positron emission tomography was able to identify previously unknown primary tumors in 2 of 4 patients after an unsuccessful conventional diagnostic workup such as chest radiography, ultrasound, computed tomography, MRI and various endoscopies. The 2 patients in which the primary tumors were detected proved to have a carcinoma of the lung, one of the patients received radiotherapy and chemotherapy after the detection of the primary tumor by FDG PET. The primary tumor of the lung demonstrated no focal FDG uptake after the successive treatment. On the other hand, in one patient with prostatic carcinoma and another in which the primary tumor has yet to be detected, FDG PET was unable to identify the primary tumor. This suggests a limitation of PET studies in detecting cancers. Because of increased glycolysis in cancer cells, FDG PET can be used to detect cancers with its high sensitivity, surveying the entire body non-invasively in one session. PET has the advantage of detecting primary tumors of an unknown origin when compared to conventional diagnostic studies.
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PMID:[Evaluation of 18F-FDG positron emission tomography (PET) in the detection of unknown primary tumors]. 1042 68

We describe a rare case of metastatic intra-suprasellar adenocarcinoma from colonic cancer mimicking a meningioma of the "diaphragma sellae". Autopsy studies indicate breast and lung carcinoma to be the most frequent primary tumor metastasizing this site, particularly in patients with systemic spread. While diabetes insipidus is reported to be one of the commonest symptoms in these cases, the only clinical manifestation of the tumor in our patient was a bitemporal hemianopia, while the primary tumor remained asymptomatic. In the available literature are reported only two pituitary metastasis from operated colon carcinoma. In both cases the diagnosis of the colon cancer preceded the pituitary operation. The clinico-pathological and neuroradiological aspects of this unusual lesion are analyzed in the light of the relevant literature on the topic focusing on recent MRI acquisitions.
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PMID:Diaphragma sellae metastasis from colon carcinoma mimicking a meningioma. A case report. 1044 59

The necessity for a compulsive attitude toward preoperative assessment of lung cancer is to be emphasized, since rational treatment and prognosis depend largely on the stage of disease at the time of diagnosis. In the preoperative setting, the techniques used should be sequential, logical, and help to identify patients suitable for treatment with curative intent. With regard to the primary tumor (T status), the accuracy of CT or MRI to predict the need for extended resections is limited. Similarly, all noninvasive methods to determine the nodal status (N) are valuable, but mediastinoscopy has a greater sensitivity and specificity than either CT or MRI. The role of routine organ screening for the detection of distant occult metastasis in the asymptomatic patient is still controversial. Ultimately, the prognosis of the resected patient with lung cancer is based on complete intraoperative staging, which can be done by either systematic node sampling or complete lymphadenectomy. At present, neither of these techniques has been shown to improve the quality of staging or survival.
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PMID:Clinical and surgical staging of non-small cell lung cancer. 1077 62

Capromab Pendetide imaging illustrates the successful translation of monoclonal antibody technology from the laboratory to the clinic. It provides a means of identifying otherwise occult soft tissue metastases in patients with adenocarcinoma of the prostate. When utilized with other clinical, pathological and laboratory findings, Capromab Pendetide imaging enables more accurate disease staging and monitoring than is afforded by other imaging modalities such as CT and MRI. In the primary disease setting Capromab Pendetide imaging should be reserved for use in patients with negative bone scans who are at high risk for metastatic disease based on such factors as advanced clinical stage, high Gleason score and significantly elevated serum PSA or alkaline phosphatase. Due to low sensitivity for small-volume disease, a negative Mab scan may not eliminate the need for a staging lymph node dissection but should encourage further consideration of local treatment options. Capromab Pendetide should be used with caution in patients at low risk for metastatic disease. Positive scan findings in low risk patients should be confirmed before altering the treatment plan since some false positive scans should be anticipated in a population with low disease prevalence. Capromab Pendetide imaging has not been shown to be reliable in determining the local extent of the primary tumor but new techniques involving co-registration of SPECT and CT images show promise in this regard. In the patient with recurrent disease following primary therapy, the predictive value of Capromab Pendetide imaging of the prostate or prostate fossa is limited, particularly following RT. Its more important role in this setting is to identify lymph node metastases in the high risk patient with a negative bone scan who might otherwise be a candidate for local salvage therapy. A large prospective study is needed for confirmation, but preliminary data suggest that Capromab Pendetide imaging is helpful in identifying those patients with PSA elevation after radical prostatectomy who are most likely to benefit from salvage RT. As with any imaging technique, Capromab Pendetide has strengths and weaknesses that must be understood to maximize patient benefit by utilizing the scan in clinical settings where it is most likely to be useful and least likely to be misleading. Capromab Pendetide is a technically demanding procedure best performed and interpreted at sites with experience and expertise.
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PMID:Capromab Pendetide imaging of prostate cancer. 1080 17

