Resumen\\u000a Objectivo Neustro objetivo es analizar los resultados del tratamiento adyuvante en pacientes operados por un carcinoma rectal localmente\\u000a avanzado, tratados con radioquimioterapia concomitante o secuencial.\\u000a \\u000a \\u000a \\u000a Material y métodos Entre enero de 1994 y septiembre de 1997, 122 pacientes fueron tratados postquirúrgicamente por un adenocarcinoma rectal en\\u000a estadio B2-C. Setenta y siete pacientes fueron tratados siguiendo un esquema alternante de quimiorradioterapia y
Javier Valencia Julve; Ricardo Escó Barón; Javier Sanz Lacalle; Miguel Burillo Cordero; Pedro Mateo de las Heras; Carmen Lainez Baquero
Serie de preguntas que los pacientes con cáncer pueden hacerle al médico sobre las opciones de tratamiento si el cáncer es avanzado, las formas de controlar los síntomas y cómo prepararse para la etapa final de la vida.
With the remarkable recent diagnostic and therapeutic advances and the discovery of a possible pathogenetic role of hepatitis B virus, the study and treatment of hepatocellular carcinoma are entering a new era. Parallel developments in the pathological study of this malignancy are also to be expected. To coincide with this new era, this book presents the authors' accumulated pathomorphological knowledge of hepatocellular carcinoma. The detailed coverage is based on the examination findings of 439 cases of hepatocellular carcinoma autopsied at the authors' department in the last twenty years.
Nakashima, T.; Kojiro, M.
Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC ... The cause of medullary carcinoma of the thyroid (MTC) is unknown. Unlike other types of thyroid cancer, MTC is less likely to be caused by radiation therapy to the neck given ...
The presence of distant metastases may be asymptomatic in patients who present with symptoms and signs due to the local mass effects of an invasive pituitary adenoma. A case of pituitary carcinoma in a 54-year-old man who presented with widespread asymptomatic distant metastases 12 years after initial diagnosis is reviewed. The long course and asymptomatic metastases suggested a relatively slow-growing malignancy. The factors that played a role in the pathogenesis of the metastasis are unknown. A review of the literature on pituitary carcinoma suggests that accurate diagnosis and a multidisciplinary approach to management of such lesions emphasizing surgery, radiotherapy, and hormonal manipulation may provide these patients with the longest and best quality of survival. ImagesFigure 1Figure 2Figure 3p48-bFigure 4Figure 5Figure 6
Cusimano, Michael D.; Ohori, Paul; Martinez, A. Julio; Jungreis, Charles; Wright, Donald C.
Parathyroid carcinoma is a rare cause of hypercalcaemia due to primary hyperparathyroidism. Ninety five percent of parathyroid carcinomas are functional tumours. Surgery is the only potential curative treatment. This is a case of a 53 years lady, who presented with pathological fracture of femur, hypercalcaemia, deranged renal functions, change in voice, difficulty in swallowing and markedly raised parathormone levels. Doppler ultrasound localized an irregular mass at right lower gland. SESTAMIBI scan showed probability of adenoma in the region of right lower thyroid pole. Intra-operatively, tumour was found stuck to esophagus and right recurrent laryngeal nerve passing through it. Enlarged parathyroid gland was removed in toto along with the recurrent laryngeal nerve, right thyroid lobe and its isthmus. PMID:23217487
Gauhar, Tooba Mahmud; Shahzad, Noman; Mahmud, Tayyaba; Khwaja, Muhammad Azim
This is a case of thymic carcinoma-a rare and highly aggressive type of tumor found in the anterior mediastinum. During a routine chest X-ray, a 66-yr-old male pilot was found to have a mediastinal mass. After diagnosis, he underwent chemotherapy, surgery, and radiation therapy and 1 yr after completion of these therapies he was re-issued a third-class medical certificate to fly. PMID:17225487
St Hill, Sacha
Parathyroid carcinoma is a rare endocrine malignancy. The reported incidence is from 0.5 to 5% of primary hyperparathyroidism cases in various series. The cause is unknown, but clinical correlations with different genetic syndromes exist. Mutations in the HPRT2 gene seem to play a significant role in the pathogenesis of this disease. Men and women are equally affected, usually in the fourth or fifth decade of life. Most patients will present with signs and symptoms of hypercalcaemia. Cases of non-functioning carcinoma are exceedingly rare. Surgical resection is the most effective method of treatment and palliation. A significant proportion of patients will experience recurrence, and will need further surgical and, eventually, medical management of hypercalcaemia. The disease is progressive but slow growing. Most patients will require multiple operations to resect recurrent disease. The main cause of morbidity and mortality is the sequela of uncontrolled chronic hypercalcaemia rather than tumour burden. The current paper will review the epidemiology, pathogenesis, clinical presentation and diagnostic work-up of this disease. Surgical management in different scenarios is reviewed in detail, followed by other types of treatment and management of incurable disease.
Givi, B.; Shah, J.P.
Bartholin gland carcinoma is a rare tumor. Treatment is not consensual due to the absence of prospective and randomized controlled trials. Bartholin gland carcinoma is actually treated similarly to primary median squamous cell carcinoma of the vulva. Here we report two cases of 42- and 67-year-old females who developed respectively an adenoid cystic carcinoma, and a squamous carcinoma of Bartholin gland. PMID:24951185
Chraibi, Z; Hebert, T; Body, G; Arbion, F; Ouldamer, L
Basosquamous carcinoma (BSC) is a rare aggressive epithelial neoplasm with features of both basal cell carcinoma and squamous cell carcinoma, with a tendency toward local recurrence and a propensity for lymph node and distant metastases. The aim of the present study was to report the case of a 63-year-old Caucasian male with BSC in the auricular region.
Lima, Nadia Lages; Verli, Flaviana Dornela; de Miranda, Joao Luiz; Marinho, Sandra Aparecida
Sclerosing mucoepidermoid carcinoma is an unusual type of mucoepidermoid carcinoma with special histological features which differ from those of the classic type of mucoepidermoid carcinoma. We report the case of a 32-year-old male, who reported to the Vydehi Institute of Dental Sciences, Bangalore, India, with an asymptomatic swelling over the right parotid region which had been present for the previous two and a half years. Histopathological sections of the tumour mass showed mucous and epidermoid cell nests in a dense, hyalinised, sclerotic stroma. A diagnosis of sclerosing mucoepidermoid carcinoma was made. A superficial parotidectomy was performed on the patient and he has remained disease free to date.
Bhat, Keshava; Pandey, Bhavna; Shetty, Pushparaja; Manohar, Vidya; Shruthilaxmi, M. K.; Patidar, Madhvika
Actinomycosis is rare compared to carcinoma, but the two conditions can present with very similar clinical pictures. Two cases of actinomycosis are reported, one thoracic and one pelvic-abdominal which presented as carcinoma and proceeded to surgery without a histological diagnosis having been established. PMID:8552543
Hinnie, J; Jaques, B C; Bell, E; Hansell, D T; Milroy, R
The authors are presenting here, a case of sebaceous carcinoma in a 50-year-old male who presented with 6-month history of a fungating mass in the right eye near medial canthus. Exenteration of eye was done, and a diagnosis of sebaceous carcinoma was made on histopathological examination.
Varshney, Manoranjan; Alam, Kiran; Aziz, Mehar; Maheshwari, Veena; Gaur, Kavita; Rizvi, SyedAli Raza
Renal cell carcinomas are rare in children, and they show significant differences in their histology and pathogenesis when compared to those common in adults. The most common subtypes seen preferentially in children are the translocation-associated tumors, papillary renal cell carcinoma, renal medullary carcinoma, and oncocytic renal cell carcinoma following neuroblastoma. The histological diagnosis of renal cell carcinoma is made difficult by the considerable heterogeneity within and overlap between each of the above subtypes and by similarities to other pediatric renal neoplasms. While no effective therapies have yet been identified, there is considerable promise that the new Children’s Oncology Group protocol will provide knowledge that will guide the future therapy of these lesions.
Perlman, Elizabeth J.
Fibrolamellar carcinomas are a unique type of primary liver cancer. They occur most commonly in children and young adults. Their etiology remains a mystery, as they are not associated with chronic liver disease. Fibrolamellar carcinomas are not indolent tumors, but have an overall better prognosis than typical hepatocellular carcinomas, in part because of the younger age at presentation and the lack of cirrhosis. The most important prognostic feature is whether the tumor is resectable. Histologically, the tumor is made up of large cells that contain abundant mitochondria. The nuclei of the tumor cells have prominent nucleoli. The tumor cells induce the formation of extensive intratumoral fibrosis, which often grows in parallel, or lamellar bands. The tumor cells clearly show hepatocellular features but are also unique in showing both biliary and neuroendocrine differentiation. The uniqueness of fibrolamellar carcinoma extends to their molecular findings. While the genetic abnormalities that lead to fibrolamellar carcinomas are not yet known, studies have shown that they lack mutations in the genes most commonly mutated in typical hepatocellular carcinoma (TP53 and CTNNB1). In this paper, the clinical, pathological, and basic science literature on fibrolamellar carcinoma is comprehensively reviewed. Key areas of needed research are also discussed.
Sarcomatoid renal cell carcinoma (SRCC) is an aggressive tumor variant thought to arise predominantly from differentiation of clear cell carcinoma. A few reports of SRCC associated with non-clear cell tumors led to the presumption that SRCC may arise from any renal cell carcinoma, although direct evidence of this is lacking. We report a case of a 70-year-old male patient, who presented with acute left upper quadrant abdominal pain and was diagnosed to have SRCC after pathological examination. The patient is on high dose interleukin (IL-2)-based immunotherapy and is apparently free of disease six months after surgery. PMID:21196626
Akhtar, Kafil; Shamshad, Ahmad; Sufian, Zaheer; Tariq, Mansoor
... a pathologist diagnose squamous cell lung carcinoma? Your primary care physician will conduct a thorough physical examination and ... test does not provide a definite diagnosis, your primary care physician may prescribe further tests, which may include ...
Forty-seven patients with rhinophyma were studied, five of whom had basal cell carcinoma of the nose. The microscopic changes of rhinophyma are characterized by epidermal epithelial hyperplasia and pilosebaceous gland hyperplasia, fibrosis, inflammation, ...
D. W. Acker E. B. Helwig
Renal cell carcinoma is the eighth most common malignancy in adults and the most common malignancy in the kidney. It is thus a very common disease for radiologists. This review aims to provide a general overview of the imaging techniques used to diagnose, characterize, and help plan the treatment of renal cell carcinoma as well as to review basic aspects related to staging, imaging-guided percutaneous treatment, and follow-up in the most common clinical scenarios. PMID:24268598
Bazan, F; Busto, M
Papillary thyroid carcinomas are the most common thyroid cancers and constitute more than 70% of thyroid malignancies. The\\u000a most common etiologic factor is radiation, but genetic susceptibility and other factors also contribute to the development\\u000a of papillary thyroid carcinoma. The most common variants include conventional, follicular variant and tall cell variant. However,\\u000a many other uncommon variants have been described including
Ricardo V. Lloyd; Darya Buehler; Elham Khanafshar
The authors present a case of a papillary type renal cell carcinoma. The tumor is mostly discovered accidentally; a histopathological evaluation is indispensable for an exact diagnosis. Because of a better prognosis, differentiation of this tumor type from the classic variant of renal cell carcinoma is necessary, however, the contralateral appearance of a second tumor is not to be excluded, which necessitates a strict patient follow-up. Prevalence of this tumor is higher in patients with chronic dialysis. PMID:11570010
Glasz, T; Rusz, A; Doros, A; Schaff, Z
Urinary carcinogens promote late malignant transformation of the colon after a ureterosigmoidostomy. An unusual case is presented where, despite the early removal of the latter and hence cessation of urine flow, a colonic carcinoma developed at the site of previous anastomosis. The importance of surveillance of all patients who have undergone this procedure to avoid an iatrogenic cancer is emphasised.???Keywords: rhabdomyosarcoma; ureterosigmoidostomy; colonic carcinoma
Huang, A; McPherson, G
Colorectal carcinoma is one of the most common cancers and one of the leading causes of cancer-related death in the United States. Pathologic examination of biopsy, polypectomy and resection specimens is crucial to appropriate patient managemnt, prognosis assessment and family counseling. Molecular testing plays an increasingly important role in the era of personalized medicine. This review article focuses on the histopathology and molecular pathology of colorectal carcinoma and its precursor lesions, with an emphasis on their clinical relevance.
Fleming, Matthew; Ravula, Sreelakshmi; Tatishchev, Sergei F.
Basal cell carcinoma is the commonest malignancy in Caucasians with incidence rates of 300 per 100,000 reported in the USA. Rates are increasing at over 10% per year leading to a lifetime risk of 30%. Although mortality is low, the disease is responsible for considerable morbidity and places a substantial burden on health service provision in the UK. Furthermore, lesions may recur and patients often develop multiple tumours giving major implications for treatment and follow-up. Four main types of basal cell carcinoma are seen: nodulo-ulcerative; pigmented; morpheaform and superficial. Diagnosis is by histological evaluation although many tumours have a characteristic clinical appearance. The differential diagnosis is large. Identified risk factors include male gender, skin type 1, red/blonde hair and increasing age. Patients with basal cell carcinoma are more likely to develop malignant melanoma and squamous cell carcinoma but it is still unclear whether there is a link with internal malignancy. The main treatment modalities are surgery and radiotherapy. Each has advantages and disadvantages. The choice of treatment depends on many factors. Principles of treatment include identification of high-risk patients to enable early detection, complete removal of the lesion, and careful follow-up to detect recurrence or new lesions. Approximately 10% of tumours recur, depending on site, size and treatment modality. Metastatic basal cell carcinoma and the association of ultraviolet radiation to basal cell carcinoma risk are reviewed. Images Figure 1 Figure 2 Figure 3 Figure 4
Lear, J. T.; Smith, A. G.
Adenoid cystic carcinoma is a rare tumor arising from the minor salivary glands;, the palate being the commonest site. Distant metastasis and perineural invasion areis common in adenoid cystic carcinoma. Diagnosis of adenoid cystic carcinoma is made usually with the help of clinical features, radiographic features and histologic features. We reported a case of adenoid cystic carcinoma of palate involving left maxillary sinus. The diagnosis of the case and brief review of literature of adenoid cystic carcinoma is discussed. The aim here is to highlight the importance of diagnosis, treatment and long-term follow-up of the patients with adenoid cystic carcinoma.
Mehta, Dhaval N.; Parikh, Shilpa J.
The most important condition associated with hepatocellular carcinoma is chronic hepatitis B virus infection. This article summarizes the information linking hepatocellular carcinoma with conditions other than hepatitis B virus infection. PMID:2542707
Lisker-Melman, M; Martin, P; Hoofnagle, J H
The aim of this study was to clarify the relationship of endometrial hyperplasia to endometrial carcinoma. From 1979 through 1990, 115 cases of stage I–IV endometrial carcinomas treated initially by hysterectomy were reviewed histologically. Forty-two of 115 (36.5%) patients had hyperplasia in the endometrium adjacent to the carcinoma. Women with both endometrial carcinoma and hyperplasia were significantly younger than those
Tsunehisa Kaku; Naoki Tsukamoto; Tooru Hachisuga; Nobuhiro Tsuruchi; Kunihiro Sakai; Toshio Hirakawa; Satoshi Amada; Toshiaki Saito; Toshiharu Kamura; Hitoo Nakano
The pathogenesis of thyroid carcinoma in Graves' goiter is still obscure and the methods for preoperative diagnosis of such carcinomas is not well established. We studied the incidence, clinical features, and pathological findings of thyroid carcinoma in Graves' goiter. From October, 1983 to September, 1985, a total of 739 patients with Graves' disease underwent subtotal thyroidectomy at Ito Hospital, Tokyo.
Osamu Ozaki; Kunihiko Ito; Kaoru Kobayashi; Koji Toshima; Hiroyuki Iwasaki; Tohru Yashiro
The most common presentation for carcinoma of the thyroid is as a cold nodule in the thyroid gland. Other appearances for thyroid carcinoma do exist, however; two such examples are presented. Incidence and presentation of thyroid carcinoma is discussed, as are guidelines for detecting patients that have a higher than average incidence of thyroid malignancy. PMID:3791789
Bartold, K P; Abghari, R; Sangi, V B
Esophageal carcinoma rarely metastasizes to brain. In our center, among 504 cases of esophageal cancer registered for treatment during a 15-year (1990-2005) period, brain metastasis from esophageal carcinoma was detected in only 1 case. An unusual case of esophageal carcinoma that presented with brain metastasis is reported here. PMID:19542674
Agrawal, Rashi; Shukla, Prity; Shukla, Vikas; Chauhan, Arvind
Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case of a 62-year old female with non-functional sarcomatoid carcinoma of the right adrenal gland. There was no radiological evidence of locoregional metastases. Patient underwent right adrenalectomy. Follow up after 3 months showed para-aortic lymphadenopathy and similar left adrenal mass on computed tomography. Patient refused further treatment and succumbed to the disease. A brief case report with review of literature is presented.
Shaikh, Aftab S.; Bakhshi, Girish D.; Khan, Arshad S.; Jamadar, Nilofar M.; Nirmala, Aravind Kotresh; Raza, Arif Ahmed
Bronchioloalveolar carcinoma is an exceptional morphological case of adenocarcinoma, compiling 3-9% of primary lung cancer. Its growth is characterized by spread of neoplastic cells in the peripheral air space without destroying underlying architecture. Carcinoma is spreading by blood vessels and alveoles. Bronchioloalveolar carcinoma distinguishes itself by variety of clinical and radiological symptoms. During the radiological researches separates consolidating infiltration and solitary types. They manifest by unequal density which can be in 30% incorrectly valuing as bronchopneumonia. The aim of our work is to analyze confirmed cases of bronchioloalveolar carcinoma and to summarize definite characteristic radiological signs, which can help to diagnose bronchioloalveolar carcinoma. PMID:12695640
Mikalauskas, Vytenis; Basevicius, Algidas; Sakalauskas, Raimundas
AIMS: To assess the presence of carcinoma in situ (CIS) in patients with nasopharyngeal carcinoma (NPC) and to see if the number of biopsy sites facilitates detection of CIS. METHODS: Formalin fixed, paraffin wax embedded biopsy specimens (n = 285) from 187 patients with NPC in 1987 were studied for the presence of CIS as well as for the histological assessment of the subtype of CIS. RESULTS: Fifteen (8.0%) patients had CIS, representing 8.3% of all new patients with NPC and 11.6% of patients with persistent disease or relapse. CIS was undifferentiated or poorly differentiated, no cases of well differentiated squamous cell CIS were identified. There was no significant difference in the incidence of CIS when multiple endoscopic biopsy specimens were taken rather than single forceps biopsy specimens. CONCLUSIONS: CIS can only be identified in a few patients with NPC largely because of late presentation with advanced disease at the time of diagnosis and the focal nature of the dysplastic process. The presence of dysplasia in relapses of NPC suggests that these tumours may be second growths rather than regrowths of a primary tumour. Images
Chan, C W; Nicholls, J M; Sham, J S; Dickens, P; Choy, D
An allelotype analysis of endometrial carcinoma was undertaken to identify chromosomal loci that are relevant to this tumor type. A total of 70 highly polymorphic microsatellite markers, distributed among all nonacrocentric chromosome arms, were examined for evidence of loss of heterozygosity or allelic imbalance in DNA samples from matched normal and tumor tissues. An average of 21 informative tumor cases
Takafumi Fujino; John I. Risinger; N. Keith Collins; Fu-shing Liu; Hiroshi Nishii; Hiroyuki Takahashi; Eva-Marie Westphal; J. Carl Barrett; Hiroshi Sasaki; Matthew F. Kohler; Andrew Berchuck; Jeff Boyd
To examine the extent and variation of allelic loss in a common adult tumor, polymorphic DNA markers were studied from every nonacrocentric autosomal arm in 56 paired colorectal carcinoma and adjacent normal colonic mucosa specimens. This analysis was termed an allelotype, in analogy with a karyotype. Three major conclusions were drawn from this analysis: (i) Allelic deletions were remarkably common;
Bert Vogelstein; Eric R. Fearon; Scott E. Kern; Ann C. Preisinger; Yusuke Nakamura; Ray White
Basal cell carcinoma is the commonest malignancy in Caucasians with incidence rates of 300 per 100,000 reported in the USA. Rates are increasing at over 10% per year leading to a lifetime risk of 30%. Although mortality is low, the disease is responsible for considerable morbidity and places a substantial burden on health service provision in the UK. Furthermore, lesions
J. T. Lear; A. G. Smith
During the past 11 years almost 4,000 necropsies have been performed at the Southern General Hospital, Glasgow, and of these, 924 showed malignancy of which 45 were of primary carcinoma multiplex. Two cases showed triple and one quadruple malignancy, and the remainder two primary malignant tumours. Images
Cameron, J. Malcolm; Litton, A.; Lyon, D. S.
Of the greater than 17,000 individuals with newly diagnosed thyroid carcinoma in the United States this year, 80% have papillary carcinoma and 5?10% have follicular carcinoma . These ‘‘differentiated carcinomas’’ derive from the thyroid hormone producing follicular epithelium. Cervical metastases from thyroid carcinoma are commonly identified, and less frequently metastases are found in extracervical locations such as lungs, bone, or
Steven I. Sherman
Recurrent Neuroendocrine Carcinoma of the Skin; Stage I Neuroendocrine Carcinoma of the Skin; Stage II Neuroendocrine Carcinoma of the Skin; Stage III Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin
This paper will focus on knowledge related to brain metastases from ovarian carcinoma. So far, less than 600 cases were documented in the literature with an incidence among ovarian carcinoma patients ranging from 0.29% to 11.6%. The ovarian carcinoma was usually an advanced-stage epithelial serous carcinoma, and the median interval between diagnosis of ovarian carcinoma and brain metastases was 2 years. Most often, brain metastases, affected the cerebrum, were multiple and part of a disseminated disease. Treatment of brain metastasis has evolved over the years from whole brain radiotherapy (WBRT) only to multimodal therapy including surgical resection or stereotactic radiosurgery followed by WBRT and/or chemotherapy. The median survival after diagnosis of brain metastases was 6 months; nevertheless, a significantly better survival was achieved with multimodal therapy compared to WBRT only. It is suggested that brain imaging studies should be included in the followup of patients after treatment for ovarian carcinoma.
Piura, Ettie; Piura, Benjamin
Cancer of the esophagus still poses considerable treatment problems, with a poor 5-year survival rate after surgery, an even worse outlook after radiation and surgery, and a not very satisfactory response to chemotherapy. After several years of continued research, in 1983 we developed a Radio Frequency System with endotract electrode and thermosensors for administering hyperthermochemoradiotherapy to patients with carcinoma of the esophagus. Results in 129 patients are discussed. Immediate improvement of subjective complaints and decrease or elimination of the cancer lesion are so distinct that this treatment, by means of an endotract antenna, shows promise as a modality for esophageal lesions and may find application in diseases such as colorectal cancer or carcinoma of the uterine cervix.
Sugimachi, K.; Inokuchi, K.
Opinion statement Advanced renal cell carcinoma (RCC) is a disease that is highly resistant to systemic therapy and is difficult to treat. Nephrectomy\\u000a should be seriously considered in patients who present with metastatic disease prior to systemic therapy, and surgery remains\\u000a a reasonable option in patients who present with resectable metastases. Numerous studies with many different treatment modalities,\\u000a including chemotherapy, immunotherapy,
Matthew I. Milowsky; David M. Nanus
Malignant tumours of the penis are a rare entity. They are mostly squamous cell carcinomas and arise from the glands or the coronal sulcus. Glans brachytherapy has been developed to avoid mutilating surgery and allow organ preservation. Indications of brachytherapy are tumours less than 4 cm with no invasion of the uretra or corpora cavernosa. Local control is equivalent after brachytherapy and surgery. This article describes the indications, the technique, outcome and toxicity of penile brachytherapy. PMID:23490170
Blanchard, P; Delannes, M; Haie-Meder, C
Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney cancer are highest in European\\u000a and Scandinavian countries and North America (1). It is estimated that 36,160 new cases of kidney and renal pelvis cancer were diagnosed in 2005, with an estimated 12,660\\u000a resulting deaths in the United States (2). There has been a
Ziya Kirkali; Cag Cal
Carcinoma of the breast is the most frequent cancer in women in the United States and the second leading cause of cancer deaths.\\u000a In the year 2005, it is estimated that more than 210,000 new cases will be diagnosed, while approx 40,000 will die from the\\u000a disease. A slight decrease in mortality has been noted in recent years, attributable to
John Hill; G. Thomas Budd
Colorectal cancer is the third most common malignancy in the United States, excluding skin carcinoma, and is the second leading cause of cancer-related death. The American Cancer Society estimated that approximately 145,000 new cases of colorectal cancer would be diagnosed in 2005 and approximately 56,000 people would die of the disease . Colorectal cancer death rates have been steadily declining
Martin J. O’Connell; Ronald B. Workman; R. Edward Coleman
This paper will focus on knowledge related to brain metastases from endometrial carcinoma. To date, 115 cases were documented in the literature with an incidence of 0.6% among endometrial carcinoma patients. The endometrial carcinoma was usually an advanced-stage and high-grade tumor. In most patients (~90%), brain metastasis was detected after diagnosis of endometrial carcinoma with a median interval from diagnosis of endometrial carcinoma to diagnosis of brain metastases of 17 months. Brain metastasis from endometrial carcinoma was either an isolated disease limited to the brain only (~50%) or part of a disseminated disease involving also other parts of the body (~50%). Most often, brain metastasis from endometrial carcinoma affected the cerebrum (~75%) and was solitary (~60%). The median survival after diagnosis of brain metastases from endometrial carcinoma was 5 months; however, a significantly better survival was achieved with multimodal therapy including surgical resection or stereotactic radiosurgery followed by whole brain radiotherapy (WBRT) and/or chemotherapy compared to WBRT alone. It is suggested that brain imaging studies should be considered in the routine follow up of patients with endometrial carcinoma and that the search for a primary source in females with brain metastases of unknown primary should include endometrial biopsy.
Piura, Ettie; Piura, Benjamin
A 24-year-old female patient with parathyroid carcinoma, the rarest endocrine malignancy, had two pregnancies. In the first pregnancy, she had severe nausea and fatigue. Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period. Hyperemesis gravidarum masked a diagnosis of hypercalcemia. Neck ultrasound and Tc-99m sestamibi found an enlarged lower right parathyroid gland. The gland was surgically removed, and an initial pathology report described atypical adenoma. Shortly afterward, she became pregnant again. During the second pregnancy, her calcium level was frequently controlled but was always in the normal range. Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution, hypoalbuminemia and maternal hypercalciuria (mediated by increased glomerular filtration). During lactation, calcium levels rose, and a new neck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node. Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells. The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes (pathology report; parathyroid carcinoma with metastases). Over the next five years, four consecutive surgeries were performed to remove malignant parathyroid tissue, lymph nodes and local metastases. Following the surgical procedures, no hypocalcemia was observed. More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate, cinacalcet and loop diuretic. No elements of multiple endocrine neoplasia were present.
Baretic, Maja; Tomic Brzac, Hrvojka; Dobrenic, Margareta; Jakovcevic, Antonia
Thirty-five of totally 50 patients with carcinoma vulvae were treated with bleomycin. Most of the patients were older people and had more advanced disease. They were grouped according to the TNM system and the age. Bleomycin alone (2 X 15 mg/m2 weekly; 390 and 420 mg total dose) was given to two patients. One of the patients had a complete remission and the other one a partial remission with reduction in tumor size of more than 50%. Nineteen patients received bleomycin (2 X 10 up to 2 X 15 mg/m2 weekly: 200-300 mg total dose) in combination with radiation therapy using fast electrons (betatron; 3000-5000 R). In this group 21,1% of the patients had complete remission and 31,5% of patients had a partial remission of more than 50% tumor size reduction (objective remission rate 52,6%). Bleomycin was also beneficial when combined with surgery plus irradiation. Palliative irradiation was used in four patients with a very advanced disease. Eleven patients were irradiated postoperatively with fast electrons (4000-6000 R). In this group, 65% of the patients were free from recurrences more than one year after the beginning of the treatment. Our results indicate that combined therapies using bleomycin, surgery and radiation therapy were more effective in the treatment of vulvar carcinoma than single treatments alone. It should be emphasized that bleomycin is effective as a palliative treatment of squamous cell carcinoma of the vulva. PMID:59432
Marici?, Z; Kolari?, K; Krusi?, J
NUT midline carcinoma (NMC) is a rare, genetically defined, aggressive human cancer defined by rearrangements of the gene NUT. In the majority (approximately 75%) of NMCs most of the coding sequence of NUT on chromosome 15q14 is fused BRD4 or BRD3, creating chimeric genes that encode BRD-NUT fusion proteins. In the remaining cases, NUT is fused to an unknown partner gene; these tumors are termed NUT-variant. Diagnosis of NMC is made by demonstration of expression of the NUT-fusion protein using a monoclonal antibody to NUT for immunohistochemistry, and confirmation of the fusion (BRD-NUT or NUT-variant) by fluorescent in situ hybridization or RT-PCR. Because the reagents and expertise required to diagnose NMC are not available in most laboratories, and the incomplete awareness of this disease, NMC is frequently undiagnosed or misdiagnosed, and its actual prevalence is unknown. NMC does not arise from any specific tissue type or organ. It presents as a poorly differentiated carcinoma originating from midline locations such as the head, neck or mediastinum. Although rare, NMCs occur throughout life and advanced local disease is frequently accompanied by distant hematogenous metastases. There remains no effective treatment for NMC, there are no guidelines, and current approaches to treatment are based on discussions amongst a few oncologists who each have had a single experience treating this disease. BRD-NUT functions to block cellular differentiation and promote uncontrolled growth of carcinoma cells.
Nasophryngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for
P. J. Moloy; Y. T. Chung; P. B. Krivitsky; R. C. Kim
Gallbladder carcinoma is an aggressive cancer associated with a poor prognosis. Unfortunately, the precise molecular mechanisms of development and progression of this highly malignant tumor remain unknown. It is still unclear whether loss of heterozygosity (LOH) plays a significant role in gallbladder carcinogenesis, but recent studies have found a high incidence of LOH at several chromosomes in gallbladder carcinoma. In
Tamotsu Kuroki; Yoshitsugu Tajima; Kei Matsuo; Takashi Kanematsu
Congenital absence of vagina is a very rare anomaly and treatment is surgical. As this anomaly is a rare condition, carcinoma arising in the neovagina is also rare. Optimal treatment of this malignancy has not yet been determined. A carcinoma in the Davydov neovagina is reported upon with a review of the literature. PMID:1547936
Balik, E; Maral, I; Sözen, U; Bezircioglu, I; Tugsel, Z; Velibese, S
Adrenocortical carcinoma is a rare heterogeneous neoplasm with an incompletely understood pathogenesis and a poor prognosis. Previous studies have identified overexpression of insulin-like growth factor 2 (IGF-2) and constitutive activation of ?-catenin as key factors involved in the development of adrenocortical carcinoma. Most patients present with steroid hormone excess, for example Cushing syndrome or virilization, or abdominal mass effects, but
Rossella Libé; Matthias Kroiss; Bruno Allolio; Martin Fassnacht
The occurence of squamous cell carcinoma on long-lasting ulcers is classic. Malignant transformation may occur on burn scars and chronic ulcers of varying etiology, including infectious agents. Transformation of old lobomycosis lesion scars into squamous cell carcinoma has been rarely reported. Careful and long-term follow-up of such patients is important to avoid carcinomatous transformation.
Nogueira, Lisiane; Rodrigues, Luciana; Rodrigues, Carlos Alberto Chirano; Santos, Monica; Talhari, Sinesio; Talhari, Carolina
Background: Carcinomas in children are rare and have not been well studied. Methods: We conducted a population-based case–control study and examined associations between birth characteristics and childhood carcinomas diagnosed from 28 days to 14 years during 1980–2004 using pooled data from five states (NY, WA, MN, TX, and CA) that linked their birth and cancer registries. The pooled data set contained 57?966 controls and 475 carcinoma cases, including 159 thyroid and 126 malignant melanoma cases. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: White compared with ‘other' race was positively associated with melanoma (OR=3.22, 95% CI 1.33–8.33). Older maternal age increased the risk for melanoma (ORper 5-year age increase=1.20, 95% CI 1.00–1.44), whereas paternal age increased the risk for any carcinoma (OR=1.10per 5-year age increase, 95% CI 1.01–1.20) and thyroid carcinoma (ORper 5-year age increase=1.16, 95% CI 1.01–1.33). Gestational age <37 vs 37–42 weeks increased the risk for thyroid carcinoma (OR=1.87, 95% CI 1.07–3.27). Plurality, birth weight, and birth order were not significantly associated with childhood carcinomas. Conclusion: This exploratory study indicates that some birth characteristics including older parental age and low gestational age may be related to childhood carcinoma aetiology.
Johnson, K J; Carozza, S E; Chow, E J; Fox, E E; Horel, S; McLaughlin, C C; Mueller, B A; Puumala, S E; Reynolds, P; Von Behren, J; Spector, L G
Non-invasive breast cancer is comprised of two distinct entities: lobular carcinoma in-situ (LCIS) and ductal carcinoma in-situ (DCIS). The natural history of each clinical entity is described and a biologic interpretation of the available data is offered. Lobular carcinoma in-situ is considered only a risk marker rather than a precursor for the subsequent development of invasive cancer, so that once the diagnosis is established, further operative intervention is unnecessary and serial follow-up alone is recommended. The treatment of ductal carcinoma in-situ must take into account that breast-preserving therapy is now considered optimal treatment of invasive cancer of the breast, the disease we are trying to prevent. The pitfalls of recommending treatment based on retrospective data is emphasized and the need to support clinical trials designed to determine the optimal therapeutic management of intraductal carcinoma is affirmed. PMID:1325215
Posner, M C; Wolmark, N
Like the Jews, the Ibos or Igbos of Nigeria ritually circumcise males on the eighth day of birth. A retrospective review of approximately 15,000 surgical specimens collected from this ethnic group over a period of 13 years revealed 32 cases of carcinoma of the prostate but only 4 cases of penile carcinoma. One tumour arose on the glans penis. This localisation pattern suggests that, in circumcised males, smegma-induced squamous carcinoma of the glans can be abolished but not the ordinary squamous carcinoma that can develop by chance on the rest of the penis as well as on the glans. International urology would benefit from careful documentation of squamous carcinoma affecting various parts of the neonatally circumcised penile skin. PMID:4027519
Onuigbo, W I
Chemokines play a paramount role in tumor progression. In hepatocellular carcinoma (HCC) progression, chemokines and their receptors play an intricate role. Currently, chemokines and their receptors such as the CXCL12-CXCR4 axis, CX3CL1-CX3CR1 axis and the CCL20-CCR6 axis have received much research attention. Although a large number of studies show that these axes are strongly associated with HCC, the exact mechanism by which these axes promote the growth and progression of HCC remains unknown. In this paper, several chemokines and their receptor interactions in HCC progression, growth and metastasis and immune response to HCC are reviewed.
Huang, Fan; Geng, Xiao-Ping
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world. In most cases, HCC is diagnosed at a late stage. Therefore, the prognosis of patients with HCC is generally poor. The recommended screening strategy for patients with cirrhosis includes the determination of serum ?-fetoprotein (AFP) levels and an abdominal ultrasound every 6 months to detect HCC at an earlier stage. AFP, however, is a marker characterized by poor sensitivity and specificity, and abdominal ultrasound is highly dependent on the operator's experience. In addition to AFP, Lens culinaris agglutinin-reactive AFP (AFP-L3), des-?-carboxy prothrombin (DCP), glypican-3 (GPC-3), osteopontin (OPN), and several other biomarkers (such as squamous cell carcinoma antigen-immunoglobulin M complexes [SCCA-IgM], alpha-1-fucosidase [AFU], chromogranin A [CgA], human hepatocyte growth factor, insulin-like growth factor) have been proposed as markers for the early detection of HCC. For these markers, we describe the mechanisms of production, and their diagnostic and prognosis roles. None of them is optimal; however, when used together, their sensitivity in detecting HCC is increased. Recent research has shown that some biomarkers have mitogenic and migratory activities in the angiogenesis of HCC and are a factor of tumor growth. PMID:22846859
Bertino, Gaetano; Ardiri, Annalisa; Malaguarnera, Michele; Malaguarnera, Giulia; Bertino, Nicoletta; Calvagno, Giuseppe Stefano
The majority of the patients with advanced prostate carcinoma have painful skeletal metastases, which are responsible for significant skeletal morbidity and disability. Most of these metastases are osteosclerotic, but it has been shown that the abnormal osteoblastic bone formation within metastases is preceded by osteoclastic activation, which appears to be associated with bone pain. This provides the rationale for using bisphosphonates, which are powerful and selective inhibitors of osteoclastic bone resorption. Several bisphosphonates have been shown to be clinically useful for the treatment of several conditions characterized by abnormal osteoclastic bone resorption, including Paget's disease, primary hyperparathyroidism, myelomatosis, and skeletal metastases. Its efficacy in relieving pain in patients with skeletal metastases due to prostate carcinoma has been confirmed in a few studies. The bisphosphonate clodronate was extensively investigated in the study unit. When infused intravenously i.v. (300 mg/day) relief of bone pain become appreciable within 3 days, sometimes preceded by a transient pain flare. These clinical results are very consistent and the residual pain usually is of extraosseous origin. Thus, with regard to pain of strictly bone origin, unresponsive patients are quite rare. Oral administration also is effective, but due to its limited intestinal absorption the effective dose is on the order of 1600-3200 mg/day. These doses usually are well tolerated, but they may be a problem for severely ill patients. Furthermore, the efficacy of treatment becomes apparent only after a few days. Thus, oral clodronate usually is adopted as a continuation of an i.v. course. The duration of the i.v. therapy should be individualized, but usually the more prolonged the treatment the longer the duration of the effect. For practical reasons, clodronate is infused daily for 5 days (Monday-Friday) and the treatment course is repeated at the time of any significant recurrence. The oral continuation prevents or delays the recurrence of bone pain in most patients, but in some patients this therapy has to be integrated occasionally with i.v. infusion. The duration of the effect for the same bioavailable dose is somewhat related to the degree of malignancy of the primary tumor. In an uncontrolled study, the author also evaluated the effectiveness of alendronate given either i.v. or orally. A single infusion of 5 mg alendronate i.v. produces roughly the symptomatic effect of 5 i.v. infusions of 300 mg clodronate. Alendronate, 40 mg orally/day, was effective in reducing bone pain in 11 of 12 patients with bone metastases due to prostate carcinoma but who were not confined to bed. In some patients with prostate carcinoma and a diffuse metastatic invasion of the skeleton, there is indirect biochemical and histologic evidence of osteomalacia. This can be aggravated by bisphosphonate administration because of the transient striking prevalence of osteoblastic activity over bone resorption, which also occasionally causes the appearance of symptomatic hypocalcemia. Therefore, the use of large oral supplements of calcium is recommended, particularly at the start of therapy. It is conceivable that these calcium supplements also may be able to improve the final clinical outcome of the bisphosphonate therapy. In conclusion, administration of large doses of bisphosphonates is one of the most cost-effective palliation treatments for patients with prostate carcinoma with bone metastases, both as first-line therapy and in the long term. With appropriate doses, a large proportion of patients can be maintained free of bone pain until death. Studies of the ability of lower doses to prevent skeletal morbidity in patients without metastases or with asymptomatic bone lesions are warranted. PMID:9362435
Background The hepatocellular carcinoma is one of the most common malignant tumors and carries a poor survival rate. The management of\\u000a patients at risk for developing HCC remains intricate.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A literature search identified potential markers for hepatocellular carcinoma. These markers were analysed and justification\\u000a was provided for these factors’ inclusion to (or exclusion from) the markers of hepatocellular carcinoma (HCC).
Giulia Malaguarnera; Maria Giordano; Isabella Paladina; Massimiliano Berretta; Alessandro Cappellani; Mariano Malaguarnera
Hepatocellular carcinoma (HCC) is responsible for a large proportion of cancer deaths worldwide. HCC is frequently diagnosed after the development of clinical deterioration at which time survival is measured in months. Long-term survival requires detection of small tumors, often present in asymptomatic individuals, which may be more amenable to invasive therapeutic options. Surveillance of high-risk individuals for HCC is commonly performed using the serum marker alfa-fetoprotein (AFP) often in combination with ultrasonography. Various other serologic markers are currently being tested to help improve surveillance accuracy. Diagnosis of HCC often requires more sophisticated imaging modalities such as CT scan and MRI, which have multiphasic contrast enhancement capabilities. Serum AFP used alone can be helpful if levels are markedly elevated, which occurs in fewer than half of cases at time of diagnosis. Confirmation by liver biopsy can be performed under circumstances when the diagnosis of HCC remains unclear.
Di Bisceglie, Adrian M.
Today, hepatocellular carcinoma (HCC) represents the leading cause of death in patients with liver cirrhosis; in most western countries the incidence is also expected to increase further. Due to insufficient surveillance of patients at risk, most cases are diagnosed in an intermediate to advanced stage, leading-together with the underlying liver cirrhosis-to limited therapeutic options and a dismal prognosis. Therefore, classification according to stage and interdisciplinary treatment decisions in experienced centers are of paramount importance to provide an individualized treatment plan when considering potentially curative (resection, liver transplantation, local ablation) and palliative (transarterial approaches, sorafenib) treatment options. There is hope that the prognosis of patients with HCC can be improved in the near future by better prevention, stringent surveillance, multimodality treatment approaches, and an expansion of personalized medicine. PMID:24240604
Wörns, M A; Klöckner, R; Weinmann, A; Galle, P R
Hepatocellular carcinoma (HCC) is considered to be one of the most common malignancies worldwide, and the most common one in Africa and Asia. Over the last decade, a rising incidence of up to 10-15/100,000 per population has been seen in the Western world, with an estimate of 250,000 deaths and more than a million worldwide per year. By the year 2010, the World Health Organization expects that HCC will be the leading cause of cancer mortality surpassing lung cancer. This increasing incidence is most likely related to an increasing prevalence of chronic hepatitis C (HC) and B (HB) virus infections and other diseases inducing chronic inflammation (Befeler and Di Bisceglie 2002; Llovet et al. 2003).
Helmberger, Thomas K.
Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive neoplasm of the paranasal sinuses, which has recently been characterized as a distinct pathologic entity. The prognosis for patients with SNUC is poor. Early case reports describe patients with lesions that were clinically advanced at initial presentation and surgically unresectable. Survival was reported in months after treatment with chemotherapy and radiation. As more experience was gained with treatment of SNUC, it was found that aggressive, combined surgical therapy of lesions previously considered unresectable has shown increased survival. We report a case of a 38-year-old man with SNUC originating in the posterior ethmoid, extending into the anterior cranial fossa and orbit, who was treated with preoperative hyperfractionated radiation therapy, chemotherapy, and craniofacial resection. ImagesFigure 1Figure 2
Pitman, Karen T.; Costantino, Peter D.; Lassen, Lorenz F.
Merkel cell carcinoma (MCC) is a rare, clinically aggressive cutaneous neuroendocrine neoplasm with a high mortality rate. Though the etiology is not precisely known, Merkel cell polyomavirus (MCV) DNA has been found recently in a large percentage of MCC tumors. Other suggested risk factors include sun-exposure, immunosuppression and a history of prior malignancy. Work-up of patients with MCC most notably includes nodal staging via clinical exam or sentinel lymph node biopsy (SLNB). The prognosis for most patients with MCC is poor, and the rarity of MCC precludes the prospective, randomized clinical trials necessary to elucidate optimum treatment protocols. Most published data support the use of a multimodality approach centered around surgical excision with negative margins, SNLB to establish the presence or absence of nodal metastases, adjuvant radiothearpy (RT) to decrease the risk of recurrence, and systemic chemotherapy in the case of widespread disease.
Ramahi, Emma; Choi, Jehee; Fuller, Clifton D.; Eng, Tony Y.
Thyroid cancers represent about 1% of all human cancers. Differentiate thyroid carcinomas (DTCs), papillary and follicular cancers, are the most frequent forms, instead Anaplastic Thyroid Carcinoma (ATC) is estimated to comprise 1–2% of thyroid malignancies and it accounts for 14–39% of thyroid cancer deaths. The annual incidence of ATC is about one to two cases/million, with the overall incidence being higher in Europe (and area of endemic goiter) than in USA. ATC has a more complex genotype than DTCs, with chromosomal aberrations present in 85–100% of cases. A small number of gene mutations have been identified, and there appears to be a progression in mutations acquired during dedifferentiation. The mean survival time is around 6?months from diagnosis an outcome that is frequently not altered by treatment. ATC presents with a rapidly growing fixed and hard neck mass, often metastatic local lymph nodes appreciable on examination and/or vocal paralysis. Symptoms may reflect rapid growth of tumor with local invasion and/or compression. The majority of patients with ATC die from aggressive local regional disease, primarily from upper airway respiratory failure. For this reason, aggressive local therapy is indicated in all patients who can tolerate it. Although rarely possible, complete surgical resection gives the best chance of long-term control and improved survival. Therapy options include surgery, external beam radiation therapy, tracheostomy, chemotherapy, and investigational clinical trials. Multimodal or combination therapy should be useful. In fact, surgical debulking of local tumor, combined with external beam radiation therapy and chemotherapy as neoadjuvant (before surgery) or adjuvant (after surgery) therapy, may prevent death from local airway obstruction and as best may slight prolong survival. Investigational clinical trials in phase I or in phase II are actually in running and they include anti-angiogenetic drugs, multi-kinase inhibitor drugs.
Taccaliti, Augusto; Silvetti, Francesca; Palmonella, Gioia; Boscaro, Marco
Thyroid cancers represent about 1% of all human cancers. Differentiate thyroid carcinomas (DTCs), papillary and follicular cancers, are the most frequent forms, instead Anaplastic Thyroid Carcinoma (ATC) is estimated to comprise 1-2% of thyroid malignancies and it accounts for 14-39% of thyroid cancer deaths. The annual incidence of ATC is about one to two cases/million, with the overall incidence being higher in Europe (and area of endemic goiter) than in USA. ATC has a more complex genotype than DTCs, with chromosomal aberrations present in 85-100% of cases. A small number of gene mutations have been identified, and there appears to be a progression in mutations acquired during dedifferentiation. The mean survival time is around 6?months from diagnosis an outcome that is frequently not altered by treatment. ATC presents with a rapidly growing fixed and hard neck mass, often metastatic local lymph nodes appreciable on examination and/or vocal paralysis. Symptoms may reflect rapid growth of tumor with local invasion and/or compression. The majority of patients with ATC die from aggressive local regional disease, primarily from upper airway respiratory failure. For this reason, aggressive local therapy is indicated in all patients who can tolerate it. Although rarely possible, complete surgical resection gives the best chance of long-term control and improved survival. Therapy options include surgery, external beam radiation therapy, tracheostomy, chemotherapy, and investigational clinical trials. Multimodal or combination therapy should be useful. In fact, surgical debulking of local tumor, combined with external beam radiation therapy and chemotherapy as neoadjuvant (before surgery) or adjuvant (after surgery) therapy, may prevent death from local airway obstruction and as best may slight prolong survival. Investigational clinical trials in phase I or in phase II are actually in running and they include anti-angiogenetic drugs, multi-kinase inhibitor drugs. PMID:22783225
Taccaliti, Augusto; Silvetti, Francesca; Palmonella, Gioia; Boscaro, Marco
We have recently described a new nail tumor known as onychocytic matricoma. Herein, we describe its malignant counterpart. Clinically, the tumor simulates onychomatricoma (OM). Histologically, this in situ malignant epithelial tumor exhibits a distinct picture of onychocytic differentiation with signs of both nail matrical differentiation and nail plate differentiation. We have proposed the name onychocytic carcinoma for this singular adnexal neoplasm. Given the peculiar thickening of the nail plate observed in OM, onychocytic matricoma, and onychocytic carcinoma, the clinical individualization of a new type of nail band pattern could be proposed. It presents as an acquired localized (monodactylous) longitudinal pachyonychia. Such longitudinal pachyonychia allow the recognition of the matrical nail tumor, which has a limited etiological spectrum. Xantholeucopachyonychia suggests mainly OM and rarely onychocytic carcinoma. Pachymelanonychia suggests onychocytic matricoma and rarely pigmented OM or onychocytic carcinoma. PMID:23518638
Perrin, Christophe; Langbein, Lutz; Ambrossetti, Damien; Erfan, Nouran; Schweizer, Jürgen; Michiels, Jean-François
January 09, 2009 7:30 AM - 6:00 PM National Institutes of Health Neurosciences Center Rockville MD + Add to Outlook Calendar Workshop on Merkel Cell Carcinoma Basic, Epidemiologic, Translational and Clinical Research January 9th, 2009 National Institutes
\\u000a In this article, we review available evidence on the treatment of patients with nonurothelial cancer of the bladder. More\\u000a than 150 published works were reviewed in preparation for this summary. Squamous cell carcinoma and adenocarcinoma are ideally\\u000a treated with radical cystectomy. High-risk groups for these diseases are defined. Small cell carcinoma should be treated with\\u000a multimodality therapy, including chemotherapy. Other
Hassan Abol-Enein; Bruce R. Kava; Adrienne J. K. Carmack
Adrenocortical carcinoma is a rare heterogeneous neoplasm with an incompletely understood pathogenesis and a poor prognosis. Previous studies have identified overexpression of insulin-like growth factor 2 (IGF-2) and constitutive activation of ?-catenin as key factors involved in the development of adrenocortical carcinoma. Most patients present with steroid hormone excess, for example Cushing syndrome or virilization, or abdominal mass effects, but a growing proportion of patients with adrenocortical carcinoma (currently >15%) is initially diagnosed incidentally. No general consensus on the diagnostic and therapeutic measures for adrenocortical carcinoma exists, but collaborative efforts, such as international conferences and networks, including the European Network for the Study of Adrenal Tumors (ENSAT), have substantially advanced the field. In patients with suspected adrenocortical carcinoma, a thorough endocrine and imaging work-up is recommended to guide the surgical approach aimed at complete resection of the tumor. To establish an adequate basis for treatment decisions, pathology reports include the Weiss score to assess malignancy, the resection status and the Ki67 index. As recurrence is frequent, close follow-up initially every 3 months is mandatory. Most patients benefit from adjuvant mitotane treatment. In metastatic disease, mitotane is the cornerstone of initial treatment, and cytotoxic drugs should be added in case of progression. Results of a large phase III trial in advanced adrenocortical carcinoma are anticipated for 2011 and will hopefully establish a benchmark therapy. New targeted therapies, for example, IGF-1 receptor inhibitors, are under investigation and may soon improve current treatment options. PMID:21386792
Fassnacht, Martin; Libé, Rossella; Kroiss, Matthias; Allolio, Bruno
Gallbladder carcinoma is an aggressive cancer associated with a poor prognosis. Unfortunately, the precise molecular mechanisms of development and progression of this highly malignant tumor remain unknown. It is still unclear whether loss of heterozygosity (LOH) plays a significant role in gallbladder carcinogenesis, but recent studies have found a high incidence of LOH at several chromosomes in gallbladder carcinoma. In particular, LOH on chromosomes 1p, 3p, 5p, 8p, 9p, 9q, 13q, 16q, and 17p has been highlighted and LOH on 3p, 9p, 13q, 16q, and 17p has been detected in preneoplastic lesions and in the early phase of gallbladder carcinoma during multistep carcinogenesis. The proto-oncogene, K-ras, is the best known genetic alteration in several human neoplasms, including gallbladder carcinoma. The accumulation of these genetic changes leads to a disruption in cell-cycle regulation and also continuous cell proliferation. We present an overview of K-ras alteration and LOH at several chromosome loci in gallbladder carcinoma. Further studies of the molecular mechanism in gallbladder carcinoma and the delineation of the genetic influence involved should promote our understanding of gallbladder carcinogenesis. PMID:15674488
Kuroki, Tamotsu; Tajima, Yoshitsugu; Matsuo, Kei; Kanematsu, Takashi
One-hundred-and-seventeen patients with histologically proven carcinoma of the gallbladder are reviewed. The majority of the patients presented with advanced disease with extension and metastasis to the liver and to lymph nodes along the common bile duct. Four patients had localized disease recognized at the time of operation; two were treated with cholecystectomy and two with cholecystectomy and hepatic resection. There were no five-year survivals among these patients. Fourteen patients had clinically inapparent carcinoma at the time of cholecystectomy; the diagnosis being established postoperatively by histologic examination of the excised gallbladder. There were two five-year survivors in this group of patients. Both survivors had early papillary carcinoma confined to the gallbladder wall. The remaining patients with inapparent carcinoma died within three years of the time of operation with recurrent carcinoma. The present report and review of the recent literature emphasizes the poor prognosis associated with carcinoma of the gallbladder. Even with apparently localized lesions, the survival rate is extremely poor. Extended resection, while not of proven value, may improve the survival rate.