MRI of the breast has proved its role in the diagnosis of breast cancer. Despite the amount of studies with MRI, the technique has not been standardised yet. This is one of the reasons for the huge difference in specificity the reported in the different studies (from 30% to 95%). Because the many pitfalls of the technique, the specificity of MRI of the breast is correlated to the experience of the investigator. When the established indications are respected, specificity increases. Presently accepted indications are: differentiation between postoperative fibrosis and tumor recurrence, multifocality or contralateral breast carcinoma, evaluation of prosthesis, discrepancy between the different diagnostic techniques, high risk patients with dense breasts. Less frequently but nevertheless a good indication is proven axillary lymph node metastases from an unknown primary tumor. Microcalcifications still are not a good indication for MRI of the breast. MRI is still inferior to mammography in detecting ductal in-situ carcinoma or very small carcinomas because the neo-angiogenesis of these tumors is too faint to be detected by contrast-enhanced MRI. MRI instead of mammography or to solve a problem resulting from a bad mammographical examination is certainly not advised. New sequences, including diffusion and perfusion, and new contrast agents are keenly awaited.
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PMID:MR imaging of the breast--present indications. 1085 4

The increasing use of 3D treatment planning in head and neck radiation oncology has created an urgent need for new guidelines for the selection and the delineation of the neck node areas to be included in the clinical target volume. Surgical literature has provided us with valuable information on the extent of pathological nodal involvement in the neck as a function of the primary tumor site. In addition, few clinical series have also reported information on radiological nodal involvement in those areas not commonly included in radical neck dissection. Taking all these data together, guidelines for the selection of the node levels to be irradiated for the major head and neck sites could be proposed. To fill the missing link between these guidelines and the 3D treatment planning, recommendations for the delineation of these node levels (levels I-VI and retropharyngeal) on CT (or MRI) slices have been proposed using the guidelines outlined by the Committee for Head and Neck Surgery and Oncology of the American Academy for Otolarynology-Head and Neck Surgery. These guidelines were adapted to take into account specific radiological landmarks more easily identified on CT or MRI slices than in the operating field.
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PMID:Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. 1092 32

OBJECTIVE: To evaluate patterns of enhancement in the nipple-areolar-complex (NAC) on contrast-enhanced MRI. METHODS: We reviewed the MR images of 37 patients in which enhancement of the NAC was demonstrated on gadolinium-enhanced dynamic fast radiofrequency spoiled gradient recalled echo (fast-SPGR) images. Time intensity profiles derived from signal intensity values were constructed, and findings correlated with histological results. RESULTS: Three types of curve were observed. In the first type seen in adenoma of the nipple, rapid initial increase in signal intensity with an early peak (1 min) occurred followed by gradual washout. In the second type seen in direct invasion from carcinoma, subareolar intracystic papilloma, or Paget's disease, rapid initial increase in signal intensity followed by a more gradual increase or plateau was seen. In the third type seen in carcinoma without nipple invasion, fibrocystic disease and fibroadenoma, a gradual increase in signal intensity was observed throughout the examination period. CONCLUSION: Early and prominent enhancement of the NAC on contrast-enhanced MRImay indicate the presence of a primary lesion in the NAC or secondary involvement by a primary tumor elsewhere in the breast.
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PMID:Enhancement of the Nipple-Areolar-Complex on Contrast-Enhanced MR Imaging of the Breast. 1109 60