Beltz, William R.; Condon, Robert E.
Background It is known that all tumors studied in sufficient number to draw conclusions show characteristic/specific chromosomal rearrangements, and the identification of these chromosomes and the genes rearranged behind the aberrations may ultimately lead to a tailor-made therapy for each cancer patient. Knowledge about the acquired genomic aberrations of ovarian carcinomas is still unsatisfactory. Methods We cytogenetically analyzed 110 new cases of ovarian carcinoma of different histological subtypes using karyotyping of G-banded chromosomes and high-resolution comparative genomic hybridization. We first compared the aberration patterns identified by the two genomic screening techniques using the so-called “classical” pathological classification in which the carcinomas are grouped as tumors of types I and II. We also broke down our findings according to the more “modern” classification which groups the carcinomas in five different categories. Results The chromosomal breakpoints identified by karyotyping tended to cluster to 19p/q and to 11q, but no unquestionably recurrent rearrangement could be seen. Common imbalances were scored as gains from 1q, 3q, 7q, and 8q and losses from 17p, 19q, and 22q. Gain of material from 8q23 and losses from 19q and 22q have previously been described at high frequencies in bilateral and borderline ovarian carcinomas. The fact that they were present both in “precursor” lesions, i.e., borderline tumors, as well as in tumors of more advanced stages, i.e., carcinomas, highlights the possibility of an adenoma-carcinoma sequence in ovarian carcinogenesis. Conclusion Based on the relatively simple genomic changes we identified in the low-grade serous carcinomas examined (n?=?7) and which largely corresponded to the aberration pattern formerly identified in borderline tumors, one can interpret the cytogenetic data as supporting the view that the low-grade carcinomas represent a phenotypically more advanced stage of borderline tumors. Whether transition from low-grade to high-grade carcinoma also occurs, is a question about which the genomic data is still inconclusive.
One of the major controversies in dermatopathology is the relationship of keratoacanthoma to squamous cell carcinoma. Leaders in the field remain polarized in their views. Carcinomas with distinct follicular pattern of differentiation have been described in reference to the isthmus as trichilemmal carcinomas, to the follicular bulb as pilomatricomal carcinomas, and to the stem cell or rapidly amplifying cell compartment as basal cell carcinomas (trichoblastic carcinomas). We have employed the term infundibulocystic or infundibular squamous cell carcinoma to identify a subset of squamous cell carcinomas that demonstrate this pattern of differentiation. The recognition of infundibular squamous cell carcinoma is important in that well-differentiated examples are likely to have been diagnosed as keratoacanthoma, whereas moderately or poorly differentiated tumors would be more often reported as squamous cell carcinomas, leading to underrecognition of these infundibular variants of squamous cell carcinoma. The descriptive term infundibulocystic or infundibular squamous cell carcinoma may help to better define an alternative follicular-based pathway to squamous cell carcinoma distinct from the more common evolution from solar keratoses and also refine the classification of keratoacanthoma. PMID:18360115
Kossard, Steven; Tan, Kong-Bing; Choy, Carolyn
We are reporting a case of a 42-yr-old female with a history of right breast carcinoma. She was surgically treated (breast quadrantectomy with axillary dissection) and receiving a third cycle of adjuvant chemotherapy when a feeling of a constant pressure in the front of the neck and lack of air occurred. Subsequent work-up revealed a node in the right thyroid lobe with enlarged paratracheal bilateral and right mid and lower jugular lymph nodes. Fine-needle aspiration cytology, repeated within a 20 days window and analyzed by two different cytologists, showed a medullary thyroid carcinoma with a cervical lymph nodes metastasis so the patient underwent total thyroidectomy with selective and paratracheal neck dissection. Histology and immunohistochemistry revealed the specimen to be metastasis of breast carcinoma. During regular follow-up of our patient, eighteen months after initial diagnosis, no new metastases were found. To our best knowledge, this is the first described case of a thyroid metastasis of breast carcinoma that was cytologically misdiagnosed as a medullary thyroid carcinoma. PMID:23397757
Slipac, Juraj; Janjanin, Sasa; Ljepava, Dejan; Hutinec, Zdenka; Bence-Zigman, Zdenka
... signs of thymoma and thymic carcinoma include a cough and chest pain. Sometimes thymoma and thymic carcinoma ... you have any of the following problems: A cough that doesn't go away. Chest pain. Trouble ...
BackgroundThis study assesses the risk of bronchogenic carcinoma after solid organ transplantation. Although the overall incidence of malignancy is increased after solid organ transplantation, the risk of bronchogenic carcinoma in the transplant population has not been systematically studied.
Marc de Perrot; Dennis A Wigle; Andrew F Pierre; Ming S Tsao; Thomas K Waddell; Thomas R. J Todd; Shaf H Keshavjee
Although the experts acknowledge that there is no conclusive evidence linking secondhand smoke to head and neck cancer, a recent report by the Environmental Protection Agency classifies secondhand smoke as a group A carcinogen. There is strong evidence linking it to carcinoma of the lung. Whereas you may not be able to tell your patient that the same cause and effect is present for head and neck cancer, it is the editor's belief that this will one day be proven. Three experts agreed to treat this patient with surgery followed by full-course radiotherapy, although the surgical approaches differed. They included a marginal mandibulectomy, radical neck dissection, and plating of the remaining mandible (Dr. Strome) and a composite resection (Drs. Ward and Johnson). For reconstruction, options included a modified FAMM flap or a split-thickness skin graft (Dr. Strome), tongue flap or pectoralis major myocutaneous flap (Dr. Ward), or a split-thickness skin graft (Dr. Johnson). One consultant suggested resecting the neck mass and treating the primary tumor and neck with radiotherapy. A dental consultation is in order prior to radiotherapy (Dr. Goepfert). With regard to this woman's mental status, all the experts called for counseling. The husband should be included in the discussions (Dr. Strome and Ward) and consideration should be given to the Women's Right Advocacy Group (Dr. Johnson). PMID:8407321
Strome, M; Ward, P; Johnson, J; Goepfert, H
Anaplastic thyroid carcinoma may represent the ultimate dedifferentiation step of thyroid tumorigenesis and is one of the poorest cancers in human. It accounts for less than 2% of thyroid cancers and affects older patients in their sixth to eighth decade. Usual clinical presentation is a rapidly growing thyroid mass invading surrounding structures with compressive symptoms. Cervical lymph nodes enlargement and distant metastases occur frequently. Though cytological results obtained by fine needle aspiration may be suggestive of diagnosis, tissue biopsy for immunohistochemical study can be necessary to exclude lymphoma and to validate aggressive therapies. Patients developing anaplastic thyroid cancer must be referred urgently in cancer centers to plan multimodality therapeutic approach depending on their performance status. The treatment regimen combines surgery when feasible, hyperfractionated and accelerated external beam radiotherapy and doxorubicin based chemotherapy. Such treatment can provide control of locoregional disease but does not impact on overall survival in patients with distant metastases. The prognosis is dismal with a mean survival of four to nine months after diagnosis. Long survivors are patients with emerging disease presenting a resectable tumor and receiving adjuvant radiotherapy and/or chemotherapy. Therapeutic researches investigate redifferenciation strategies and targeted therapies to inhibit EGF receptors and neoplastic angiogenesis. Primary prevention of this lethal disease may consist of adequate treatment of differentiated thyroid cancers and goiters in elderly. PMID:18423422
Wemeau, J-L; Do Cao, C
Clear cell renal cell carcinoma(ccRCC)with a von Hippel-Lindau(VHL)gene alteration is the most frequent histological phenotype of renal cell cancer(RCC). This gene alteration suppresses ubiquitination and increases hypoxia-inducible factor (HIF)-alpha accumulation, resulting in the upregulation of HIF-alpha target genes, which in turn leads to hypervascular tumor formation. Sorafenib, sunitinib, axitinib, and pazopanib are kinase inhibitors that block vascular endothelial growth factor receptor(VEGFR). Other families of targeted drugs for RCC are antibodies against VEGF, such as bevacizumab, and mammalian target of rapamycin inhibitors, such as temsirolimus and everolimus, which exert anti-angiogenic effects by downregulating HIF-alpha expression. Thus, the newly developed targeted drugs for RCC are classified as anti-angiogenic drugs. However, the frequency of a sustained complete response(CR)in response to these drugs is quite low, indicating that the exploration of other modalities of treatment, besides anti-angiogenic drugs, is warranted. PMID:24743196
A 55-year-old man who presented himself with gross hematuria and right back pain was found to have a right renal mass with evidence of metastasis to the lymph nodes, bone and lung (cT1bN1M1). He underwent a transperitoneal right nephrectomy. Tumor expressed markers of CD10, P504S and CK19 immunohistochemically, so histopathological examination revealed tubulocystic carcinoma of the right kidney (pT3a). After the patient received sunitinib therapy, computed tomography revealed reduction in the size of the metastatic lung nodule and lymph nodes, indicating a partial response. He is alive without disease progression at 12 months after nephrectomy. Tubulocystic carcinoma has been referred to by Amin et al as low-grade collecting duct carcinoma and is not yet included in the World Health Organization (WHO) 2004 classification of renal tumors. The cells lining the tumor range from cuboidal to columnar and have large nuclei with low-grade changes and abundant eosinophilic or amphophilic cytoplasm. Hobnail cells are commonly seen. Immunohistochemically, tubulocystic carcinomas are strongly positive for markers of the proximal nephron (CD10, P504S) and the distal nephron (parvalbumin, CK19). Despite a low nuclear grade, tubulocystic carcinomas occasionally show progressive behavior clinically. Although there is no established salvage therapy, sunitinib was found to be effective for this patient. PMID:22191279
Teramoto, Sakiko; Niwakawa, Masashi; Muraoka, Kentaro; Ogawa, Masahiro; Kunieda, Futoshi; Matsuzaki, Masato; Yamashita, Ryo; Matsui, Takashi; Yamaguchi, Raizo; Tobisu, Ken-ichi
Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis, and it can be classified as either a functional or nonfunctional tumor. Affected patients usually present with abdominal pain or with symptoms related to the mass effect or hormonal activity of the tumor. Several cases of spontaneously ruptured nonfunctional adrenocortical carcinoma have been reported, but no case of a spontaneous rupture of functioning adrenocortical carcinoma has been described. We report a functioning adrenocortical carcinoma that spontaneously ruptured during a work-up.
Chung, Jin Ook; Cho, Dong Hyeok; Lee, Jae Hyuk; Kwon, Dong Deuk; Chung, Dong Jin
Primary carcinomas of small intestine are rare, and most are adenocarcinomas. Duodenum is the commonest site. Primary squamous cell carcinomas are exceptional. Small intestine, however, is the commonest site for metastatic spread in the gastrointestinal tract. Both adeno and squamous cell carcinoma from a wide variety of sites can metastasise to the small intestine. The authors report a case of a squamous cell carcinoma arising in the ileum of a 65-year-old woman.
Mumtaz, Shazia; Ahmad, Zubair; Fatima, Saira; Qureshi, Asim
Fibrolamellar hepatocellular carcinoma is a subtype of hepatocellular carcinoma occurring in non-cirrhotic liver at a younger\\u000a age. The tumor expresses both hepatocellular and cholangiocellular markers. Previously, our group described overexpression\\u000a of tight junction protein claudin 4 in cholangiocellular carcinoma in contrast to hepatocellular carcinoma. In the present\\u000a study, tight junction protein expressions were studied to possibly clarify bipotential lineage of
Attila Patonai; Boglárka Erdélyi-Belle; Anna Korompay; Áron Somorácz; Beate K. Straub; Peter Schirmacher; Ilona Kovalszky; Gábor Lotz; András Kiss; Zsuzsa Schaff
Mammary small cell carcinoma (SmCC) is a very rare neoplasm with a poor prognosis compared with other invasive carcinomas. We studied the histological and immunohistochemical profiles of two cases of mammary SmCC, and compared them with those of five cases of carcinoma with endocrine features (CEF) and five cases of invasive ductal carcinoma (IDC), to elucidate the correct diagnosis of mammary SmCC. Immunohistochemical analysis was performed with antibodies against cytokeratins (CKAE1/AE3, CK34betaE12, CKCAM5.2, CK7, CK8, CK19, CK20), epithelial membrane antigen (EMA), vimentin, CD10, neural cell adhesion molecule (NCAM; CD56), neuron-specific enolase (NSE), chromogranin A, S-100 protein, carcino-embryonic antigen (CEA), E-cadherin, N-cadherin, thyroid transcription factor-1 (TTF-1), p53, estrogen (ER), progesterone (PR), HER2/neu, bcl-2, synaptophysin, calcitonin and Leu7. SmCCs were diffusely and strongly positive for NCAM in comparison with CEFs and IDCs. SmCCs were negative for vimentin, whereas CEFs and IDCs were positive. Neuro-endocrine carcinomas, including SmCCs and CEFs, were diffusely and strongly positive for NSE, compared with IDCs. Moreover, neuroendocrine carcinomas were negative for CK34betaE12, CK20 and CD10, whereas IDCs were positive. Our study suggests that NCAM and vimentin are useful markers for the diagnosis of mammary SmCC. CK34betaE12, NSE, CD10, CK20 and chromogranin A appear to be useful for differentiating neuroendocrine carcinoma from IDCs. PMID:15010880
Yamamoto, Junya; Ohshima, Koichi; Nabeshima, Kazuki; Ikeda, Seiyou; Iwasaki, Hiroshi; Kikuchi, Masahiro
Primary small cell carcinomas of the kidney are rare, locally aggressive and fatal neoplasms. Approximately half of the reported cases show combined features of transitional cell carcinoma. We reported an unusual case of primary small cell carcinoma of the kidney and studied with light microscopy, immunohistochemistry and flow cytometry. PMID:12684121
Kilicarsalan Akkaya, Bahar; Mustafa, Usta; Esin, Ozel; Turker, Koksal; Gulten, Karpuzoglu
Four different genetic abnormalities may occur in endometrioid adenocarcinomas of the endometrium (mircosatellite instability and mutations in the PTEN, k-RAS and ?-catenin genes), whereas nonendometrioid carcinomas of the endometrium often have p53 mutations and loss of heterozygosity on several chromosomes. Occasionally, a nonendometrioid carcinoma may develop as a result of dedifferentiation of a preexisting endometrioid carcinoma; in such a case,
Xavier Matias-guiu; Lluis Catasus; Elena Bussaglia; Helena Lagarda; Arnald Garcia; Cristina Pons; Josefina Muñoz; Rosmary Argüelles; Pilar Machin; Jaime Prat
Syringoid eccrine carcinoma is a very rare skin tumor. Herein we describe a 72-year-old male patient presenting with a syringoid eccrine carcinoma of the nipple with associated axillary lymph node metastases. Surgery associated with adjuvant radiotherapy was performed. To the best of our knowledge, this is the first case of syringoid eccrine carcinoma of the nipple ever reported.
Ballardini, Pierluigi; Margutti, Guido; Pedriali, Massimo; Querzoli, Patrizia
Syringoid eccrine carcinoma is a very rare skin tumor. Herein we describe a 72-year-old male patient presenting with a syringoid eccrine carcinoma of the nipple with associated axillary lymph node metastases. Surgery associated with adjuvant radiotherapy was performed. To the best of our knowledge, this is the first case of syringoid eccrine carcinoma of the nipple ever reported. PMID:23754922
Ballardini, Pierluigi; Margutti, Guido; Pedriali, Massimo; Querzoli, Patrizia
Nasopharyngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for diagnosis and follow-up study. The virus has not been conclusively shown to cause nasopharyngeal cancer, however. Histologically, nasopharyngeal carcinoma is anaplastic in 75% of cases and better differentiated in 25% of patients. All tumors are treated by high-dose irradiation to the primary site and both sides of the neck. Surgical treatment, in the neck only, is reserved for irradiation failures. The prognosis is better in patients younger than 40 years, in patients without clinical cervical nodal involvement and, unexpectedly, in patients with anaplastic tumors. ImagesFigure 1.Figure 2.
Moloy, Peter J.; Krivitsky, Paul B.; Kim, Ronald C.; Chung, Yiu Ting
Nasopharyngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for diagnosis and follow-up study. The virus has not been conclusively shown to cause nasopharyngeal cancer, however.Histologically, nasopharyngeal carcinoma is anaplastic in 75% of cases and better differentiated in 25% of patients. All tumors are treated by high-dose irradiation to the primary site and both sides of the neck. Surgical treatment, in the neck only, is reserved for irradiation failures. The prognosis is better in patients younger than 40 years, in patients without clinical cervical nodal involvement and, unexpectedly, in patients with anaplastic tumors. PMID:2994305
Moloy, P J; Chung, Y T; Krivitsky, P B; Kim, R C
Nasophryngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for diagnosis and follow-up study. The virus has not been conclusively shown to cause nasopharyngeal cancer, however. Histologically, nasopharyngeal carcinoma is anaplastic in 75% of cases and better differentiated in 25% of patients. All tumors are treated by high-dose radiation to the primary site and both sides of the neck. Surgical treatment, in the neck only, is reserved for irradiation failures. The prognosis is better in patients younger than 40 years, in patients without clinical cervical nodal involvement and, unexpectedly, in patients with anaplastic tumors. 18 references, 2 figures, 2 tables.
Moloy, P.J.; Chung, Y.T.; Krivitsky, P.B.; Kim, R.C.
We studied 80 hepatocellular carcinomas from three continents for p53 gene (TP53) mutations and hepatitis B virus (HBV) sequences. p53 mutations were frequent in tumors from Mozambique but not in tumors from South Africa, China, and Germany. Independent of geographic origin, most tumors were positive for HBV sequences. X gene coding sequences of HBV were detected in 78% of tumors, whereas viral sequences in the surface antigen- and core antigen-encoding regions were present in less than 45% of tumors. These observations indicate that hepatocellular carcinomas are genetically heterogeneous. Mozambican-type of hepatocellular carcinomas are characterized by a high incidence of p53 mutations related to aflatoxins. In other tumors, the rarity of p53 mutations combined with the frequent presence of viral X gene coding sequences suggests a possible interference of HBV with the wild-type p53 function.
Unsal, H; Yakicier, C; Marcais, C; Kew, M; Volkmann, M; Zentgraf, H; Isselbacher, K J; Ozturk, M
Tumor-to-tumor metastasis of breast carcinoma to meningioma is a rare phenomenon. It is likely underdiagnosed given the relatively high prevalence and comorbidity of these two primary tumor types, the lack of standardized methodologies for its diagnosis, and the tendency to obfuscate this lesion with simple meningioma or cerebral metastasis of breast carcinoma. Careful histopathologic study of the resected meningioma is the cornerstone of diagnosis of these lesions, although certain conventional radiological features along with specialized modalities may clue the diagnosis. Vigilance for this lesion is appropriate in selected patients with known breast cancer or meningioma, as the two are often coexistent in the same patient, permitting tumor-to-tumor metastasis. Detection of this rare disease process may alter the treatment plan and prognosis. Here, we report a case of breast carcinoma-to-meningioma metastasis in a patient who developed subacute neurological decline while undergoing long-term treatment of her primary, late-stage breast cancer.
Sayegh, Eli T.; Henderson, Grant A.; Burch, Ezra A.; Reis, Gerald F.; Cha, Soonmee; Oh, Taemin; Bloch, Orin; Parsa, Andrew T.
The authors studied 80 hepatocellular carcinomas from three continents for p53 gene (TP53) mutations and hepatitis B virus (HBV) sequences. p53 mutations were frequent in tumors from Mozambique but not in tumors from South Africa, China, and Germany. Independent of geographic origin, most tumors were positive for HBV sequences. X gene coding sequences of HBV were detected in 78% of tumors, whereas viral sequences in the surface antigen- and core antigen-encoding regions were present in less than 35% of tumors. These observations indicate that hepatocellular carcinomas are genetically heterogeneous. Mozambican-types of hepatocellular carcinomas are characterized by a high incidence of p53 mutations related to aflatoxins. In other tumors, the rarity of p53 mutations combined with the frequent presence of viral X gene coding sequences suggests a possible interference of HBV with the wild-type p53 function.
Unsal, H.; Isselbacher, K.J. (Massachusetts General Hospital Cancer Center, Charlestown, MA (United States)); Yakicier, C.; Marcais, C.; Ozturk, M. (Institut National de la Sante et de la Recherche Medicale, Lyon (France)); Kew, M. (Univ. of Witwatersrand, Johannesburg (South Africa)); Volkmann, M. (Univ. of Heidelberg (Germany)); Zentgraf, H. (Deutsches Krebsforschungszentrum, Heidelberg (Germany))
Adrenocortical carcinoma (ACC) is an orphan malignancy that has attracted increasing attention during the last decade. Here we provide an update on advances in the field since our last review published in this journal in 2006. The Wnt/?-catenin pathway and IGF-2 signaling have been confirmed as frequently altered signaling pathways in ACC, but recent data suggest that they are probably not sufficient for malignant transformation. Thus, major players in the pathogenesis are still unknown. For diagnostic workup, comprehensive hormonal assessment and detailed imaging are required because in most ACCs, evidence for autonomous steroid secretion can be found and computed tomography or magnetic resonance imaging (if necessary, combined with functional imaging) can differentiate benign from malignant adrenocortical tumors. Surgery is potentially curative in localized tumors. Thus, we recommend a complete resection including lymphadenectomy by an expert surgeon. The pathology report should demonstrate the adrenocortical origin of the lesion (eg, by steroidogenic factor 1 staining) and provide Weiss score, resection status, and quantitation of the proliferation marker Ki67 to guide further treatment. Even after complete surgery, recurrence is frequent and adjuvant mitotane treatment improves outcome, but uncertainty exists as to whether all patients benefit from this therapy. In advanced ACC, mitotane is still the standard of care. Based on the FIRM-ACT trial, mitotane plus etoposide, doxorubicin, and cisplatin is now the established first-line cytotoxic therapy. However, most patients will experience progress and require salvage therapies. Thus, new treatment concepts are urgently needed. The ongoing international efforts including comprehensive "-omic approaches" and next-generation sequencing will improve our understanding of the pathogenesis and hopefully lead to better therapies. PMID:24081734
Fassnacht, Martin; Kroiss, Matthias; Allolio, Bruno
Thyroid cancer is a rare disease. Aetiological factors are increased secretion of TSH and exposure of the growing gland to ionizing radiation. Pathological classification is in two main groups: differentiated and undifferentiated. Differentiated is subdivided into papillary, follicular and medullary. Papillary and medullary carcinomas occur in young patients, grow slowly, spread by lymphatics. Treatment is surgical excision of thyroid and affected nodes plus thyroid hormone replacement. Follicular carcinoma spreads by blood to lungs and bones. Treatment is total thyroidectomy and radioiodine therapy of the metastases followed by thyroid hormone replacement. Undifferentiated tumours occur in old patients. They are identified by drill biopsy and treated with radiotherapy.
Forty-eight patients with advanced bronchogenic carcinoma were treated with a combination of CCNU and Adriamycin. There was an overall objective response rate of 38%. This consisted of 1 of 12 (8%) patients with epidermoid carcinoma, 5 of 15 (33%) with adenocarcinoma, 2 of 5 (40%) with large cell undifferentiated carcinoma and 10 of 16 (63%) with small cell undifferentiated carcinoma. The overall median survival time (MST) from initiation of therapy was 28 weeks. The MST was 18 weeks for patients with epidermoid carcinoma, 30 weeks for those with adenocarcinoma, 39 weeks for those with large cell carcinoma, and 30+ weeks for those with small cell carcinoma. Objective tumor response was associated with prolonged survival. There were no drug related deaths and toxicity was minimal. PMID:206337
Trowbridge, R C; Kennedy, B J; Vosika, G J
Introduction. Most common metastasis sites of breast cancer are the lungs, bones, liver, and brain, whereas uterine involvement by metastatic breast disease is rare. Metastatic carcinoma of the uterus usually originates from other genital sites, most commonly being from the ovaries. Invasive lobular carcinoma spreads to gynecologic organs more frequently than invasive ductal carcinoma. Case Report. A 57-year-old postmenopausal woman was diagnosed with breast carcinoma 2 years ago and modified radical mastectomy was performed. Pathological examination of tumor revealed invasive ductal carcinoma, stage IIIc. She presented with abdominal pain and distension. Diagnostic workup and gynecologic examination revealed lesions that caused diffuse thickening of the uterus wall. Endometrial sampling was performed for confirmation of the diagnosis. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Breast carcinoma metastases in endometrium and myometrium were confirmed histopathologically and immunohistochemically. Conclusion. We herein report the first case of isolated uterine patient who had invasive ductal carcinoma of breast.
Arslan, Deniz; Tural, Deniz; Tatl?, Ali Murat; Akar, Emre; Uysal, Mukremin; Erdogan, Gulgun
Secretory carcinoma is a rare form of breast carcinoma which has a predilection for juveniles and young adults (usually less than 30 years of age), becoming progressively less common with advancing age. It is a low grade breast carcinoma which shows distinct features at histology. Diagnosis of this carcinoma on fine needle aspiration cytology (FNAC) is difficult. We report a case of a 62-year-old woman diagnosed to have secretory carcinoma of breast on FNAC. Histopathological examination confirmed the diagnosis. The recognition of secretory carcinoma is important because the cytological findings can be confused with those of lactating breast. Preoperative diagnosis is essential for appropriate surgical therapy. Secretory carcinoma is reported to have good prognosis, but surgical therapy with an axillary node dissection is recommended, since axillary metastases have been found in approximately 30% of the recorded cases. PMID:22438622
Shanthi, Vissa; Rama Krishna, Baddukonda Appala; Rao, Nandam Mohan; Sujatha, Ciddarla
Since February, 1977, 735 patients having a history of receiving radiation therapy for benign conditions of the head and neck areas during infancy and childhood were examined in a thyroid screening program, and 159 patients were found to have palpable thyroid nodules. These patients had thyroid function tests and indirect laryngoscopy and were followed closely on suppression therapy consisting of either Cytomel or thyroid extract. Thyroidectomy was advised in those in whom the nodules persisted or increased in size. This study documents the incidence of carcinoma and other benign pathological changes and postoperative complications in this group of patients. So far, 49 patients had either a lobectomy with isthmusectomy or a total thyroidectomy. Eleven patients were found to have carcinoma (six had papillary, fou had mixed papillary and follicular, and one had follicular carcinoma). Three patients had a therapeutic modified neck dissection following the documentaion of microscopic involvement of paratracheal lymph nodes. A high incidence of chronic nonspecific thyroiditis, postradiation fibrosis, and follicular adenomas were also found in these patients. Three patients had temporary hypocalcemia (two weeks) and none had wound infection, hematoma, or postoperative nerve palsy. Of patients who had surgical resection, 22.4% showed thyroid carcinoma.
Razack, M.S.; Sako, K.; Shimaoka, K.; Getaz, E.P.; Rao, U.; Parthasarathy, K.L.
Since February 1977, 735 patients having a history of receiving radiation therapy for benign conditions of the head and neck areas during infancy and childhood were examined in a thyroid screening program, and 159 patients were found to have palpable thyroid nodules. These patients had thyroid function tests and indirect laryngoscopy and were followed closely on suppression therapy consisting of either Cytomel or thyroid extract. Thyroidectomy was advised in those in whom the nodules persisted or increased in size. This study documents the incidence of carcinoma and other benign pathological changes and postoperative complications in this group of patients. So far, 49 patients had either a lobectomy with isthmusectomy or a total thyroidectomy. Eleven patients were found to have carcinoma (six had papillary, four had mixed papillary and follicular, and one had follicular carcinoma). Three patients had a therapeutic modified neck dissection following the documentation of microscopic involvement of paratracheal lymph nodes. A high incidence of chronic nonspecific thyroiditis, postradiation fibrosis, and follicular adenomas were also found in these patients. Three patients had temporary hypocalcemia (two weeks) and none had wound infection, hematoma, or postoperative nerve palsy. Of patients who had surgical resection, 22.4% showed thyroid carcinoma.
Razack, M.S.; Sako, K.; Shimaoka, K.; Getaz, E.P.; Rao, U.; Parthasarathy, K.L.
Differentiated thyroid carcinoma accounts for 90% of all thyroid cancers and occurs as papillary carcinoma in 90% of cases. It was shown as this is characterized by an excellent long-term prognosis, although in follow-up long series, were described recurrence rates up to 35%. Although in the past has not been attributed prognostic significance to the lymph nodes, in the last decade has shown how these can affect the rate of locoregional recurrence of differentiated thyroid carcinoma. This renewed interest in lymph node metastatic disease has prompted a shift in surgical treatments more aggressive, with a view to achieving a low incidence of locoregional recurrence. Analyzing the more recent guidelines formulated at the international level, we can highlight how we gradually consolidated the role of prophylactic central compartment lymphadenectomy in the surgical treatment of patients with differentiated thyroid carcinoma. The aim of this treatment, in fact, is not only to reduce the mortality of patients, but to obtain an adequate staging, facilitate radiotherapy treatment, obtain undetectable thyroglobulin levels, avoiding the need for repeated reiterventi, made more simple follow-up. All these objectives can be achieved by careful surgery. Total thyroidectomy associated with prophylactic lymphadenectomy of the central compartment was found to achieve these objectives, although in the absence of data from randomized trials, its role remains controversial. PMID:20646368
Varaldo, E; Ansaldo, G L; Puglisi, M; Pennati, S; Torre, G C
The purpose of this paper is to review the indications for transrectal ultrasound; to briefly describe the sonographic technique; to describe the sonographic findings of prostatic carcinoma; to review the indications for transrectal sonographic-guided biopsy; and to discuss the controversles of routine screening and staging. ImagesFigures 1-3
Murray, Daniel J.; Cooperberg, Peter L.; Goldenberg, S. Larry; Toi, Ants
Up to the mid 19 (th) century primary bronchial carcinoma was unknown. Primary tumours and metastases of malignant lung tumours were often not distinguished one from the other. Only in 1871, Theodor Langhans from Marburg reported the first certain observation of bronchial carcinoma. Definite information on the increasing frequency of lung and bronchial carcinomas at the beginning of the 20 (th) century was only obtained by autopsy statistics. The Cancer Registry of the Saarland showed that the incidence of lung cancer has not increased since 1970 in men, but has tripled in women. Already in 1923, Theodor Fahr from Hamburg referred to the danger of smoking. In Germany the so-called Schneeberg's lung cancer plays an important role among occupational lung cancer diseases. Only after Germany's reunification the drama of the uranium miners of the former so-called Wismut AG became fully known. Regarding occupational diseases, asbestos-related bronchial carcinomas and mesotheliomas are at the top of the causes of death today. PMID:15343491
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The major etiologies and risk factors for development of HCC are well defined and some steps of hepatocellular carcinogenesis have been elucidated. Despite these scientific advances and the implementation of measures for early detection of HCC in patients who are at risk of this disease, survival of patients
Hans Christian Spangenberg; Robert Thimme; Hubert E. Blum
The renal cell carcinoma (RCC) rarely occurs in childhood. We report here 3 cases of RCC in children. Two girls and 1 boy aged 14, 8 and 13 years old, respectively, presented with gross hema- turia as their main complaint. They underwent ultrasonography and computerized tomography, which revealed unilateral renal tumor with lymph nodal involvement in all 3 cases. They
Luciano R. Barros; Sidney Glina; Luiz F. Mello
INTRODUCTION Primary gallbladder carcinoma is a rare aggressive neoplasm of elderly with poor prognosis. The tumour is often unresectable at the time of diagnosis. Metastasis to heart is rare and only 6 cases have been reported in the indexed literature. We herein report a case of gallbladder carcinoma metastasizing to heart. PRESENTATION OF CASE A 54 year old female presented with dyspnoea and chest pain with past history of radical cholecystectomy and palliative chemotherapy for adenocarcinoma of gallbladder. Chest X-ray showed cardiomegaly and 2-D ECHO revealed features of tumour deposits on the surface of myocardium and malignant pericardial effusion. Mini-thoracotomy and pericardial window procedure was done to relieve distressing symptoms and biopsy of pericardial tissue revealed metastatic adenocarcinoma. In spite of intensive care, patient succumbed to disease in the post-operative period. DISCUSSION Primary adenocarcinoma of gallbladder is the most common malignancy of biliary tract and fifth most common malignancy of gastro-intestinal system with dismal prognosis. It most commonly spreads to liver and regional lymph nodes, very rarely distant metastasis occurs to kidney, adrenal, thyroid and bones as reported in the literature. Metastasis to heart presents with symptoms of cardiac failure due to pericardial effusion. Even with intensive care patients will invariably succumb to the disease. CONCLUSION Metastatic spread to heart from carcinoma of gallbladder is very rare. Should a patient be suspected of or an operated case of gallbladder carcinoma present with symptoms of congestive heart failure and massive pericardial effusion, cardiac metastasis should be considered.
Gunjiganvi, Mallikarjun; Singh, Ksh Kala; Harsha, H.S.; Bipin, Th
Abstract Background No effective systemic therapy exists for patients with advanced hepatocellular carci- noma. A preliminary study suggested that sorafenib, an oral multikinase inhibitor of the vascular endothelial growth factor receptor, the platelet-derivedgrowth factor receptor, and Raf may be effective in hepatocellular carcinoma. Methods
Josep M. Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F. Greten; Peter R. Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix
We report a patient with longstanding Darier's disease (DD) involving the mucous membrane of the esophagus who developed esophageal carcinoma. A number of small white plaques were observed around the carcinoma in the postoperative specimens of the esophageal mucosal epithelium. Histopathological findings of the specimens near the carcinoma showed suprabasal clefts and villi formation, features consistent with DD, with no evidence of malignancy. There was some speculation on the pathogenic relationship between esophageal carcinoma and DD in this patient, but nothing was confirmed. Immunohistochemistry of lesional skin examined with antibody against desmogleins (Dsgs) 1 + 2 showed a diffuse pattern throughout the cytoplasm in most of the suprabasal acantholytic cells, whereas some of the spherical acantholytic cells showed a ring pattern surrounding the nucleus. In electron microscopy, these areas stained with Dsgs corresponded to dispersed tonofibrils in the suprabasal acantholytic cells and perinuclear aggregation of tonofibrils in the spherical acantholytic cells. This implies that in DD patients, some affinity remains after acantholysis between Dsgs and intermediate filaments, possibly through other desmosomal components. PMID:10980472
Shimizu, H; Tan Kinoshita, M T; Suzuki, H
The combined occurrence of pancreatic carcinoma with acute or chronic pancreatitis is seldom seen in medical practice, but when present it is a challenging dilemma, plagued by confusing overlapping clinical findings and pitfalls in diagnostic imaging tests. This article reviews the presumptive pathophysiological aspects of this relationship, the perplexing clinical presentations and the advantages and limitations of the noninvasive imaging
E. J. Balthazar
Patients with metastatic renal cell carcinoma (RCC) generally show a poor prognosis; treatment approaches have not significantly improved patient survival. Temsirolimus inhibits the mammalian target of rapamycin kinase. Clinical studies have shown positive results when the drug is administered to patients with this disease.The clinical benefit of temsirolimus for poor-risk, advanced RCC patients was demonstrated in a Phase III study
T. Otto; C. Eimer; H. Gerullis
Hepatocellular carcinoma is the sixth most common cancer globally and the second most lethal cancer worldwide. This SnapShot depicts the molecular and morphological features of this heterogeneous disease, as well as outlines associated prognostic factors, current and emerging therapies, and challenges ahead. PMID:24735926
Marquardt, Jens U; Thorgeirsson, Snorri S
In Western industrialized countries, colorectal adenocarcinoma is the second most common solid malignant tumor. Despite radical surgery in 75% to 80% of all cases, about 50% of patients with colorectal carcinoma die of this tumor. The essential advances of the last years are the reduction in the surgical complication rate and postoperative mortality. Recent studies show that radiotherapy for rectal
Thirty-one patients with malignant tumors of the middle ear and external auditory canal (EAC) were observed at the University of Virginia Hospital from 1956 through 1980. Of 27 patients with carcinoma, 21 had squamous cell carcinoma, 4 had basal cell carcinoma and 2 had adenoid cystic carcinoma. The 27 patients with carcinoma are reviewed with regard to clinical presentation, treatment
S. S. Hahn; J. A. Kim; N. Goodchild; W. C. Constable
We reclassified 720 nonmedullary invasive thyroid carcinomas diagnosed and treated between 1975 and 1993. Twenty-seven cases met the criteria of insular carcinoma and 29 cases those of widely invasive follicular carcinoma. Comparison of these histotypes with respect to pathologic stage and overall, relative, and visceral metastasis-free survival showed a significant association between histotype and pT and pN categories. In particular, pT4 (p < 0.001) and pN1 (p < 0.001) categories were more frequent in the insular carcinoma histotype. By contrast, no significant differences in overall, relative, or visceral metastasis-free survival were observed between insular carcinoma and widely invasive follicular carcinoma. Molecular analysis by polymerase chain reaction-single-strand conformation polymorphism demonstrated RAS gene family point mutations in five of eight cases analyzed in each of the two histotypes, with a high proportion of CAA-->AAA transversion at codon 61 of the N-RAS gene in insular carcinoma. These findings suggest that insular carcinoma represents a de novo entity distinct from widely invasive follicular carcinoma, that widely invasive follicular carcinoma has biologic characteristics more consistent with poorly differentiated than well-differentiated carcinomas, and that both insular carcinoma and widely invasive follicular carcinoma share similar molecular alterations. PMID:9414190
Pilotti, S; Collini, P; Mariani, L; Placucci, M; Bongarzone, I; Vigneri, P; Cipriani, S; Falcetta, F; Miceli, R; Pierotti, M A; Rilke, F
Background Metaplastic breast carcinoma is a rare aggressive malignant neoplasm. The purposes of this study are to review the pathologic features and clinical outcomes of metaplastic breast carcinoma compared to invasive ductal carcinoma and to evaluate the prognosis of metaplastic breast carcinoma. Methods The cases of 55 patients with metaplastic breast carcinomapresenting between 1991 and 2006 were analyzed and compared to the cases of 767 age-matched patients with invasive ductal carcinoma from the same time period. Results The group of patients with metaplastic breast carcinoma presented with a larger tumor size, lower lymph node involvement, higher percentage of triple-negative (estrogen receptor-, progesterone receptor- and human epidermal growth factor receptor-2-negative) cases, and Ki-67 over-expression compared with the group of patients with invasive ductal carcinoma and triple-negative invasive ductal carcinomas. Patients in the metaplastic breast carcinoma group tended to have more local (often chest wall) recurrences (P = 0.038) and distant (often lung) metastases (P = 0.001) than those in the invasive ductal carcinomas group. The prognosis of metaplastic breast carcinoma was poorer than that of invasive ductal carcinoma and triple-negative invasive ductal carcinomas; the 5-year overall survival rate was 54.5% in metaplastic breast carcinoma versus 85.1% in invasive ductal carcinoma, and 73.3% in triple-negative invasive ductal carcinomas (P <0.001). The 5-year disease-free survival rate was 45.5% in metaplastic breast carcinoma versus 71.2% in invasive ductal carcinoma, and 60.3% in triple-negative invasive ductal carcinomas (P <0.001). Multivariate analysis revealed tumor size larger than 5.0 cm, lymph node involvement and Ki-67?14% were significantly related to 5-year overall survival (P = 0.010; P = 0.010; P = 0.035) and 5-year disease-free survival (P = 0.020; P = 0.018; P = 0.049). Conclusions Metaplastic breast carcinoma shows a poorer prognosis than both invasive ductal carcinoma and triple-negative invasive ductal carcinomas. Tumor size larger than 5.0 cm, lymph node involvement and Ki-67 ?14% indicate a poor prognosis in patients with metaplastic breast carcinoma.
Nevoid basal cell carcinoma syndrome is an autosomal dominant multisystem disorder characterized by developmental anomalies and occurrence of multiple basal cell carcinomas and other tumors in early childhood. In this article, the authors report a case of a 19-year-old African American male with nevoid basal cell carcinoma syndrome and a history of medulloblastoma at age 2, meningioma at age 14, thyroid follicular adenomas with papillary carcinoma at age 15, and 2 basal cell carcinomas at ages 16 and 18. Recently, he developed sinonasal undifferentiated carcinoma (SNUC). The radiology and pathology of the sinonasal carcinoma are presented in this report. Review of the literature reveals that this is the first case of SNUC occurring in a patient with nevoid basal cell carcinoma syndrome. PMID:17652545
Sobota, Amy; Pena, Maria; Santi, Mariarita; Ali Ahmed, Atif
Diagnostic difficulty in the morphologic assessment of endometrial carcinomas may arise in pathology practice. Challenges in tumor classification exist especially in the setting of high-grade carcinomas. These include FIGO grade 3 endometrioid, serous, clear cell, and undifferentiated carcinomas, in addition to carcinomas of mixed cell type and those exhibiting ambiguous morphologic features. This comprehensive review details key morphologic and immunophenotypic features of prototypic endometrial carcinomas, including a description of both well-established and novel immunohistochemical markers in the evaluation of these tumors. It also provides recommendations regarding prudent use of these ancillary techniques in distinguishing between various histologic subtypes of endometrial carcinoma that frequently result in persistent diagnostic problems. PMID:24951284
Chiang, Sarah; Soslow, Robert A
Pancreatic malignancies can be subdivided into endocrine and non-endocrine processes. Of the non-endocrine tumours, ductal carcinoma is the most common, and the ductal carcinomas can be further subdivided into adenocarcinomas and squamous cell carcinomas. The adenocarcinomas constitute most of the non-endocrine pancreatic malignancies, and the treatment options for these, although limited in efficacy, are relatively well established. The squamous cell carcinoma pathology is a rare entity, and few reports of it are found in the literature. As a result, treatment options for squamous cell carcinoma of the pancreas are poorly understood. Here, we report the presentation of a 48-year-old woman with metastatic squamous cell carcinoma of the pancreas. The subsequent investigations, treatment, and outcome are described.
Al-Shehri, A.; Silverman, S.; King, K.M.
Three tumor markers for hepatocellular carcinoma (HCC) are available in Japan: alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonists-II (PIVKA-II), and Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3). Although AFP has drawbacks in its specificity, it is widely utilized in treatment evaluation and prognosis prediction. PIVKA-II is a unique marker that does not correlate with AFP value and can predict microvascular invasion. AFP-L3 is a highly specific marker and strong predictor of poor prognosis. These three markers are indispensable in every aspect of clinical practice of hepatocellular carcinoma including surveillance, diagnosis, treatment evaluation, and prognosis prediction. PMID:22620007
Tateishi, Ryosuke; Enooku, Kenichiro; Shiina, Shuichiro; Koike, Kazuhiko
Clinicopathological studies support a broad classification of endometrial carcinoma into two major types, designated as type I and type II, which correlate with their biological behavior. More recently, molecular studies have provided further insights into this classification scheme by elucidating the genetic events involved in the development and progression of endometrial carcinoma. Microsatellite instability and mutations in the PTEN gene have been widely associated with type I (endometrioid) endometrial carcinoma, while p53 mutations have been identified in the majority of type II endometrial carcinoma, of which uterine serous carcinoma is the prototype. Uterine clear cell carcinoma (UCC) is an uncommon variant of endometrial carcinoma, and clinicopathological studies have produced conflicting results regarding its biological behavior with 5-year survival ranging from 21 to 75%. The molecular characteristics of endometrioid and serous carcinoma have been studied extensively; however, there have been few molecular genetic studies of the clear cell subtype. In this study, we evaluated 16 UCCs (11 pure and 5 mixed) for mutations in the p53 gene, PTEN gene and for microsatellite instability. Although we found that these alterations were uncommon in pure clear cell carcinomas, all three were identified. In addition, two cases of mixed serous and clear cell carcinoma showed an identical mutation of the p53 gene in the histologically distinct components and one case of mixed clear cell and endometrioid carcinoma had identical mutations in the PTEN and p53 genes, and microsatellite instability in both components. Our data suggest that UCC represent a heterogeneous group of tumors that arise via different pathogenetic pathways. Additional molecular studies of pure clear cell carcinoma are required to further elucidate the genetic pathways involved in its development and progression. PMID:14976538
An, Hee-Jung; Logani, Sanjay; Isacson, Christina; Ellenson, Lora H
Mucoepidermoid carcinoma is the most common malignant salivary gland tumor of children and adults, showing diverse histopathologic features. Mucoepidermoid carcinoma with both melanin pigmentation and spindle cell differentiation has not been previously reported. We report the first documented case of pigmented mucoepidermoid carcinoma with spindle cell differentiation in a 34-year-old woman who presented with a swelling of the floor of the mouth. PMID:24275356
Liyanage, R L P R; Wadusinghearachchi, N S; Siriwardena, B S M S; Jayasooriya, P R; Tilakaratne, W M
The authors base their experience on 12 women affected by endometrial carcinoma. Problems have been diagnosed in the post-menopausal and climacterium period, considering the clinical, hormonal and lipidic profile and some tumoral markers. The most risk factors for the endometrial adenocarcinoma have been collected in the adiposity with hypertension and hyperglycemia, above all in nullipara women with late menopause and dyslipidemia. PMID:8414144
Giannone, R; Bernorio, R; Poli, M
Cancer is a heritable disorder of somatic cells: environment and heredity are both important in the carcinogenic process.\\u000a The primal force is the “two hits” of Knudson’s hypothesis, which has proved true for many tumours, including renal cell carcinoma.\\u000a Knudson et al. [1, 2] recognised that familial forms of cancer might hold the key to the identification of important regulatory
Manuel Valladares Ayerbes; Guadalupe Aparicio Gallego; Silvia Díaz Prado; Paula Jiménez Fonseca; Rosario García Campelo; Luis Miguel Antón Aparicio
As in other malignant tumors, prognosis in renal cell carcinoma (RCC) depends on tumor extent and metastasis at the time of\\u000a primary diagnosis. Staging systems formalize the way in which the extent of RCC is being described and classified. Primary\\u000a staging of RCC aims at evaluating surgical options. Since surgical excision, which is the mainstay of therapy in non-metastatic\\u000a RCC,
Ullrich G. Mueller-Lisse; Ulrike L. Mueller-Lisse; Thomas Meindl; Eva Coppenrath; Christoph Degenhart; Anno Graser; Michael Scherr; Maximilian F. Reiser
\\u000a Hepatocellular carcinoma (HCC) invariably develops within a setting of chronic inflammation caused by either hepatotropic\\u000a viruses, toxins, metabolic liver disease or autoimmunity. Mechanisms that link these two processes are not completely understood,\\u000a but transcription factors of the NF-?B family and signal transducer and activator of transcription 3 (STAT3), cytokines such\\u000a as IL-6 and IL-1? and ligands of the epidermal growth
Malcolm R. Alison; Linda J. Nicholson; Wey-Ran Lin
Locoregional therapies for hepatocellular carcinoma have progressed greatly in the last 30 years, beginning with the introduction of chemoembolization. Embolization techniques have evolved with the use of drug-eluting beads and radioembolization with yttrium-90. In the last 10 years, several new ablation techniques were developed including radiofrequency ablation, microwave ablation, cryoablation, laser ablation, and irreversible electroporation. Isolated or in combination, these techniques have already shown that they can improve patient survival and/or provide acceptable palliation. PMID:21689621
Guimaraes, Marcelo; Uflacker, Renan
To evaluate the efficacy of transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma, the prognostic factors, and the side effects, 72 patients undergoing 170 chemoembolizations with lipiodol-mediated injection of adriamycin were investigated. The 1-, 2-, and 3-year survivals are 83, 61, and 56%, respectively. Significant prognostic factors for survival (by Mantael-Haenszel) are Child-Pugh and Okuda status (p=0.00001 and p=0.01
Fabio Farinati; Nicola De Maria; Cinzia Marafin; Làszlò Herszènyi; Stefano Del Prato; Michela Rinaldi; Luciano Perini; Romilda Cardin; Remo Naccarato
Opinion statement Hepatocellular carcinoma (HCC) is an increasingly prevalent clinical problem. The presence of cirrhosis in the majority of\\u000a patients makes treatment difficult because both the stage of the tumor and the stage of cirrhosis must be taken into account.\\u000a This is compounded by the difficulty in diagnosing HCC in the early stages, where treatment is most effective, and the lack
Aaron Shields; K. Rajender Reddy
Summary Metastasis to the skull frequently occurs in patients with lung, breast and prostate cancer. However, skull metastases from\\u000a hepatocellular carcinoma (HCC) have been rarely reported. We review the literature on skull metastasis from HCC and report\\u000a a case of a 46-year-old male, who was diagnosed as HCC and was operated on by trans-arterial embolization and lobectomy in\\u000a Oct. 2004. He
C.-T. Hsieh; J.-M. Sun; W.-C. Tsai; T.-H. Tsai; Y.-H. Chiang; M.-Y. Liu
Introduction Adenoid cystic carcinoma (ACC) of the breast is a rare condition, and cases in male patients are even less common. Case We describe a case of ACC of the breast with axillary lymph node metastasis, disseminated osteolytic bone metastasis and bone marrow involvement in a 41-year-old man. Conclusion Male breast ACC is an extremely rare malignancy; there can be difficulty in obtaining a final diagnosis. We report this case because of its rarity.