Mammography remains the most important breast exam; mammography, know to be highly sensitive in detecting microcalcifications. Ultrasound is not suitable for screening, but it allows enough resolution to discriminate the very subtle differences of acoustic impedance among the breast tissue. The indications for MRI of the breast is far established may be defined as follows: 1) patients with silicone implants with or without mastectomy; 2) patients whose breast are difficult to evaluate by combined mammography and ultrasonography, who have: a) had breast conservation therapy, b) axillary lymph-node metastasis from an unknown primary tumor; c) postoperative scarring; d) proven carcinoma of one breast, MRI being performed to exclude multifocality. The authors recommend caution in the use of breast MRI in the assessment and management of suspected recurrent carcinoma.
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PMID:[Imaging of the breast tissue]. 1110 76

A 73-year-old woman presented to our hospital with epigastric pain and swelling of the left upper limb. Enlarged lymph nodes with adhesion were palpable in the left cervical region and supraclavicular fossa. Tests were performed with the thought that the left upper limb swelling was secondary to venous compression by the enlarged lymph nodes. Gastroscopy detected a torose lesion on the anterior wall at the gastric angle and biopsy revealed that it was moderately differentiated adenocarcinoma. MRI showed metastasis to the sixth cervical vertebra and the first thoracic vertebra. Based on these findings, she was diagnosed as having progressive gastric cancer with metastasis to Virchow's lymph node and the cervical and thoracic vertebrae. Because it was considered impossible to perform radical gastrectomy, chemotherapy was given. Since renal dysfunction was suggested by a serum Cr of 1.5 mg/ml and a Ccr of 26.2 ml/min, TS-1 was administered at a lower dose (50 mg/day for 4 weeks) than usual, followed by 2 weeks off therapy to complete 1 course. During TS-1 therapy, the plasma 5-FU concentration at 4 h was 129.5 ng/ml, indicating that an effective plasma level of the drug was achieved. TS-1 therapy was considered effective because it reduced the diameter of the primary tumor and the lymph node metastasis, with only mild adverse reactions including myelosuppression.
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PMID:[Successful TS-1 therapy in a patient with non-resectable gastric cancer and renal dysfunction]. 1114 71

Orbital metastases of hepatocellular carcinoma are rare. The authors report a case of hepatocellular carcinoma metastatic to the orbit. A 56-year-old woman with hepatitis B infection as confirmed serologic test for hepatitis B surface antigen (HBsAg) demonstrated superior displacement of the left eyeball. The clinical appearance of the patient demonstrated an inferior displacement of the right eye. MRI disclosed an orbital mass that extended toward the lower eyelid and into the temporal fossa with destruction of the lateral orbital wall. Upon subsequent abdominal computed tomographic scans, the primary tumor was found in the liver. A biopsy specimen of the orbit showed trabecular structures with eosinophilic cytoplasm. Bile canaliculi and sinusoids were also seen. The tumor cells showed vesicular nuclei with mitoses. Immunohistochemical markers such as high-molecular-weight keratin and alpha-fetoprotein showed a positive response. However, immunohistochemical markers such as low-molecular-weight keratin and polyclonal carcinoembryonic antigen showed as negative. We diagnosed the tumor as a hepatocellular carcinoma metastatic to the orbit. A review of the pertinent literature disclosed relatively few occurrences of hepatocellular carcinoma metastasizing to the orbit.
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PMID:Hepatocellular carcinoma metastatic to the orbit. 1121 42


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