Yoo, Seung Jin; Lee, Dong Seok; Oh, Ho Suk; Kim, Hyun Joong; Kim, Moon Ho; Ahn, Youg Chel; Kang, Gil Hyun; Eom, Dae-Woon; Cha, Choong Hwan; Ahn, Heui June
Safety and Tolerability of Everolimus as Second-line Treatment in Poorly Differentiated Neuroendocrine Carcinoma / Neuroendocrine Carcinoma G3 (WHO 2010) and Neuroendocrine Tumor G3 - an Investigator Initiated Phase II Study
Poorly Differentiated Neuroendocrine Carcinoma,; Neuroendocrine Carcinoma, Grade 3; Neuroendocrine Carcinoma, Grade 1 [Well-differentiated Neuroendocrine Carcinoma] That Switched to G3; Neuroendocrine Carcinoma, Grade 2 [Moderately Differentiated Neuroendocrine Carcinoma] That Switched to G3; Neuroendocrine Tumor, Grade 3
Odontogenic carcinoma is rare group of malignant epithelial odontogenic neoplasms with characteristic clinical behavior and histological features, which requires an aggressive surgical approach. The pathogenesis of this rare group remains still controversial and there have been many varied opinions over the classification of this rare group of lesions. As there have not been many reviews on odontogenic carcinoma, the existing knowledge is mostly derived from the published case reports. This review is discussing the pathogenetic mechanisms and is updating the knowledge on nomenclature system of less explored odontogenic carcinomas. This review might throw light on the pathogenesis and nomenclature system of odontogenic carcinoma and this knowledge may be applied therapeutically.
Panda, Swagatika; Sahoo, Sujit Ranjan; Srivastav, Gunjan; Padhiary, Subrat; Dhull, Kanika Singh; Aggarwal, Sonia
Sclerosing mucoepidermoid carcinoma is an unusual type of mucoepidermoid carcinoma with special histological features which differ from those of the classic type of mucoepidermoid carcinoma. We report the case of a 32-year-old male, who reported to the Vydehi Institute of Dental Sciences, Bangalore, India, with an asymptomatic swelling over the right parotid region which had been present for the previous two and a half years. Histopathological sections of the tumour mass showed mucous and epidermoid cell nests in a dense, hyalinised, sclerotic stroma. A diagnosis of sclerosing mucoepidermoid carcinoma was made. A superficial parotidectomy was performed on the patient and he has remained disease free to date. PMID:24790751
Bhat, Keshava; Pandey, Bhavna; Shetty, Pushparaja; Manohar, Vidya; Shruthilaxmi, M K; Patidar, Madhvika
Upper tract urothelial cell carcinoma accounts for 5% of all urothelial tumors. Compared to lower urinary tract tumors, upper tract urothelial carcinoma is diagnosed more frequently at advanced stages. Open radical nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, with the advancement of minimally invasive techniques and the benefits of these procedures regarding perioperative morbidity, cosmesis, and earlier convalescence, these options have shown promise in managing the patients with upper tract urothelial carcinoma. Despite the perioperative advantages, concerns exist on the oncological safety after minimally invasive surgery. In this article, we provide a comprehensive overview of the surgical management of upper tract urothelial carcinoma.
Bird, Vincent G.; Kanagarajah, Prashanth
AIMS--To determine whether neural invasion in advanced gastric cancer is of clinicopathological significance. METHODS--The study population comprised 121 cases of primary advanced gastric carcinoma. Two paraffin wax embedded blocks taken from the central tissue slice in each primary tumour were used. For definitive recognition of neural invasion, immunostaining for S-100 protein was applied to one slide; the other slide was stained with haematoxylin and eosin. RESULTS--Neural invasion was recognised in 34 of 121 (28%) primary gastric carcinomas. There were significant differences in tumour size, depth of tumour invasion, stage, and curability between patients with and without neural invasion. The five year survival rates of patients with and without neural invasion were 10 and 50%, respectively. Multivariate analysis, however, demonstrated that neural invasion was not an independent prognostic factor. CONCLUSIONS--Neural invasion could be an additional useful factor for providing information about the malignant potential of gastric carcinoma. This may be analogous to vessel permeation which is thought to be important, but is not an independent prognostic factor. Images
Mori, M; Adachi, Y; Kamakura, T; Ikeda, Y; Maehara, Y; Sugimachi, K
Multiple modalities for treatment of hepatocellular carcinoma are available, depending on tumor size and number. Surgical resection remains the gold standard, so long as the residual liver function reserve is sufficient. In patients with advanced cirrhosis, liver transplantation is the preferred option, as these patients may not have adequate hepatic reserve after resection. Salvage liver transplantation has also become an option for a select few patients who recur after surgical resection. Ablative techniques have been used for palliation as well as to either completely destroy the tumor, act as an adjunct to resection, or downstage the tumor to meet Milan criteria such that a patient may be a candidate for liver transplantation. Radiofrequency ablation, microwave ablation, chemoembolization, radioembolization, and irreversible electroporation have all been used in this capacity. Currently, sorafenib is the only US Food and Drug Administration-approved chemotherapeutic for hepatocellular carcinoma. The efficacy of sorafenib, in combination with other agents, transarterial chemoembolization, and surgical resection is currently being investigated. Sunitinib and brivanib, tyrosine kinase inhibitors, have failed as potential first- or second-line options for chemotherapy. Bevacizumab in combination with erlotinib is also currently being studied. Final analysis for ramucirumab and axitinib are pending. Tivantinib, a selective mesenchymal-epithelial transition factor (MET) inhibitor, is also undergoing clinical trials for efficacy in MET-high tumors. This review serves to emphasize the current and new technologies emerging in the treatment of hepatocellular carcinoma. PMID:24810646
Reataza, Marielle; Imagawa, David K
Salivary gland tumours represent 1-4% of all human neoplasms and less than 5% occur in children and adolescents. Malignant salivary gland tumours only represent 0.08% of all childhood tumours and mucoepidermoid carcinoma (MEC) is the most common histological type. The majority of MECs in the paediatric group are histologically classified as low or intermediate grade of malignancy, favouring a good prognosis. Complete excision of the lesion with free surgical margins is the treatment of choice and the one that offers the best local control of the disease. Experience with minor salivary gland carcinoma arising specifically within the nasopharynx is limited because nasopharyngeal MEC is an extremely rare malignancy and there is controversy regarding its optimal treatment. We hereby report a case of mucoepidermoid carcinoma arising from the nasopharynx in a 7-year-old girl, which was managed via an endonasal endoscopic procedure. To our knowledge the case we describe is the second case of nasopharyngeal MEC in paediatric age reported in literature and is the only one occurred in the first decade of life. PMID:23294931
Re, M; Pasquini, E
The incidence of renal cell carcinoma (RCC) has increased steadily in past few decades and is partially attributable to the increased utilization of cross-sectional imaging. Many of these carcinomas are small incidental discoveries, although a subset leads to locally advanced or distant disease. Although its molecular pathophysiology is not completely understood, knowledge of hereditary RCCs has shed light on some of the pathways involved. More recently, the rapid advances in genomics, proteomics, and metabolomics have allowed for a deeper and more nuanced understanding of the genetic aberrations that lead up to and result from the transformation of a renal tubular epithelial cell into a carcinoma. These discoveries have allowed for the development of novel therapeutics that target these pathways. They have also led to the development of diagnostic, prognostic, and predictive biomarkers that could radically change the way RCC is diagnosed and treated. Although some of the current investigations are nascent and it remains to be seen which biomarkers will become clinically available, many candidate biomarkers show promise and require external validation. Ultimately, biomarkers may allow for cost-effective screening of high-risk patients, the identification of aggressive cancers among small renal masses, the identification of high-risk patients, the detection of recurrences postoperatively with minimal imaging, and the ability to choose appropriate targeted therapies for patients with metastatic disease. PMID:24239464
Ngo, Tin C; Wood, Christopher G; Karam, Jose A
We studied the binding of EGF receptors (EGF-R) in 19 basal cell carcinomas, 8 squamous cell carcinomas, and 9 malignant melanomas. Specific binding of EGF-R was detected in 10 of the basal cell carcinomas, and in all the 8 squamous cell carcinomas. None of the malignant melanomas showed EGF-R binding. A comparative study of the receptor status vs. clinical prognostic data, such as grading and clinical course, did not reveal any significant differences, whereas in ovarian carcinomas, the EGF receptor correlated with the prognosis. PMID:2389590
Hagedorn, M; Vanscheidt, W; Strasser, W; Bauknecht, T
The coexistence of multiple and synchronous primary neoplasms in the genitourinary system has rarely been described in the literature. To our knowledge, this is the first report of a very rare tumor, a "tubulocystic carcinoma," simultaneously occurring with micropapillary urothelial carcinoma in the bladder and clear cell type renal cell carcinoma in the same kidney. Tubulocystic carcinoma is a recently entitled tumor. It had been thought to arise from the distal collecting duct for a period of time and was therefore named as a low-grade collecting duct carcinoma. Microscopically, the tumor is defined as being tubulocystic or having tubulopapillary architecture and a low nuclear grade with hobnail morphology. Its progression and treatment protocol are uncertain. PMID:19488016
Gönül, Ipek I?ik; Cakr, Asl; Sözen, Sinan; Ataoglu, Omür; Alkibay, Turgut
The differences between invasive lobular and ductal carcinomas affect the diagnostic and therapeutic management for patients with breast cancer. In most cases, this can be accomplished because of distinct histomorphologic features. However, occasionally, this task may become quite difficult, in particular when dealing with the variants of infiltrating lobular carcinoma. Lobular carcinoma has been considered a variant of mucin-secreting carcinoma with only intracytoplasmic mucin. The presence of extracellular mucin is a feature of ductal carcinoma. Herein is presented a case of lobular carcinoma with extracellular and intracellular mucin in a 43-year-old female patient, and confirmed by immunohistochemistry. Up to the present, infiltrating lobular carcinoma displaying extracellular mucin has not been described in the literature except two case. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1839906067716744
This study aimed to evaluate MR as an imaging modality for the assessment of myometrial and cervical invasion in endometrial carcinoma and for the assessment of parametrial and lymph node involvement in cervical carcinoma. Twenty-eight patients with a preoperative histological diagnosis of endometrial carcinoma/cervical carcinoma were included in the study. The findings were compared with the surgical staging and the histopathological report of the hysterectomy specimen. Accuracy in detecting myometrial and cervical involvement in patients with endometrial carcinoma was 78% for both. Accuracy in detecting parametrial and lymph node involvement in patients with cervical carcinoma was 71% and 86% respectively. MR is a reliable method for preoperative assessment of endometrial and cervical carcinoma. It helps decide operability, the type of operation and aids in the selection of patients who need to be considered for specialist referral to a gynaecologist oncologist.
Pakkal, M. V.; Rudralingam, V.; McCluggage, W. G.; Kelly, B. E.
A series of 110 cases of oral squamous cell carcinoma (SCC) together with six lymph node and one distant metastatic lesions was analysed for expression of survivin, a recent apoptosis inhibitor, by immunohistochemistry and Western blotting. In total, 91 cases (82.7%) of carcinoma and all metastasis (seven cases, 100%) were positive for survivin expression, with weighted survivin scores ranging from
L Lo Muzio; G Pannone; S Staibano; M D Mignogna; C Rubini; M A Mariggiò; M Procaccini; F Ferrari; G De Rosa; D C Altieri
Papillary carcinoma of the breast represents approximately 0.5% of all newly diagnosed cases of breast cancer. The prevalence of both invasive and in situ papillary carcinoma seems to be greater older postmenopausal women, and -in relative terms-in males. Histologic features of the tumor include cellular proliferations surrounding fibrovascular cores, with or without invasion. In this review, characteristics of both in situ and invasive disease are outlined. Immunohistochemical analyses of papillary carcinoma suggest the utility of markers such as smooth muscle myosin heavy chain, calponin, p63 and high molecular weight keratins, which can characterize the myoepithelial cell layer. With respect to radiographic evaluation of papillary carcinoma, ultrasonography is the most extensively studied imaging modality, though magnetic resonance mammography has potential utility. Available data suggest improved outcome for papillary carcinoma as compared to invasive ductal carcinoma. Treatment-related information for patients with papillary carcinoma is limited, and patterns noted in available series suggest a variable approach to this disease. The scarcity of information underscores the need for further treatment- and outcome-related studies in papillary carcinoma of the breast.
Pal, Sumanta Kumar; Lau, Sean K.; Kruper, Laura; Nwoye, Uzoamaka; Garberoglio, Carlos; Gupta, Ravi K.; Paz, Benjamin; Vora, Lalit; Guzman, Eduardo; Artinyan, Avo; Somlo, George
Thyroid cancer is the most common malignant tumor of the endocrine system. The most frequent type of thyroid malignancy is papillary carcinoma. These tumors frequently have genetic alterations leading to the activation of the mitogen-activated protein kinase (MAPK) signaling pathway. Most common mutations in papillary carcinomas are point mutations of the BRAF and RAS genes and RET\\/PTC rearrangement. These genetic
Yuri E Nikiforov
The lung, the liver, the bone tissue and the brain are the most frequent sites for renal cell carcinoma metastasis. Small bowel metastasis from renal cell carcinoma is rare, with only few cases published. We report the case of ileal metastasis from operated kidney cancer revealed by ileocolic intussusception and causing intestinal obstruction in a 32-year-old woman. PMID:23287487
Kerkeni, W; Bouzouita, A; Jarraya, H; Selmi, M S; Cherif, M; Derouich, A; Kourda, N; Dziri, C; Zermani, R; Ben Slama, M R; Chebil, M
Tuberculosis (TB) accounts for the highest number of mortalities among infectious diseases worldwide. Laryngeal TB is an extremely rare presentation of TB. It has many similarities to laryngeal carcinoma, one of the three most common cancers among males in the city, with an age standardized rate of 8.6. The associated risk factors of laryngeal carcinoma i.e. smoking, paan, betel nut
Anwar Suhail; Muhammad Sheharyar Ahmed; Zain-ul-Abdeen Sobani; Shahzad Ghaffar
Objective: This study was undertaken to investigate prognostic factors in patients with recurrent cervical carcinoma who had undergone a primary radical hysterectomy and pelvic lymphadenectomy. Study Design: A retrospective analysis of 177 patients with recurrent cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy for stage IB to II disease at a single institution was performed to evaluate clinicopathologic parameters, time
Chin-Jung Wang; Chyong-Huey Lai; Huei-Jean Huang; Ji-Hong Hong; Hung-Hsueh Chou; Kuan-Gen Huang; Jen-Daw Lin
Over the past 11 years, I have experienced a few patients with intractable ascites after extended radical surgery for gastric carcinomas, which accounted for 1.0% (4 of 394) of all gastric carcinomas resected in our institute. These 4 patients underwent total or subtotal gastrectomy with extended lymphadenectomy, including the lymph nodes of the hepatoduodenal ligament. Histopathologic examination of an intraoperative
Total pancreatectomy for periampullary carcinoma should be reserved for resectable primary carcinoma in the pancreas. The postoperative complications are reduced, and the resultant diabetes is not difficult to manage. There were no postoperative deaths in series of 12 cases of total and partial pancreatectomy. This study proposes a more aggressive approach to malignant lesions in this area. ImagesFigure 1.
Rabwin, Marcus H.; Karlan, Mitchell S.
Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in salivary glands of head and neck region. Here we present a case report of a 50 year old male who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation. PMID:22190804
Singh, Sanjay; Gokkulakrishnan; Jain, Jinendra; Pathak, Sachin; Singh, Kumar Tathagat
Oral squamous cell carcinoma is the most common malignant epithelial neoplasm affecting the oral cavity. This article overviews the essential points of oral squamous cell carcinoma, highlighting its risk and genomic factors, the potential malignant disorders and the therapeutic approaches. It also emphasizes the importance of the early diagnosis.
Markopoulos, Anastasios K
AIM To explore relationships between human carcinomas and mycoplasma infection. METHODS Monoclonal antibody PD4, which specifically recognizes a distinct protein from mycoplasma hyorhinis, was used to detect mycoplasma infection in different paraffin embedded carcinoma tissues with immunohistochemistry. PCR was applied to amplify the mycoplasma DNA from the positive samples for confirming immunohistochemistry. RESULTS Fifty of 90 cases (56%) of gastric
Su Huang; Ji You Li; Jan Wu; Lin Meng; Cheng Chao Shou
Primary squamous cell carcinoma of the endometrium is extremely rare. The 21st case of this lesion that meets Fluhmann's criteria is presented. The histogenesis of this lesion remains unclear. The etiology of squamous cell changes in the endometrium is presented, and the prognostic implication of malignant squamous cells in endometrial carcinoma is discussed. PMID:7205809
Lifshitz, S; Schauberger, C W; Platz, C A; Roberts, J A
Hybridoma cells which secrete colorectal carcinoma-specific antibodies have been produced and used to study the antigenic structure of these tumor cells. Nineteen antibodies have been studied in detail, and 15 of these are colorectal carcinoma specific. Only two antibodies reactive with carcinoembryonic antigen (CEA) have been discovered and five other antibodies that react with distinct epitopes on the cell surface
Hilary Koprowski; Zenon Steplewski; Kenneth Mitchell; Meenhard Herlyn; Dorothee Herlyn; Peter Fuhrer
Laminin 332 (LN332) is a basally expressed extracellular matrix protein that enhances the migration and invasion of breast carcinoma cells. The goal of this study was to examine LN332 expression breast carcinoma. Triple negative breast carcinomas lack estrogen receptor (ER), progesterone receptor (PR) expression and HER2 positivity. Immunohistochemistry for ER, PR, HER2, and dual silver in situ hybridization for the HER2 gene were used to define the phenotype of 243 breast cancers in biopsies or arrays. Immunohistochemistry for LN332 revealed that 70% of triple negative carcinomas stained for LN332. Cytokeratins 5/6 (CK5/6), epidermal growth factor receptor and p63 alone stained fewer triple negative breast carcinomas each, but the combination of LN332 and CK5/6 or epidermal growth factor receptor identified 92% of triple negative breast carcinoma. Of the 163 non-triple negative cases, LN332 was expressed in only 15%. The identification of LN332 in triple negative breast carcinomas is consistent with gene profiling studies showing its expression among breast carcinomas with a basal phenotype. The observation that a proinvasive protein such as LN332 is expressed in breast cancer suggests another mechanism by which the triple negative phenotype could be aggressive. PMID:22427740
Kwon, Soon-Young; Chae, Seoung W; Wilczynski, Sharon P; Arain, Ahmad; Carpenter; Philip M
There is no high risk group for cholangiocarcinoma as there is for hepatocellular carcinoma, and it has a poor prognosis because many cases are diagnosed after it has become advanced. To date, there is no effective chemotherapy or radiation therapy for cholangiocarcinoma, and extended hepatectomy is the only effective treatment. In Japan, regional lymph node dissection and extended hepatectomy have been performed aiming at curative resection, but the 5-year survival in Japan is still low, only 26.1%. The Committee on the Japanese General Rules for the Clinical and Pathological Study of Primary Liver Cancer has divided macroscopic type into 3 patterns: mass-forming type, periductal infiltrating type, and intraductal growth type, to access prognosis on a common basis. According to these groups, our patients with the intraductal growth type had a good outcome, but patients with the mass-forming type and periductal infiltrating type had a poor outcome. Many papers have reported that the presence of lymph node metastasis makes the prognosis poor. Among our cases, the 5-year survival rate for all patients who underwent hepatectomy was 26.1% and the rate for patients positive for lymph node metastasis was 10.8%, as opposed to 45.1% for patients negative for lymph node metastasis. We examined the outcome according to histological type and found that based on the histological findings, the prognosis was increasingly poor in the following order: papillary adenocarcinoma, macrotubular carcinoma, microtubular carcinoma. To achieve curative treatment in the future it will be important to clearly define the extent of hepatectomy and determine the extent of lymph node dissection required, and clearly identify other prognostic factors. PMID:9213313
Taoka, H; Kawarada, Y
Angiogenesis targeting with inhibitors of VEGF receptors is currently modifying in depth the treatment strategy of metastatic clear cell renal carcinoma. Although immunotherapy remains prescribed in selected patients with good prognosis, sunitinib and sorafenib are presently the most active agents in this malignancy. The results available, in terms of response as in terms of progression-free survival, argue in favour of the use of sunitinib in first line. The two agents have distinct toxicity profiles, which may lead in the future to select the treatment as a function of an individual patient basis. Preliminary results suggest the possibility of partial cross-resistance between them. PMID:17965000
Pouessel, Damien; Culine, Stephane
Hepatocellular carcinoma (HCC) is a common and deadly cancer whose pathogenesis is incompletely understood. Comparative genomic studies from human HCC samples have classified HCCs into different molecular subgroups; yet, the unifying feature of this tumor is its propensity to arise upon a background of inflammation and fibrosis. This review seeks to analyze the available experimental models in HCC research and to correlate data from human populations with them in order to consolidate our efforts to date, as it is increasingly clear that different models will be required to mimic different subclasses of the neoplasm. These models will be instrumental in the evaluation of compounds targeting specific molecular pathways in future preclinical studies.
Newell, Philippa; Villanueva, Augusto; Friedman, Scott L.; Koike, Kazuhiko; Llovet, Josep M.
Twenty-one HLA-A and B antigens were determined in a study of 162 patients with lung cancer. Differences between antigen frequencies in cancer and control populations were determined by chi 2 analysis with Yates correction or Fisher's exact test. Cancer patients had a decreased frequency of the antigen HLA-B40 (pc = 0.003; relative risk = 0.21). In patients with differentiated types of the carcinoma and relatively better prognosis, decreased frequency of the antigen HLA-B40 was found (pc = 0.05; relative risk = 0.27). Our investigation was based on a thorough study of literary data. PMID:2812153
Prazák, J; M?ricka, O
Binkley and Johnson first reported this syndrome in 1951. But it was in 1960, Gorlin-Goltz established the association of basal cell epithelioma, jaw cyst and bifid ribs, a combination which is now frequently known as Gorlin-Goltz syndrome as well as Nevoid Basal Cell Carcinoma Syndrome (NBCCS). NBCCS is inherited as an autosomal dominant trait with high penetrance and variable expressivity. NBCCS is characterized by variety of cutaneous, dental, osseous, opthalmic, neurologic and sexual abnormalities. One such case of Gorlin-Goltz syndrome is reported here with good illustrations. PMID:16900896
Karthiga, Kannan S; Sivapatha Sundharam, B; Manikandan, R
Carcinoma of unknown primary origin (CUP) is a heterogeneous group of cancers defined by the presence of metastatic disease with no identified primary tumor at presentation. Identifying patients with prognostically favorable disease is important, since they may derive substantial benefit, including prolonged survival, from directed treatment. In CUP cases, a focused search for the primary tumor is recommended. Whether CUP is a distinct molecular genotype-phenotype relative to metastases of known cancers is unknown. However, use of a robust immunohistochemical panel and emerging molecular data may permit development of a tailored treatment algorithm for CUP patients that will include appropriate use of targeted agents.
Varadhachary, Gauri R.
Sinonasal undifferentiated carcinoma (SNUC) is a highly aggressive malignant neoplasm that is often difficult to distinguish from other poorly differentiated carcinomas arising in the sinonasal tract. To search for a differential cytokeratin (CK) expression that could be useful for diagnostic purposes, we compared the expression of a large panel of CKs in a series of 6 SNUCs, 10 poorly differentiated squamous cell carcinomas (SCCs), 10 nonkeratinizing squamous cell carcinomas (NKSCCs), and 5 nasopharyngeal-type undifferentiated carcinomas (NPTCs). SCC, NKSCC, and NPTC frequently showed immunoreactivity for CK5/CK6, CK8, CK13, and CK19. In addition, SCC and NKSCC expressed CK14, which was not detected in NPTC, and SCC expressed CK7 (60% of cases) and CK4 (30% of cases), which were absent in NKSCC and NPTC. Three NKSCCs were associated with a Schneiderian papilloma, and the results of the immunostaining were similar in the two components, with the exception of CK4 and CK7, which were expressed by the papilloma and not by the carcinoma. In contrast to other carcinomas, SNUC was characterized by the exclusive expression of CKs of simple epithelia, such as CK8 (100% of cases), CK7 (50% of cases), and CK19 (50% of cases). Thus, there are significant differences in the pattern of CK expression between SNUC, SCC, NKSCC, and NPTC, which could be of diagnostic aid. Moreover, these findings support the hypothesis that SNUC is a separate entity from SCC and NPTC of the sinonasal tract. PMID:12459626
Franchi, Alessandro; Moroni, Michele; Massi, Daniela; Paglierani, Milena; Santucci, Marco
5To assess the potential of optical spectroscopy and imaging for improving the detection and evaluation of early skin cancer, we have been studying autofluorescence properties of various skin diseases. In this paper, the autofluorescence properties of basal cell carcinoma (BCC) under 442 nm excitation will be presented. Three different spectroscopy and imaging tools have been used in this study: (1) a portable fiber optic spectrometer for in vivo spectral measurements in an outpatient clinic; (2) a CCD imaging system for cutaneous autofluorescence imaging in vivo; and (3) a fiber optic microspectrophotometer system for frozen tissue section examination of in vitro microscopic fluorophore distribution and spectroscopy. Autofluorescence spectra from 109 BCC lesions characteristically showed decreased fluorescence intensity for BCC as compared to the surrounding normal skin. Of 109 biopsy-proven BCC lesions, 104 showed a decreased fluorescence signal. Decreased autofluorescence in BCC has also been corroborated by in vivo autofluorescence imaging of BCC lesions. Microscopic data from histologic frozen sections mirror the in vivo measurements, with decreased autofluorescence observed within and immediately around basal cell tumor nests. An optical model of basal cell carcinoma is under construction.
Zeng, Haishan; McLean, David I.; MacAulay, Calum E.; Palcic, Branko; Lui, Harvey
In patients with stage III carcinoma of the colon, adjuvant chemotherapy is indicated after R0 resection. No age limitations exist. Combination chemotherapy with FOLFOX4 or (if oxaliplatin is contraindicated) monotherapy with a fluoropyrimidine, preferably capecitabine, can be regarded as the standard treatment. Because of its unfavorable toxicity profile, the 5-FU/folic acid bolus scheme (the Mayo scheme) should no longer be used, and combinations including irinotecan also do not play a part in colon carcinoma. The combination XELOX (oxaliplatin + capecitabine) is currently being studied in phase III trials. Data on the efficacy of the targeted drugs bevacizumab and cetuximab cannot be expected until at least 2010/2011. It is important that adjuvant treatment be started in a timely manner, within 8 weeks of surgery. As far as stage II disease is concerned, adjuvant chemotherapy analogous to that for stage III should be considered in high-risk patients (T4, emergency surgery, tumor perforation/tear, < 12 lymph nodes examined). The evidence for this recommendation is, however, based mainly on unplanned subgroup analyses of randomized trials. That low-risk stage II patients can also profit from adjuvant treatment was shown in the QUASAR trial(significant survival benefit of 3.6%), so this group of patients can be offered chemotherapy containing 5-FU. For treatments involving oxaliplatin in low-risk patients there is currently insufficient evidence. PMID:19033700
Trarbach, Tanja; Kubicka, Stefan; Hacker, Ulrich; Ridwelski, Karsten; Reinacher-Schick, Anke
Herein, we report two cases of a follicular neoplasm with panfollicular differentiation showing architectural and cytologic findings suggestive of a malignancy. Immunohistochemical analysis of ?-catenin expression in the neoplasm showed nuclear and cytoplasmic immunoreactivity, with no reactivity in the transitional and shadow cells, consistent with ?-catenin expression of pilomatrical tumors. Staining for BerEp4 was positive at the periphery of both neoplasms, suggesting germinative differentiation of the neoplastic cells, whereas staining for the follicular stem-cell marker PHLDA-1 (TDAG51) showed strong focal expression in the tumor cells of both cases. Given these findings, these neoplasms show features of both panfollicular neoplasms and basal cell carcinoma with panfollicular/matrical differentiation. These are the first cases of this neoplasm reported to date. More reports are needed to assess their malignant potential. PMID:24320809
Fedeles, Flavia; Cha, Jisun; Chaump, Michael; Theroux, Brian; Farrell, David; Dufresne, Raymond; Robinson-Bostom, Leslie
Thymic carcinomas are very rare and heterogeneous groups of anterior mediastinum neoformations with an extremely aggressive behavior. Often, the diagnosis is made in the advanced stages. Paraneoplastic syndromes associated with thymic carcinoma are extremely rare. We report a case of a 64-year-old man presenting with early stage thymic carcinoma which was discovered because of associated paraneoplastic dermatomyositis. The dermatomyositis disappeared completely after radical resection of the tumor. After 20-month follow-up, the patient is in good clinical condition without recidivism of disease. PMID:22907201
Dell'Amore, Andrea; Asadi, Nizar; Caroli, Guido; Dolci, Giampiero; Bini, Alessandro; Stella, Franco
WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome is an autosomal dominant disease related to a mutation in the chemokine receptor CXCR4 resulting in altered immune function. An increased susceptibility in these patients to human papillomavirus (HPV) manifests as cutaneous warts and, in women, cervical dysplasia and squamous carcinoma. HPV-related squamous carcinoma in other sites has not been documented. We report the occurrence of HPV-related squamous cell carcinoma of the oral cavity in 2 siblings with WHIM syndrome, whose pedigree has previously been described. PMID:19926501
Cipriani, Nicole A; Blair, Elizabeth; Taxy, Jerome B
The distribution of metastatic pelvic lymph nodes (PLNs) and aortic lymph nodes (ALNs) in 27 node-positive endometrial carcinomas (ECs) was analyzed in comparison with that in 25 node-positive cervical carcinomas (CCs) and 58 node-positive ovarian carcinomas (OCs). All patients underwent systematic pelvic and aortic lymphadenectomy. Lymph nodes were classified into the five subgroups: ALN above the inferior mesenteric artery (IMA;
Koji Matsumoto; Hiroyuki Yoshikawa; Toshiharu Yasugi; Takashi Onda; Shunsuke Nakagawa; Manabu Yamada; Kei Kawana; Takeo Minaguchi; Katsutoshi Oda; Yoko Hasumi; Yuji Taketani
The increased rate of early detection of breast cancer due to widespread mammographic screening has led to an increased incidence not only of in situ but also microinvasive carcinoma (MC). MC has been reported to have a favourable prognosis, but specific definitions have varied in the past making the clinical significance of this entity a subject of debate. In fact, although the diagnosis of MC often appears in pathology reports, this term has not been used in a consistent, standardized manner. In addition, the histological diagnosis of MC can be problematical for the pathologist due to a variety of in situ patterns and artefacts that may be misinterpreted as stromal invasion. Definitions and diagnostic criteria of MC are reviewed and discussed. Based on a review of literature, incidence of axillary lymph node involvement, according to different definitions of microinvasion, is reported. PMID:18493870
Bianchi, Simonetta; Vezzosi, Vania
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world, with an extremely poor prognosis. The clinical and molecular pathogenesis of HCC is very complex and involves alterations in the structure or expression of several tumor suppressor genes, oncogenes and, possibly, mechanisms leading to genetic instability due to mismatch repair deficiency or chromosomal instability and aneuploidy due to defective chromosomal segregation. Central to the molecular pathogenesis of HCC are mutations of various genes and a genetic instability which, in most cases, result from chronic liver disease and the associated enhanced liver cell regeneration and mitotic activity. The prognosis is generally very poor. Most studies report a 5-year survival rate of less than 5% in symptomatic HCC patients. Therapeutic strategies include resection, liver transplantation, and nonsurgical interventions such as percutaneous ethanol injection, radiofrequency thermal ablation, transarterial embolization, and chemoembolization. HCC has been shown to be quite resistant to radio- and chemotherapy. PMID:12928791
Blum, H E; Hopt, U T
Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) is a suitable therapeutic option for early, unresectable HCC particularly in the setting of chronic liver disease. Following on from disappointing initial results, the seminal study by Mazzaferro et al in 1996 established OLT as a viable treatment for HCC. In this study, the “Milan criteria” were applied achieving a 4-year survival rate similar to OLT for benign disease. Since then various groups have attempted to expand these criteria whilst maintaining long term survival rates. The technique of living donor liver transplantation has evolved over the past decade, particularly in Asia, and published outcome data is comparable to that of OLT. This article will review the evidence, indications, and the future direction of liver transplantation for liver cancer.
Tanwar, Sudeep; Khan, Shahid A; Grover, Vijay Paul Bob; Gwilt, Catherine; Smith, Belinda; Brown, Ashley
Hepatocellular carcinoma (HCC) is the sixth most common cancer, and its mortality rate is the third highest after lung and colon cancer. Its incidence has significantly increased in the last two decades in close relation with the ubiquitous spread of viral hepatitis. HCC has a poor prognosis since less than 30% of newly diagnosed patients will be eligible for potential curative treatment. Molecular therapies such as sorafenib, a BRAF/ VEGFR/PDGFR tyrosine kinase inhibitor, have shown to improve survival in patients with advanced HCC. This recent success has spurred intensive research aimed at identifying aberrant activation of signaling pathways. This approach will probably aid to define previously unrecognized oncogenic addiction loops in HCC and in developing more effective targeted therapies. PMID:22212931
Sia, Daniela; Villanueva, Augusto
Hepatocellular carcinoma is one of the most common cause of cancer related death. The present review gives an overview on the loco-regional therapy performed by transarterial chemoembolization (TACE).TACE combines two different therapeutic approaches. First, application of chemotherapeutic agents into tumor's feeding vessels and second, selectively de-arterialization by different particle embolization applicated during angiography. Different chemoembolization agents and techniques are described. The methode is save and less invasive. Side effects range from the postembolization syndrom with nausea, vomiting, fever and abdominal pain up to hepatic insufficiency, which is very rare.The aim of the therapy is control clinical symptoms, prolonge progression free survival, stabilize quality of life and survival. Further indications are bridging therapy prior liver transplantation and TACE is used as a neoadjuvant therapy.Thus, TACE plays a role in the therapy of HCC and indication should be tailored to the individual patient's condition by an interdisciplinary tumor board. PMID:23413009
Petersen, Johannes; Henninger, Benjamin; Glodny, Bernhard; Jaschke, Werner
Barrett's esophagus (BE) is the premalignant lesion from which esophageal adenocarcinoma near the esophagogastric junction arises. The management of BE and the treatment of Barrett's esophageal adenocarcinoma (BEA) are important clinical issues in Europe and the United States. As the Helicobacter pylori infection rate in Japan is decreasing in the younger population, the incidence of BE and adenocarcinoma arising from BE may start increasing. Thus, we review the current status of BEA and its management. Magnifying endoscopy with narrow-band imaging is important for diagnosing dysplasia arising from BE. In Japan, adenocarcinoma arising from BE is managed the same way as squamous cell carcinoma in the same location. Strategies to prevent BEA may include medication such as non-steroidal anti-inflammatory drugs and proton pump inhibitors, and anti-reflux surgery. Understanding the pathophysiology of BE will help to reduce the incidence of BEA. PMID:23283352
Miyazaki, Tatsuya; Inose, Takanori; Tanaka, Naritaka; Yokobori, Takehiko; Suzuki, Shigemasa; Ozawa, Daigo; Sohda, Makoto; Nakajima, Masanobu; Fukuchi, Minoru; Kato, Hiroyuki; Kuwano, Hiroyuki
An evaluation of population screening to detect hepatocellular carcinoma (HCC) is made by comparative study of 66 cases of pathologically proved mass survey HCC and 220 of pathologically proved clinical HCC treated during the same period from 1972 to 1978...
Z. Tang B. Yang C. Tang Y. Yu Z. Lin
Signet ring carcinoma is a common type of adenocarcinoma of stomach but its occurrence in ampulla of Vater is extremely rare. There are only a few previous reported cases of signet ring carcinoma of ampulla of Vater. Here we reported a 61-year-old woman with obstructive jaundice. Ultrasonography and computed tomography (CT scan) examination showed intra- and extrahepatic bile duct dilatation. Endoscopic examination with biopsies revealed a small-size mass in ampulla of Vater with diagnosis of signet ring carcinoma. On consequent pancreatoduodenectomy the tumor was diagnosed as T2N0M0, stage IB. Because of the specific site of signet ring carcinoma of ampulla of Vater, the tumor seems to present itself at an early stage of disease. We review in the literature to suggest our idea. PMID:24592377
Talebi, Ardeshir; Mohammadizadeh, Fareshteh; Hani, Mohsen; Bagheri, Marzie; Bagheri, Azam
The first part of the study is a literature survey. The second part deals with patients and results of radiotherapy of the Klinik and Poliklinik fuer Radiologie der Universitaet Muenchen. The patients with mammary carcinomas, who were treated between 1960...
Renal-cell carcinoma is considered to be a radioresistant tumour, but this notion might be wrong. If given in a few (even single) fractions, but at a high fraction dose, stereotactic body radiotherapy becomes increasingly important in the management of renal-cell carcinoma, both in primary settings and in treatment of oligometastatic disease. There is an established biological rationale for the radiosensitivity of renal-cell carcinoma to stereotactic body radiotherapy based on the ceramide pathway, which is activated only when a high dose per fraction is given. Apart from the direct effect of stereotactic body radiotherapy on renal-cell carcinoma, stereotactic body radiotherapy can also induce an abscopal effect. This effect, caused by immunological processes, might be enhanced when targeted drugs and stereotactic body radiotherapy are combined. Therefore, rigorous, prospective randomised trials involving a multidisciplinary scientific panel are needed urgently. PMID:24694640
De Meerleer, Gert; Khoo, Vincent; Escudier, Bernard; Joniau, Steven; Bossi, Alberto; Ost, Piet; Briganti, Alberto; Fonteyne, Valérie; Van Vulpen, Marco; Lumen, Nicolaas; Spahn, Martin; Mareel, Marc
This article elucidates the clinical and pathological features of both ductal and lobular in-situ breast carcinoma. It quantifies the risk of invasive disease developing and outlines different treatment options with results as presently known. PMID:2175227
Phipps, R F; Rayter, Z
Lobular carcinoma is a special type of breast cancer that shows distinct clinical presentation, morphologic and molecular features, and clinical behavior, and its incidence is rising in recent years. Infiltrating lobular carcinoma (ILC) and its precursor lesions may result in diagnostic difficulties, particularly in the screening settings and their management may be problematic. Variants of lobular carcinoma, such as the pleomorphic variant, although not common, exist and some show differences in behavior warranting their recognition in view of requirements for different management strategies. Here we present a review of lobular carcinomas with particular attention to lobular in situ lesions, epidemiology, subtypes, diagnosis, molecular pathology, and grading of ILC in addition to the clinical behavior, response to therapy, and outcome of patients with ILC. PMID:20306830
Rakha, Emad A; Ellis, Ian O
Signet ring carcinoma is a common type of adenocarcinoma of stomach but its occurrence in ampulla of Vater is extremely rare. There are only a few previous reported cases of signet ring carcinoma of ampulla of Vater. Here we reported a 61-year-old woman with obstructive jaundice. Ultrasonography and computed tomography (CT scan) examination showed intra- and extrahepatic bile duct dilatation. Endoscopic examination with biopsies revealed a small-size mass in ampulla of Vater with diagnosis of signet ring carcinoma. On consequent pancreatoduodenectomy the tumor was diagnosed as T2N0M0, stage IB. Because of the specific site of signet ring carcinoma of ampulla of Vater, the tumor seems to present itself at an early stage of disease. We review in the literature to suggest our idea.
Talebi, Ardeshir; Mohammadizadeh, Fareshteh; Hani, Mohsen; Bagheri, Marzie; Bagheri, Azam
Forty-three consecutive specimens of resected rectal carcinomas, 16 abdominoperineal and 27 anterior resections, were examined\\u000a for distal intramural spread. Thirty-four of the resections were considered curative and nine palliative. Eighteen carcinomas\\u000a (42 percent) showed no distal spread, and 14 (33 percent) showed very limited distal spread (0–5 mm). In the remaining cases,\\u000a 11 (25 percent) had distal spread of more
Per M. Madsen; John Christiansen
The prevalence at death of carcinoma of the lung in miners and ex-miners has been compared in those with and without pneumoconiosis at necropsy. The prevalence of 11.4% in the group as a whole is no greater than that in the male population in North-west England. Carcinoma of the lung was present in 62 (13.1%) of those without pneumoconiosis and
G B Rooke; F G Ward; A N Dempsey; J B Dowler; C J Whitaker
\\u000a Ductal carcinoma in situ (DCIS) of the breast is a proliferation of malignant epithelial cells within parenchymal structures\\u000a of the breast, which is distinguished from invasive carcinoma by the absence of stromal invasion through the limiting basement\\u000a membrane. Although the incidence of DCIS has apparently increased over the last 20 years, this is interpreted as a result\\u000a of the enhanced
John P. Brown; Sarah E. Pinder
The biologic nature, diagnostic features and therapeutic management of patients with lobular carcinoma in its in situ and invasive forms are discussed. Although recorded studies emphasize that patients with lobular carcinoma in situ are "at risk" for the development of invasive cancer, it has not been unequivocally demonstrated whether such an event represents a persistence of cancer due to inadequate excision or a de novo lesion. In support of the latter is the contention that lobular carcinoma exhibits a propensity for multicentricity and bilaterality. The recognition that the histologic types of the subsequent invasive cancers are not universally lobular invasive might also be cited in this regard. This information also bears upon views purporting a stepwise development of lobular invasive carcinoma from its in situ analog. Analysis of our own material fails to confirm any significant association between invasive lobular carcinoma and multicentric lesions. The diagnostic difficulty in distinguishing lobular hyperplasia from in situ lobular carcinoma and the inadvisability of frozen sections for this purpose is noted. Although the results of some electron microscopic studies of the in situ lesion challenge the propriety of its "pure in situ" nature; this criticism does not appear valid from both a pathological as well as pragmatic standpoints. The various schemes have been proposed concerning the surgical management of patients with lobular carcinoma in situ are presented and discussed. Certain biologic principles prompt consideration of segmental mastectomy and axillary node sampling as an alternative, commodious form of treatment for such lesions. There does not appear to be any unique reason to invoke any different treatment regimen for lobular invasive carcinoma than has been utilized for other invasive breast cancers. Images Fig. 1A. Fig. 1B. Fig. 2A. Fig. 2B.
Fisher, E R; Fisher, B
BACKGROUND\\/AIMS: Matrix metalloproteinase-7 (MMP-7) belongs to the same family as matrix degrading metalloproteinase (MMPs) that may play an important part in cancer cell invasion and metastasis. This study reports on the MMP-7 mRNA expression level both in human gastric carcinomas and the normal gastric mucosa. METHODS: From fresh specimens of 47 surgical pairs of primary gastric carcinomas and corresponding normal
M Honda; M Mori; H Ueo; K Sugimachi; T Akiyoshi
Pseudohyperparathyroidism was diagnosed in a mature stallion presented for anorexia, weight loss, pollakiuria and constipation. Laboratory findings included hypercalcemia, hypophosphatemia, anemia and isosthenuria. Thoracocentesis indicated an exfoliating squamous cell carcinoma. At necropsy, a squamous cell carcinoma of the stomach with metastases to the abdominal and thoracic cavities was diagnosed. No osseous metastases were found. No gross or microscopic renal lesions were noted. Bone tissue showed arrested resorption, and the parathyroid gland was atrophic. PMID:639516
Meuten, D J; Price, S M; Seiler, R M; Krook, L
Hereditary nunpolyposis colorÃ©ela!cancer (HNPCC) is characterized by a familial predisposition to colorÃ©ela! carcinoma and extracolonic can cers of the gastrointestinal, urologica!, and female reproductive tracts, notably the endometrium. A genetic locus for HPNCC was recently deter mined by linkage analysis to exist on chromosome 2p; both sporadic and HNPCC-associated colorÃ©ela)carcinomas exhibit a \\
John I. Risinger; Andrew Berchuck; Matthew F. Kohler; Henry T. Lynch; Jeff Boyd
Hyalinizing clear cell carcinoma (HCCC) is an uncommon malignant salivary gland tumor accounting for about 1% of all intra-oral salivary gland tumors. Microscopic diagnosis of clear cell carcinoma may be challenging because of the spectrum of features which frequently overlaps with the other salivary gland tumors that contain clear cells, and thus it may be a diagnosis of exclusion. Here we, report a case of HCCC in a 36 years old female with detailed histological, histochemical and immunohistochemical discussion.
Baghirath, P Venkat; Kumar, J Vijay; Vinay, B Hari
Hepatocellular carcinoma is characterized by hypervascularity and a propensity for vascular invasion. Detailed analysis of complementary DNA (cDNA) microarray global gene expression data and further validation on a smaller independent sample set by reverse transcription-polymerase chain reaction established the presence of two endothelial gene clusters in hepatocellular carcinoma. Cluster I, consists of 20 cDNA clones, representing 15 unique genes. Cluster
Xin Chen; John Higgins; Siu-Tim Cheung; Rui Li; Veronica Mason; Kelli Montgomery; Sheung-Tat Fan; Matt van de Rijn; Samuel So
It is accepted that immunosuppressant therapy after organ transplantation is associated with an increase risk of neoplasm. Subungual squamous cell carcinoma of the toe is a rare condition and has not previously been reported, to our knowledge, in patients undergoing immunosuppressant therapy. The objective of this case study is to report the clinical and histopathologic findings and the multidisciplinary treatment approach for a case of subungual squamous cell carcinoma of the toe in an organ transplant recipient undergoing immunosuppressant drug therapy. PMID:20660884
Sung, Wenjay; Sam, Hakeem; Deleyiannis, Frederic W B
Hepatocellular Carcinoma Non-resectable; Hepatocellular Carcinoma Recurrent; Carcinoma, Hepatocellular; Liver Diseases; Neoplasms by Histologic Type; Digestive System Neoplasms; Carcinoma; Liver Neoplasms; Neoplasms; Neoplasms by Site; Digestive System Diseases; Adenocarcinoma; Neoplasms, Glandular and Epithelial
Collision tumor is an extremely rare tumor which defined as the concrescence of two distinct primaries neoplasms. We report here a case of collision tumor at lower third esophagus composed of small cell type neuroendocrine carcinoma (NEC), which is an very rare, highly aggressive and poorly prognostic carcinoma and squamous cell carcinoma (SqCC). In our case, pathologically, the small cell carcinoma display the characteristic of small, round, ovoid or spindle-shaped tumor cells with scant cytoplasm, which colliding with a moderately differentiated squamous cell carcinoma. Immunohistochemical staining demonstrated positive activities for CD56, synaptophysin, 34?E12, CK 5/6, ki-67 (70%-80%), but negative for CD99, chromogranin A, and TTF-1. Accurate diagnosis was made base on these findings.
Yang, Luoluo; Sun, Xun; Zou, Yabin; Meng, Xiangwei
Thymic carcinoma is a rare thymic epithelial tumor in which chemotherapy for advanced disease has not yet been established. Thymidylate synthase (TS) and orotate phosphoribosyltransferase (OPRT) protein expression levels in thymic carcinoma were evaluated as possible indicators of the anticancer activity of 5-fluorouracil (5-FU) drugs using immunohistochemistry (IHC). A total of 24 samples of thymic carcinoma were used in the present study. The tumor sections were immunohistochemically stained for TS and OPRT. As a comparison with thymic carcinoma, we also assessed the TS and OPRT protein expression levels in 55 lung cancer samples. The TS expression was positive in 12 of 24 thymic carcinoma samples (50%) and OPRT expression was positive in 10 (42%). The association between TS and OPRT expression and Masaoka stages of thymic carcinoma was analyzed. The TS and OPRT expressions in stage IV were significantly higher compared to that in stages I, II or III. We also compared the TS and OPRT expression levels between thymic carcinoma and lung cancer (33 adenocarcinomas and 22 squamous cell carcinomas). TS expression in thymic carcinoma was significantly lower compared with lung squamous cell carcinoma. OPRT expression in thymic carcinoma was significantly higher compared to lung adenocarcinoma. The combination of a relatively low expression of TS and high expression of OPRT suggests an improved antitumor effect of 5-FU drugs in thymic carcinoma compared to in lung carcinoma.
YOKOTA, KEISUKE; SASAKI, HIDEFUMI; OKUDA, KATSUHIRO; SHITARA, MASAYUKI; HIKOSAKA, YU; MORIYAMA, SATORU; YANO, MOTOKI; FUJII, YOSHITAKA
PURPOSE Mucinous ovarian carcinomas have a distinct clinical pattern compared to other subtypes of ovarian carcinoma. Here, we evaluated (i) stage-specific clinical significance of mucinous ovarian carcinomas in a large cohort and (ii) the functional role of src kinase in pre-clinical models of mucinous ovarian carcinoma. EXPERIMENTAL DESIGN 1302 ovarian cancer patients including 122 (9.4%) cases of mucinous carcinoma were evaluated for survival analyses. Biological effects of src kinase inhibition were tested in a novel orthotopic mucinous ovarian cancer model (RMUG-S-ip2) using dasatinib-based therapy. RESULTS Patients with advanced-stage mucinous ovarian cancer had significantly worse survival compared to those with serous histology: median overall survival, 1.67 versus 3.41 years, p=0.002; and median survival time after recurrence of 0.53 versus 1.66 years, p<0.0001. Among multiple ovarian cancer cell lines, RMUG-S-ip2 mucinous ovarian cancer cells showed the highest src kinase activity. Moreover, oxaliplatin treatment induced phosphorylation of src kinase. This induced activity by oxaliplatin therapy was inhibited by concurrent administration of dasatinib. Targeting src with dasatinib in vivo showed significant anti-tumor effects in the RMUG-S-ip2 model, but not in the serous ovarian carcinoma (SKOV3-TR) model. Combination therapy of oxaliplatin with dasatinib further demonstrated significant effects on reducing cell viability, increasing apoptosis, and in vivo anti-tumor effects in the RMUG-S-ip2 model. CONCLUSIONS Our results suggest that poor survival of women with mucinous ovarian carcinoma is associated with resistance to cytotoxic therapy. Targeting src kinase with combination of dasatinib and oxaliplatin may be an attractive approach in this disease.
Matsuo, Koji; Nishimura, Masato; Bottsford-Miller, Justin N.; Huang1, Jie; Komurov, Kakajan; Armaiz-Pena, Guillermo N.; Shahzad, Mian M. K.; Stone, Rebecca L.; Roh, Ju Won; Sanguino, Angela M.; Lu, Chunhua; Im, Dwight D.; Rosenshien, Neil B.; Sakakibara, Atsuko; Nagano, Tadayoshi; Yamasaki, Masato; Enomoto, Takayuki; Kimura, Tadashi; Ram, Prahlad T.; Schmeler, Kathleen M.; Gallick, Gary E.; Wong, Kwong K.; Frumovitz, Michael; Sood, Anil K.
A 13 year old patient with juvenile type IV glycogen storage disease died of the complications of hepatocellular carcinoma. To our knowledge this is the first reported case of hepatocellular carcinoma in association with type IV glycogen storage disease.??
de Moor, R A; Schweizer, J; van Hoek, B; Wasser, M; Vink, R; Maaswinkel-Mooy, P
The authors report a rare case of regional portal hypertension secondary to splenic vein obstruction by left adrenal carcinoma metastasis. They review the principal literature data concerning regional portal hypertension and adrenal cortical carcinoma. PMID:1639890
Mhiri, M N; Trifa, M; Sellami, M; Mhiri, C; Letaief, Y; Souissi, T
To investigate the pathobiological behaviors of gastric mixed-type (MT) carcinomas and gastric carcinogenesis, the clinicopathological characteristics of MT carcinomas were analyzed and compared with intestinal-type (IT) and diffuse-type (DT) carcinomas. The expression of Ki-67, caspase-3, p53, fragile histine triad (FHIT), maspin, extracellular matrix metalloproteinase inducer (EMMPRIN), vascular growth factor (VEGF), MUC-2, 4, 5AC and 6, CD44, E-cadherin, ?-catenin, and phosphorylated glycogen synthase kinase 3?-ser9 (P-GSK3?-ser9) was examined on tissue microarrays using immunohistochemistry. It was found that MT carcinomas exhibited large size, deep invasion, frequent local invasion, and lymph node metastasis in comparison with IT and DT carcinomas (p?0.05). All the markers except MUC-5AC showed higher expression in IT than DT carcinomas (p?0.05). The expression of maspin, EMMPRIN, VEGF, MUC-4, and membrane E-cadherin was stronger in MT intestinal than diffuse component (p?0.05). Immunoreactivities to Ki-67, EMMPRIN, and VEGF were weaker in IT carcinoma than in the MT intestinal portion (p?0.05), while the opposite was true for CD44, MUC-2, and MUC-6 (p?0.05). The MT diffuse component displayed a higher expression of FHIT, VEGF, and P-GSK3?-ser9 than DT carcinoma (p?0.05). The accumulative survival rate of the IT carcinoma patients was higher than the other types (p?0.05). The invasive depth, venous invasion, lymph node, peritoneal or liver metastasis, and Lauren's classification were independent prognostic factors for gastric carcinomas (p?0.05). These findings suggested that MT carcinomas were also indicated to be more aggressive than IT and DT carcinomas. Significant differences were observed in the proliferation, apoptosis, angiogenesis, mucin secretion, and cell adhesion between IT and DT carcinomas, whereas only a few of these characteristics showed differences between the MT intestinal and diffuse parts, thus suggesting that both the MT components might originate from the stem cells with similar genetic traits, but follow different histogenic pathways.
Li, Xiao-han; Hara, Takuo; Masuda, Shinji; Yang, Xiang-hong; Guan, Yi-fu; Takano, Yasuo
Medullary thyroid carcinoma represents 4-8% of thyroid malignancies; regional nodal involvement is commonly found, even at the time of first surgical approach. In these patients after surgical resection, other therapeutic choices are really limited. The Authors evaluated their experience in the period 1981-1994, concerning 14 patients, 9 females and 5 males, all affected with sporadic MTC. Diagnosis was preoperative in 10 patients and intraoperative in 4; as for the staging: in 8 patients the tumor resulted confined to the thyroid, while in the remaining 6 patients it was extra-thyroidal. In 5 patients a total thyroidectomy with regional lymphadenectomy was performed, with in 6 patients a total thyroidectomy with cervico-mediastinic total lymphadenectomy was achieved. Survival was evaluated with a short, follow-up (3 months) and calculated using the K-Mayer method. Average survival was: 5 years in patients undergoing only total thyroidectomy; 3 years and 1 month in patients undergoing total thyroidectomy and lymphadenectomy; 6 months in patients undergoing no treatment at all. Among the factors negatively affecting patients survival, the Authors pointed out: metastasis occurrence; incomplete resection and mediastinal metastasis. In conclusion surgical resection (total thyroidectomy) associated with radical lymphadenectomy resulted to be a good approach. However, prognostic factors require further investigation. PMID:9044606
Francomano, F; Cotellese, R; Scipione, P; Ricci, A; D'Aulerio, A; Ricciardi, A; Orlandi, N; Napolitano, L
Hepatocellular carcinoma (HCC) is a global health problem, although developing countries are disproportionally affected: over 80% of HCCs occur in such regions. About three-quarters of HCCs are attributed to chronic HBV and HCV infections. In areas endemic for HCV and HBV, viral transmission occurs at an early age, and infected individuals develop HCC in mid-adulthood. As these are their most productive years of life, HCC accounts for a substantial burden on the health-care system and drain of productive capacity in the low-income and middle-income countries most affected by HCV and HBV infections. Environments with disparate resource levels require different strategies for the optimal management of HCC. In high-resource environments, guidelines from the American Association for the Study of Liver Diseases or European Association for the Study of the Liver should be applied. In intermediate-resource or low-resource environments, the fundamental focus should be on primary prevention of HCC, through universal HBV vaccination, taking appropriate precautions and antiviral treatments. In intermediate-resource and low-resource environments, the infrastructure and capacity for abdominal ultrasonography, percutaneous ethanol injection, radiofrequency ablation and surgical resection should be established. Programs to provide targeted therapy at low cost, similar to the approach used for HIV therapy in the developing world, should be pursued.
Yang, Ju Dong; Roberts, Lewis R.
Hepatitis B is endemic in many regions of Asia, including China, Korea and India. This results in a heavy burden of hepatocellular carcinoma (HCC) because hepatitis B virus is a major risk factor in the development of the disease. In addition, the incidence of hepatitis-C-related HCC is on the rise in the United States. HCC patients with poor liver function reserve are not suitable candidates for resection, and liver transplantation (LT) has emerged as the treatment of choice for small unresectable HCCs. To treat more HCC patients with LT, the standard patient selection criteria have been expanded at a number of centers. Careful and well-considered selection of patients is the key to success in LT for HCC. Although tumor size and tumor number are used to predict whether transplantation is likely to be successful, the weighting that should be attached these two parameters has not been determined. In addition to the size and number of lesions, the morphology of HCC is also predictive of its behavior. Well-circumscribed lesions, in general, are less aggressive than those with poorly defined borders. On the waiting list for LT, HCC patients compete with liver failure patients. It is essential that the criteria used for selecting HCC patients for LT should be easily applicable and fair to other transplant candidates. In the face of the scarcity of deceased-donor livers and the inevitable risks for living liver donors, a predictably low rate of recurrence of HCC after LT is mandatory.
Chan, See Ching
Invasion of a bladder tumour involves the degradation and penetration of the subepithelial basement membrane. A retrospective study of 69 superficial and 15 invasive transitional cell carcinomas of bladder and a prospective study of 43 mucosal biopsies were performed in order to assess the usefulness of immunohistochemical staining of the basement membrane components, type IV collagen and laminin as prognostic indicators in superficial bladder cancer. There was a significant association between pT category and basement membrane staining. The incidence of progression of superficial tumours with patchy or absent basement membranes was significantly greater than those with complete basement membranes but there was no association with superficial recurrence. Biopsies of dysplastic epithelium had thickened and reduplicated basement membranes, possibly as a result of increased cell turnover. The results suggest that a balance exists between basement membrane production and degradation in early malignancy. This technique may be of value in the early identification of microinvasion and in the prediction of subsequent progression. PMID:3427340
Conn, I G; Crocker, J; Wallace, D M; Hughes, M A; Hilton, C J
About thyroid neoplasms the epidermoidal carcinoma represents an ingrown minority (0.3-0.74%). Several etiopathological hypotheses are considered and this testifies the notable uncertainty that still winds the origin of the neoplasm. In the actual case, the more accredited hypothesis foresees the origin of the neoplasm from a histopathological of Hashimotos' tyhroiditis. The objectivity of the case in examination constitutes the clinical picture of reference of the malignant neoplasms of the thyroid: oligosintomatic low cervical mass of increased consistence, adherent to the imminent pianos strictly following laryngeal movements, dysfagia and dysfonia. Additionally they were present pulmonary and right cervical lymphonodal metastases. After an adjuvant treatment with Paraplatin and 5-FU, to some months from the intervention of total thyroidectomy, local relapse in form of a festered mass is highlighted in sovrajugular region with result in cutaneous-esophagustracheal fistula. The diagnosis of certainty of the neoplasm, despite the rarity, it doesn't constitute a problem, albeit the percents of survival, anyway substantially more favorable respect to anaplastic neoplasms, concerning to as numerical as chronological aspects, result to be hardly discouraging. PMID:9835109
Relmi, F; Russo, A; Magnacca, F; Leombruni, E; Buccoliero, G; Picardi, N
The rather rare vulvar cancer is almost always a squamous cell carcinoma that mostly develops from an underlying VIN or HPV infection. In addition, lichen sclerosus et atrophicans, immune deficiency, nicotine abuse or anogenital intraepithelial neoplasias may play a role in the pathogenesis. Surgical therapy aims at an R0 resection in the sense of a complete vulvectomy or a radical local excision with, if necessary, plastic reconstruction. Also, the vulvar field resection with consideration of the compartment model has been discussed. Besides the classic inguinofemoral lymphadenectomy, in selected cases of vulvar cancer sentinel biopsies are performed by experienced surgeons in the larger centres. In contrast, systemic therapy plays only a subordinate role; in isolated cases down-staging by means of neoadjuvant chemotherapy may be useful. However, there is at present no indication for adjuvant chemotherapy. Neoadjuvant radiochemotherapy is also not to be recommended on account of its unfavourable ratio of efficacy to side effects. On the other hand adjuvant radiotherapy is indicated in cases of positive inguinal lymph nodes. According to the current data the indication should be made generously in such cases.
Herr, D.; Juhasz-Boess, I.; Solomayer, E. F.
Hepatocellular carcinoma (HCC) represents the most common liver cancer with an increasing incidence and it accounts for the third most common cause of cancer-related death worldwide. Even though the clinical diagnosis and management of HCC improved significantly in the last decades, this malignant disease is still associated with a poor prognosis. It has to be distinguished between patients with HCCs, which developed from liver cirrhosis, and patients without underlying liver cirrhosis as classification systems, prognosis estimation and therapy recommendations differ in-between. In case of HCC in patients with liver cirrhosis in Europe, treatment allocation and prognosis estimation are mainly based on the Barcelona-Clinic Liver Cancer (BCLC) staging system. Based on this staging system different surgical, interventional radiological/sonographical and non-interventional procedures have been established for the multimodal treatment of HCC. The BCLC classification system represents a decision guidance; however because of its limitations in selected patients treatment allocation should be determined on an individualized rather than a guideline-based medicine by a multidisciplinary board in order to offer the best treatment option for each patient. This review summarizes the current management of HCC and illustrates controversial areas of therapeutic strategies. PMID:24666568
Graf, Dirk; Vallböhmer, Daniel; Knoefel, Wolfram Trudo; Kröpil, Patric; Antoch, Gerald; Sagir, Abdurrahaman; Häussinger, Dieter
Penile carcinoma (PeCa) represents an important public health problem in poor and developing countries. Despite its unpredictable behavior and aggressive treatment, there have only been a few reports regarding its molecular data, especially epigenetic mechanisms. The functional diversity in different cell types is acquired by chromatin modifications, which are established by epigenetic regulatory mechanisms involving DNA methylation, histone acetylation, and miRNAs. Recent evidence indicates that the dysregulation in these processes can result in the development of several diseases, including cancer. Epigenetic alterations, such as the methylation of CpGs islands, may reveal candidates for the development of specific markers for cancer detection, diagnosis and prognosis. There are a few reports on the epigenetic alterations in PeCa, and most of these studies have only focused on alterations in specific genes in a limited number of cases. This review aims to provide an overview of the current knowledge of the epigenetic alterations in PeCa and the promising results in this field. The identification of epigenetically altered genes in PeCa is an important step in understanding the mechanisms involved in this unexplored disease.
Kuasne, Hellen; Marchi, Fabio Albuquerque; Rogatto, Silvia Regina; de Syllos Colus, Ilce Mara
Developments in the knowledge of molecular biology of renal cell carcinoma (RCC) over the past 20 years have been identified. Angiogenesis is playing a key role in the physiopathology of RCC. Von Hippel-Lindau (VHL) alterations, HIFalpha accumulation and vascular endothelial growth factor (VEGF) overexpression are important mediators of this process. Several stategies have been developped to target angiogenesis for the treatment of metastatic RCC. These include inhibition of VEGF receptors (inhibition of the tyrosine kinase activity) or binding to the VEGF protein. Several additional kinases inhibitions including PDGF receptors are also targeted. Sunitinib (SU11248) is an orally biovailable small molecule that has demonstrated superiority over interferon-alpha for the treatment of metastatic RCC. In a recent randomized phase III study conducted in 750 patients, the response rate to sunitinib was 31% and to interferon 6%. The median of progression free survival (PFS) was 11 months for sunitinib and 5 months for interferon (p < 0.001). Sorafenib (BAY43-9006) was found to inhibit Raf1, but also VEGFR2 and 3, Flt3, PDGFR-a and b and c-kit, has been tested in a phase III study against placebo after one prior systemic therapy. The median of the time to progression (TTP) for sorafenib was 24 weeks versus 12 weeks for patients in the placebo arm (p = 0,01). Other molecules tested in metastatic RCC will be presented including axitinib, pazopanib and bevacizumab. PMID:17846009
Billemont, Bertrand; Méric, Jean-Baptiste; Izzedine, Hassan; Taillade, Laurent; Sultan-Amar, Valentine; Rixe, Olivier
The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.
Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)], E-mail: email@example.com; Mancuso, Anthony A. [Department of Diagnostic Radiology, University of Florida College of Medicine, Gainesville, FL (United States); Hinerman, Russell W.; Malyapa, Robert S. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Werning, John W. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States); Amdur, Robert J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Villaret, Douglas B. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States)
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related mortality worldwide. Unfortunately, only 20% of HCC patients are amenable to curative therapy (liver transplantation or surgical resection). Locoregional therapies such as radiofrequency ablation (RFA), percutaneous ethanol injection, microwave coagulation therapy, and transcatheter arterial chemoembolisation play a key role in the management of HCC. The choice of the treatment modality depends on the size of the tumour, tumour location, anatomic considerations and the number of tumours present and liver function. RFA therapy for HCC can be performed safely using a percutaneous, laparoscopic, or an open approach, even in patients with poor functional reserve. Since the introduction of RFA, several randomised controlled trials and non-randomised studies comparing RFA and other therapies for HCC have been conducted. In addition, in the last decade there have been technical advances in RFA therapy for HCC, resulting in significant improvement in the prognosis of HCC patients treated with this modality. In this review, we primarily focus on percutaneous RFA therapy for HCC and refer to current knowledge and future perspectives for this therapy. We also discuss new emerging ablation techniques. PMID:23937321
Nishikawa, Hiroki; Kimura, Toru; Kita, Ryuichi; Osaki, Yukio
Hepatocellular carcinoma is the fifth most common human cancer worldwide, with an overall 5-year survival in the range of 10%. In addition to the very substantial role of chronic viral hepatitis in causing hepatocellular carcinoma, nutritional status and specific nutritional factors appear to influence disease risk. This is apparent in the increased risk associated with non-alcoholic hepatic cirrhosis occurring in the context of obesity, the metabolic syndrome, and type 2 diabetes. Specific nutrients and ingested toxins, including ethanol, aflatoxin, microcystins, iron, and possibly components of red meat, also are associated with increased hepatocellular carcinoma risk. Other dietary components, including omega-3 fatty acids and branched chain amino acids, may have protective effects. Recent data further suggest that several metabolic regulatory drugs, including metformin, pioglitazone, and statins, may have the potential to decrease the risk of hepatocellular carcinoma. The available data on these nutritional and metabolic factors in causing hepatocellular carcinoma are reviewed with the goal of identifying the strength of current knowledge and directions for future investigation.
Nine dogs were diagnosed with cranial mediastinal carcinomas. Based on histological and immunohistochemical analysis, four dogs were diagnosed with ectopic follicular cell thyroid carcinomas, one dog with ectopic medullary cell thyroid carcinoma, two dogs with neuroendocrine carcinomas and two dogs with anaplastic carcinomas. Clinical signs and physical examination findings were associated with a space-occupying mass, although one dog was diagnosed with functional hyperthyroidism. Surgical resection was attempted in eight dogs. The cranial mediastinal mass was invasive either into the heart or into the cranial vena cava in three dogs. Resection was complete in six dogs and unresectable in two dogs. All dogs survived surgery, but four dogs developed pulmonary thromboembolism and two dogs died of respiratory complications postoperatively. Adjunctive therapies included pre-operative radiation therapy (n=1) and postoperative chemotherapy (n=3). Three dogs had metastasis at the time of diagnosis, but none developed metastasis following surgery. The overall median survival time was 243 days. Local invasion, pleural effusion and metastasis did not have a negative impact on survival time in this small case series. PMID:19178660
Liptak, J M; Kamstock, D A; Dernell, W S; Ehrhart, E J; Rizzo, S A; Withrow, S J
Of 362 patients undergoing ileal pouch-anal anastomosis, 12 (five with chronic ulcerative colitis and seven with familial adenomatous polyposis) had 16 associated carcinomas. Incidental carcinoma was found in four patients who had undergone ileal pouch-anal anastomosis, six patients had known carcinoma, and carcinoma was suspected in two patients with high-grade dysplasia. No tumor was Stage C or D. After a
Othon Wiltz; Hasan F. Hashmi; David J. Schoetz; Patricia L. Roberts; John J. Murray; John A. Coller; Malcolm C. Veidenheimer
Activating mutations in the TERT promoter were recently identified in up to 71% of cutaneous melanoma. Subsequent studies found TERT promoter mutations in a wide array of other major human cancers. TERT promoter mutations lead to increased expression of telomerase, which maintains telomere length and genomic stability, thereby allowing cancer cells to continuously divide, avoiding senescence or apoptosis. TERT promoter mutations in cutaneous melanoma often show UV-signatures. Non-melanoma skin cancer, including basal cell carcinoma and squamous cell carcinoma, are very frequent malignancies in individuals of European descent. We investigated the presence of TERT promoter mutations in 32 basal cell carcinomas and 34 cutaneous squamous cell carcinomas using conventional Sanger sequencing. TERT promoter mutations were identified in 18 (56%) basal cell carcinomas and in 17 (50%) cutaneous squamous cell carcinomas. The recurrent mutations identified in our cohort were identical to those previously described in cutaneous melanoma, and showed a UV-signature (C>T or CC>TT) in line with a causative role for UV exposure in these common cutaneous malignancies. Our study shows that TERT promoter mutations with UV-signatures are frequent in non-melanoma skin cancer, being present in around 50% of basal and squamous cell carcinomas and suggests that increased expression of telomerase plays an important role in the pathogenesis of these tumors.
Griewank, Klaus G.; Murali, Rajmohan; Schilling, Bastian; Schimming, Tobias; Moller, Inga; Moll, Iris; Schwamborn, Marion; Sucker, Antje; Zimmer, Lisa; Schadendorf, Dirk; Hillen, Uwe
The diagnosis of DCIS is not always straightforward. Many studies have illustrated the central problem in diagnosing DCIS, which is that the heterogeneity of the disease allows it to be easily confused with a variety of other diseases, such as atypical ductal hyperplasia (ADH), microinvasive carcinoma, invasive carcinoma, lymphatic invasion, lobular carcinoma in situ (LCIS), and other intraductal lesions.
AIMS: This study compared the mammographic appearance, site and histological features of synchronous and metachronous bilateral breast carcinomas.METHODS: Site, type of abnormality and background pattern seen on the diagnostic mammograms of 63 women with bilateral breast carcinoma were compared. The histological type and grade of all the carcinomas were verified by histological review.RESULTS: There was a tendency for the contralateral
N. J Hall; A. J Evans; J Kollias; H Denley; S. E Pinder; I. O Ellis; R. W Blamey; A. R. M Wilson
68 cases of gastric carcinomas and 31 tissue samples adjoining the carcinomas were investigated by impulse cytophotometry, cytomorphology and histology, respectively. Differentiated adenocarcinoma tended to aneuploidy, while undifferentiated carcinoma often showed euploidy. The adjoining mucosa was characterized by polymorphism of the mucous superficial epithelial cells and the histograms showed slight abnormalities.Copyright © 1980 S. Karger AG, Basel
A. S. Petrova; G. N. Subrichina; O. V. Tschistjakova; T. A. Lukina; H. Weiss; G. Wildner
The binding of monoclonal antibody specific for colon carcinoma was inhibited by serum from patients with adenocarcinoma of the colon but not by serum from patients with other bowel diseases or from healthy volunteers. Of other malignancies studied, serum from two patients with gastric carcinoma and two patients with pancreatic carcinoma also inhibited the specific binding of monoclonal antibody. The
Hilary Koprowski; Meenhard Herlyn; Zenon Steplewski; Henry F. Sears
Invasive micropapillary carcinoma (IMPCa) of breast is histologically characterized by growth of cohesive tumor cell clusters within prominent clear spaces resembling dilated angiolymphatic vessels. In this study, eighty three breast carcinomas with IMPCa differentiation were identified by review of the invasive carcinoma cases in our institution and correlated retrospectively with standard clinicopathologic parameters and survival status relative to a control
Hind Nassar; Tracy Wallis; Aleodor Andea; Jyotirmoy Dey; Volkan Adsay; Daniel Visscher
Acinar cell carcinoma of the pancreas is a rare malignant tumour developing from acinar cells, accounting for approximately 1% of pancreatic exocrine tumours. We experienced a case of an acinar cell carcinoma with fatty change. To the best of our knowledge, this is the first case report of an acinar cell carcinoma with fatty change in the clinical literature.
Chung, W-S; Park, M-S; Kim, D W; Kim, K W
Verrucous carcinoma has a special propensity to mimic benign lesions of the oral cavity. A case of the oral verrucous carcinoma in maxillary alveolar ridge, extending to buccal vestibule, cheek, and labial mucosa, which was diagnosed and initially treated as chronic candidiasis, is presented. Clinical, histopathological, and therapeutic considerations related to diagnosis of the verrucous carcinoma in the oral cavity are discussed. PMID:22720181
Garcia, Natália Galvão; Oliveira, Denise Tostes; Hanemann, João Adolfo Costa; Pereira, Alessandro Antônio Costa
Verrucous carcinoma has a special propensity to mimic benign lesions of the oral cavity. A case of the oral verrucous carcinoma in maxillary alveolar ridge, extending to buccal vestibule, cheek, and labial mucosa, which was diagnosed and initially treated as chronic candidiasis, is presented. Clinical, histopathological, and therapeutic considerations related to diagnosis of the verrucous carcinoma in the oral cavity are discussed.
Garcia, Natalia Galvao; Oliveira, Denise Tostes; Hanemann, Joao Adolfo Costa; Pereira, Alessandro Antonio Costa
Background. Laryngotracheal invasion worsens prog- nosis in patients with thyroid carcinoma. The extent of resection is controversial. Methods. We performed a retrospective study of pa- tients with thyroid carcinoma and invasion of the larynx or trachea between 1964 and 2005. Results. Eighty-two patients, mean age 64 years and 50% female, underwent segmental airway resection. Dif- ferentiated carcinoma was present in
Henning A. Gaissert; Jimmie Honings; Hermes C. Grillo; Dean M. Donahue; John C. Wain; Cameron D. Wright; Douglas J. Mathisen
Invasive micropapillary carcinoma is associated with frequent lymph node metastasis and adverse clinical outcome. Initially described as a variant of breast and ovarian carcinoma, it has subsequently been found in other organs, most recently the colon. Reports of colorectal micropapillary carcinoma to date are limited in number, and their molecular profile has not been established. The aims of the present
Montse Verdú; Ruth Román; Miquel Calvo; Natàlia Rodón; Beatriz García; Marta González; August Vidal; Xavier Puig
Mucinous carcinoma of the breast is one of the rarer forms of intramammary cancer, often presenting as a lobulated, fairly well circumscribed mass on mammography, sonography, and gadolinium-enhanced magnetic resonance imaging. It accounts for 1% to 7% of all breast cancers and generally carries a better prognosis than other types of malignant breast cancers. Metastatic disease occurs at a lower frequency than in other types of invasive carcinoma. We present an atypical case of mucinous carcinoma in a woman who presented with a palpable intramammary lymph node metastasis from an unknown breast primary. Subsequent magnetic resonance imaging and percutaneous biopsy demonstrated histologic findings consistent with a mixed mucinous neoplasm with a micropapillary pattern.
DeLeon, Patricia; DeLeon, William
We report herein a clinical case of a patient with meningeal carcinomatosis from penile squamous cell carcinoma. A 68-year-old man presented with mental changes, headaches, and unstable gait. Examinations revealed brain metastases and infiltration of the leptomeninges and subarachnoid space by carcinoma cells. Only 11 months earlier the patient had been diagnosed with penile squamous cell carcinoma of poor differentiation and had underwent subtotal penectomy and adjuvant chemotherapy and radiation. Infiltration of the central nervous system with penile cancer is extremely rare, and only five cases with brain metastases have been described to date. This is the first report of a patient with penile cancer spread to the leptomeninges. PMID:20013145
Skripuletz, Thomas; Pul, Refik; Herrmann, Julian; Bueltmann, Eva; Wurster, Ulrich; Stangel, Martin; Trebst, Corinna
Ductal carcinoma in situ represents a biologically and histologically heterogeneous group of lesions characterized by the proliferation of neoplastic epithelial cells confined to the ducts of the breast. Before screening mammography, ductal carcinoma in situ was considered uncommon; patients were usually diagnosed by a breast mass or bloody nipple discharge, and their treatment was mastectomy. Today it represents 20% to 30% of mammographically detected breast cancers and 10% to 15% of all diagnosed breast cancers in the United States. The invariable progression of this cancer to invasive breast cancer requiring mastectomy has been challenged, but because most patients have been treated with mastectomy, knowledge about ductal carcinoma in situ is limited and primarily based on retrospective data. Further insight will emerge from randomized prospective studies that are near completion. Currently available data indicate that breast-conserving treatments are valid alternatives to mastectomy for most patients with this disease. Images Figure 1.
Barth, A; Brenner, R J; Giuliano, A E
Adenoid Cystic Carcinoma (ACC) of cervix behaves aggressively and it has a propensity for local infiltration, invasion in lymphatic vessels as well as perineural spaces, with subsequent haematogenous spread. In advanced disease (Stage III and IV), outcome is invariably poor. Moreover, these cases have a high tendency to recur locally and also to metastasize to distant sites. There are no standard treatment protocols because of rarity of disease. The guidelines for its management are established similarly as for staged squamous cell carcinoma of cervix. Therefore, recommended treatment in advanced disease is aggressive multimodality treatment, which includes chemotherapy and radiotherapy. We are presenting a case of adenoid cystic carcinoma of cervix in 55 years old patient, staged as III B. The patient was treated with concomitant radiotherapy and chemotherapy. The patient responded well to treatment and is disease free, three years after treatment.
Kaur, Paramjeet; Khurana, Anil; Chauhan, Ashok K.; Singh, Gajender; Kataria, Sant Parkash; Singh, Sunita
Pancreatic ductal carcinoma, one of the leading causes of cancer mortality, is typically diagnosed at an advanced stage, which significantly contributes to its high mortality rates. Studies have demonstrated that resection of small pancreatic tumors and tumors at lower stages correlates with improved survival. Detection of pancreatic carcinoma at an early, surgically resectable stage is the key to decreasing mortality and improving survival. Identification of sensitive diagnostic biomarkers as screening tools is crucial in detecting preinvasive pancreatic neoplasms. Numerous new DNA-, RNA- and protein-based biomarkers have been extensively investigated. This review aims to provide an update on these molecular markers, including biomarkers from blood, tissue as well as pancreatic juice and cystic fluid. These biomarkers hold potential utility in early diagnosis and prognostification of pancreatic ductal carcinoma, though many of which need to be validated in large-scale prospective studies before they can be used in clinical settings.
Liang, John J.; Kimchi, Eric T.; Staveley-O'Carroll, Kevin F.; Tan, Dongfeng
The structures of normal ductal and ductular epithelium were compared with cytological peculiarities of pancreas carcinoma. This provided the basis on which to propose histogenetic classification of exocrine pancreas carcinoma. Most of the pancreas carcinomas are adenocarcinomas and originate from small lateral ductules. Preneoplastic ductal alterations, such as proliferation of ductal epithelium, adenomatous dysplasia, and light-cell transformation, may be topographically distinguished from ductular changes, including centroacinic hyperplasia, oncocytic transformation, microglandular metaplasia, ductulo-acinic metaplasia, hepatocellular metaplasia, and peri-insular metaplasia. The close correlations that exist between ductular and acinic cells may be summarised under the cover term of terminal ductulo-acinic intercalated duct complex. Dysplasia is generally accompanied by decline in neutral glycosaminoglycans and occurrence of unsubstituted sialomucin of the embryonic type. PMID:2781881
Schulz, H J
Dual malignancy was first reported by Billroth in 1889. Incidence of second malignancy in cancer patients is as high as 10%, but synchronous anaplastic thyroid cancer along with breast tumor is a rare entity. We present a case of a 61-year-old female with a synchronous anaplastic carcinoma thyroid with ductal carcinoma breast. The plausible association of breast cancers with thyroid carcinomas should thus be evaluated in larger cohort studies. More importantly, this report is to highlight the unusual synchronous occurrence of anaplastic thyroid cancer with ductal breast cancer and the therapeutic challenges involved in such cases.
Ghosh, Saptarshi; Rao, P. B. Ananda; Sarkar, Shreyasee; Kotne, Sivasankar; Turlapati, S. P. V.; Mishra, Anindita
Carcinoma cuniculatum, a unique variant of well-differentiated squamous cell carcinoma, has been only rarely reported in the esophagus. We report 9 cases of esophageal carcinoma cuniculatum diagnosed on esophagectomy specimens in 7 men and 2 women during a 20-year period. All but 1 of the patients presented with persistent or progressive dysphagia. All patients had an esophageal mass or lesion on endoscopic examination. In 8 cases (88.8%), the tumor was located in the distal esophagus. Burrowing was noted on the tumor surface in 2 recent cases on macroscopic examination. All carcinomas were invasive either at the mucosa (n=2), submucosa (n=1), muscularis propria (n=4), adventitia (n=3), or adventitia and lung (n=1). All carcinomas demonstrated a common histologic pattern characterized by hyperkeratosis, acanthosis, dyskeratosis, abnormal keratinization, keratin-filled cyst/furrows, koilocyte-like cells, intraepithelial neutrophils, and focal cytologic atypia. In situ hybridization for human papillomavirus subtypes was negative in all 10 tumors tested. None of the cases showed lymph node metastasis. Two patients died postoperatively due to complications. The remaining patients were followed up for a median duration of 84 months (48 to 214 mo). During the follow-up period, 3 patients died 49, 66, and 214 months after esophagectomy at the ages of 66, 68, and 91 years, respectively; death in these 3 cases was not related to recurrence/metastases of esophageal cancer. Four patients were alive without disease at 48, 49, 84, and 87 months after curative resection. Our report identifies a common histomorphologic pattern of esophageal carcinoma cuniculatum and supports the fact that surgical resection of the tumor by esophagectomy provides long-term survival even in patients with T3 tumor. PMID:22020041
Landau, Michael; Goldblum, John R; DeRoche, Tom; Dumot, John; Downs-Kelly, Erinn; Rice, Thomas W; Xiao, Shu-Yuan; Liu, Xiuli
Unlike most solid tumors, the incidence and mortality of hepatocellular carcinoma (HCC) have increased in the United States and Europe in the past decade. Most patients are diagnosed at advanced stages, so there is an urgent need for new systemic therapies. Sorafenib, a tyrosine kinase inhibitor (TKI), has shown clinical efficacy in patients with HCC. Studies in patients with lung, breast, or colorectal cancers have indicated that the genetic heterogeneity of cancer cells within a tumor affect its response to therapeutics designed to target specific molecules. When tumor progression requires alterations in specific oncogenes (oncogene addiction), drugs that selectively block their products might slow tumor growth. However, no specific oncogene addictions are yet known to be implicated in HCC progression, so it is important to improve our understanding of its molecular pathogenesis. There are currently many clinical trials evaluating TKIs for HCC, including those tested in combination with (eg, erlotinib) or compared with (eg, linifanib) sorafenib as a first-line therapy. For patients who do not respond or are intolerant to sorafenib, TKIs such as brivanib, everolimus, and monoclonal antibodies (eg, ramucirumab) are being tested as second-line therapies. There are early stage trials investigating the efficacy for up to 60 reagents for HCC. Together, these studies might change the management strategy for HCC, and combination therapies might be developed for patients with advanced HCC. Identification of oncogenes that mediate tumor progression, and trials that monitor their products as biomarkers, might lead to personalized therapy; reagents that interfere with signaling pathways required for HCC progression might be used to treat selected populations, and thereby maximize the efficacy and cost benefit. PMID:21406195
Villanueva, Augusto; Llovet, Josep M
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Despite efforts for prevention and screening as well as development of new technologies for diagnosis and treatment, the incidence of HCC has doubled, and mortality rates have increased in recent decades. A variety of important risk factors are associated with the development of HCC, with any type of cirrhosis, regardless of etiology, being the major contributor. Hepatitis C virus infection with bridging fibrosis or cirrhosis and hepatitis B virus infection are independent risk factors. The diagnosis of HCC is made without liver biopsy in over 90% of cases. Screening with ultrasound and alpha-fetoprotein (AFP) at 6-month intervals is advised; however, it is not adequate for patients on the orthotopic liver transplantation (OLT) list. Triple-phase computed tomography and/or magnetic resonance imaging are used in combination with the detection of AFP, AFP-L3%, and/or des-gamma-carboxy prothrombin due to their superior sensitivities and specificities. Several treatment modalities are available, but only surgical resection and OLT are curative. OLT is available only for patients who meet or are downstaged into Milan or University of California, San Francisco criteria. Other treatment options include radiofrequency ablation, microwave ablation, percutaneous ethanol injection, transarterial chemoembolization, radioembolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, and molecularly targeted therapies. The management of HCC is based on tumor size and location, extrahepatic spread, and underlying liver function. Given the complexity of the disease, patients are often best served in centers with experience in HCC management, where a multi-disciplinary approach can take place.
Crissien, Ana Maria
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Despite efforts for prevention and screening as well as development of new technologies for diagnosis and treatment, the incidence of HCC has doubled, and mortality rates have increased in recent decades. A variety of important risk factors are associated with the development of HCC, with any type of cirrhosis, regardless of etiology, being the major contributor. Hepatitis C virus infection with bridging fibrosis or cirrhosis and hepatitis B virus infection are independent risk factors. The diagnosis of HCC is made without liver biopsy in over 90% of cases. Screening with ultrasound and alpha-fetoprotein (AFP) at 6-month intervals is advised; however, it is not adequate for patients on the orthotopic liver transplantation (OLT) list. Triple-phase computed tomography and/or magnetic resonance imaging are used in combination with the detection of AFP, AFP-L3%, and/or des-gamma-carboxy prothrombin due to their superior sensitivities and specificities. Several treatment modalities are available, but only surgical resection and OLT are curative. OLT is available only for patients who meet or are downstaged into Milan or University of California, San Francisco criteria. Other treatment options include radiofrequency ablation, microwave ablation, percutaneous ethanol injection, transarterial chemoembolization, radioembolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, and molecularly targeted therapies. The management of HCC is based on tumor size and location, extrahepatic spread, and underlying liver function. Given the complexity of the disease, patients are often best served in centers with experience in HCC management, where a multi-disciplinary approach can take place. PMID:24829542
Crissien, Ana Maria; Frenette, Catherine
A case series of 5 male patients afflicted with breast carcinoma is reported. The Authors describe symptomatology, diagnostic iter, principles of surgical treatment and results. Underlined is the wider surgical demolition in male breast cancer in comparison with females, even if natural history and biological conduct are comparable. This is because in male breast carcinoma the local and remote infiltration is more rapid than female for the less development of breast gland. Finally, indications for radiochemotherapy are comparable to female breast cancer. PMID:2177860
Cianchetti, E; Cotellese, R; Dell'Osa, A; Nardi, M; D'Aulerio, A; Puglielli, L; Di Sebastiano, P; Saragani, C; Napolitano, A M
Intraosseous mucoepidermoid carcinoma is a rare tumor which affects women more than men and is more common in the mandible. The radiological examination reveals a well-defined unilocular or multilocular radiolucent lesion. This tumor may resemble a glandular odontogenic cyst, particularly in incisional biopsies. The accurate diagnosis of these lesions is imperative because the subsequent treatment of each lesion would be different. The purpose of this study is to report two cases of intraosseous mucoepidermoid carcinoma and explicate the differentiating criteria of this lesion from the glandular odontogenic cyst. PMID:24883346
Atarbashi Moghadam, S; Atarbashi Moghadam, F
Eccrine carcinoma is an extremely rare malignancy of the skin with few well documented cases reported in the literature. It is frequently found on the lower extremities, and it equally affects both sexes in the sixth and seventh decade. In our case, we present a 46- year-old female with a recurring exophytic tumor on the right lower extremity, without local extension. The initial tumor was biopsied, excised and diagnosed as an eccrine carcinoma. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3568051328673318.
We report a case of a 49-year-old man who developed solitary rib metastasis of nasopharyngeal cancer. Patient had been treated for primary carcinoma with radiation therapy and concomitant chemotherapy. The bone metastasis presented as bulky, solid, painful mass in the posterior arch of 10th rib, within nine months the end of treatment. Biopsy of the solitary lesion presented the same histological characteristics as those of primary lesion. Although there are reported in literature series of nasopharyngeal cancer metastasizing to bone, we did not find previously published report of a nasopharyngeal carcinoma metastasizing only to a rib. PMID:24826065
De Felice, Francesca; Musio, Daniela; Magnante, Anna Lisa; Bulzonetti, Nadia; De Francesco, Irene; Tombolini, Vincenzo
The authors have encountered four cases of oil aspiration pneumonia complicated by carcinoma. Each had a clear-cut history of chronic intake of an oily substance, radiographic changes, and histologically documented oil aspiration pneumonia. Lung cancer later appeared in the involved area. A small number of similar cases also have been reported. The implication is that oil aspiration pneumonitis may induce bronchogenic carcinoma, particularly either the alveolar cell or the squamous cell variety. The radiographic diagnosis of the malignant transformation is difficult, and consequently the prognosis is poor.
Felson, B.; Ralaisomay, G.
Merkel cell carcinoma is a rare, aggressive cutaneous malignancy with high rates of recurrence, metastases, and mortality. Its nonspecific clinical presentation often delays the diagnosis, and its treatment is still controversial because of the infrequent nature of the tumor. The authors provide an overview of the current literature on epidemiology, cause, pathogenesis, staging, management, and outcomes of this disease. Effective diagnostic and treatment modalities such as wide local excision of the primary tumor, importance of sentinel node biopsy for staging, evidence for the use of adjuvant radiation therapy, and emphasis on a multidisciplinary treatment approach of Merkel cell carcinoma as it pertains to surgical practice are reviewed. PMID:23629116
Senchenkov, Alex; Moran, Steven L
The pattern of myometrial invasion in endometrioid endometrial carcinomas varies considerably; ie, from widely scattered glands and cell nests, often associated with a fibromyxoid stromal reaction (desmoplasia) and/or a lymphocytic infiltrate, to invasive glands with little or no stromal response. Recently, two distinct stromal signatures derived from a macrophage response (colony-stimulating factor 1, CSF1) and a fibroblastic response (desmoid-type fibromatosis, DTF) were identified in breast carcinomas and correlated with clinicopathologic features including outcome. In this study, we explored whether these stromal signatures also apply to endometrioid carcinomas and how their expression patterns correlated with morphologic changes. We studied the stromal signatures both by immunohistochemistry and in situ hybridization in 98 primary endometrioid carcinomas with (87 cases) and without (11 cases) myometrial invasion as well as in the corresponding regional lymph nodes metatases of 9 myoinvasive tumors. Desmoplasia correlated positively with the DTF expression signature. Likewise, mononuclear infiltrates were found in the stroma of tumors expressing CSF1. Twenty-four out of eighty-seven (27%) myoinvasive endometrioid carcinomas were positive for the macrophage signature and thirteen out of eighty-seven (15%) expressed the fibroblast signature. Eleven additional cases were positive for both DTF and CSF1 signatures (11/87; 13%). However, over half of the cases (39/87; 45%) and the majority of the non-myoinvasive tumors (8/11; 73%) failed to express any of the two stromal signatures. The macrophage response (CSF1) was associated with higher tumor grade, lymphovascular invasion, and PIK3CA mutations (P<0.05). There was a concordance in the expression of the CSF1 signature in the primary tumors and their corresponding lymph node metastases. This study is the first characterization of stromal signatures in endometrioid carcinomas. Our findings shed new light on the relationship between genetically different endometrioid carcinomas and various stromal responses. Preservation of the CSF1 macrophage stromal response in the metastases leds support to targeting the CSF1 pathway in endometrioid endometrial carcinomas. PMID:24263966
Espinosa, Iñigo; Catasus, Lluis; D' Angelo, Emanuela; Mozos, Ana; Pedrola, Nuria; Bértolo, Cristina; Ferrer, Irene; Zannoni, Gian Franco; West, Robert B; van de Rijn, Matt; Matias-Guiu, Xavier; Prat, Jaime
Radioaerosol inhalation lung scintigraphy is discussed and its interpretation based on the segmental anatomy of the lung is presented. Correlation between bronchography and inhalation scintigraphy in 26 cases of bronchogenic carcinoma showed that partial obstruction of a major bronchus produces a clear "hot spot" with peripheral decrease of aerosol deposition, while partial or complete obstruction of the segmental bronchi causes segmentally decreased deposition distal to the site of obstruction. Even at an early stage, bronchogenic carcinoma may be detected by aerosol inhalation scintigraphy whenever the tumors are large enough to produce visible abnormalities of aerosol deposition. PMID:935399
Itoh, H; Ishii, Y; Suzuki, T; Hamamoto, K; Torizuka, K
We report a case of a 49-year-old man who developed solitary rib metastasis of nasopharyngeal cancer. Patient had been treated for primary carcinoma with radiation therapy and concomitant chemotherapy. The bone metastasis presented as bulky, solid, painful mass in the posterior arch of 10th rib, within nine months the end of treatment. Biopsy of the solitary lesion presented the same histological characteristics as those of primary lesion. Although there are reported in literature series of nasopharyngeal cancer metastasizing to bone, we did not find previously published report of a nasopharyngeal carcinoma metastasizing only to a rib.
Musio, Daniela; Magnante, Anna Lisa; Bulzonetti, Nadia; De Francesco, Irene; Tombolini, Vincenzo
SUMMARY The therapeutic landscape of advanced renal cell carcinoma has grown increasingly more complex with the recent approval of several molecularly targeted agents. While researchers focus on developing predictive algorithms and identifying novel therapeutic targets and agents, clinical practitioners continue to face many practical challenges when determining therapeutic strategies for individual patients. This review will discuss several of these challenges including patient selection strategies, sequential therapy, optimal dose and schedule of various drugs, and therapeutic options for patients with nonclear-cell renal cell carcinoma.
Cho, Daniel C
A 44 year old female presented with an intraoral soft tissue swelling in the retromolar region, which was painless, mobile and fluctuant in nature. Computed tomography as well as preoperative ultrasound revealed thick walled cystic lesion. The lesion was clinically diagnosed as mucocele. Ultrasound guided fine needle aspiration was done, which revealed turbid, straw colour fluid. This cystic swelling was completely excised and histopathologically identified to be low grade Mucoepidermoid carcinoma. This unusual presentation of Mucoepidermoid carcinoma as an intraoral cyst is one of the rare and unique reported case.
Ranganath, Mahesh Kumar; Matmari, Veeresh; Narayanaswamy, Umashankar D.; Bavle, Radhika M.
Intraosseous mucoepidermoid carcinoma is a rare tumor which affects women more than men and is more common in the mandible. The radiological examination reveals a well-defined unilocular or multilocular radiolucent lesion. This tumor may resemble a glandular odontogenic cyst, particularly in incisional biopsies. The accurate diagnosis of these lesions is imperative because the subsequent treatment of each lesion would be different. The purpose of this study is to report two cases of intraosseous mucoepidermoid carcinoma and explicate the differentiating criteria of this lesion from the glandular odontogenic cyst.
Atarbashi Moghadam, S.; Atarbashi Moghadam, F.
A 48 years old man presented with subacute intestinal obstruction resulting from an intraluminal colorectal mass. He underwent partial colectomy. Histological diagnosis of mucinous adenocarcinoma with focal areas of heterotopic ossification was made. Although the presence of heterotopic ossification has no known prognostic implication in colorectal carcinoma, however, it is important that both radiologist and pathologist be aware of this phenomenon as distinct from carcinosarcoma that has poorer prognosis. From the available literature reviewed and to the best of our knowledge, this is the first reported case of mucinous colorectal carcinoma with heterotopic ossification in Saudi Arabia. PMID:22015126
Badmos, Kabir Bolarinwa; Seada, Laila Salah; Faraj, Abdelfattah Abueisha
Small cell carcinoma of the ovary of the hypercalcemic type is a rare tumor. We report a case in a 34-year-old patient, revealed by a pelvic pain. The imaging found a large mass of the right ovary. The patient had right oophorectomy and total hysterectomy, a left oophorectomy, pelvic and a para-aortic lymphadenectomy. She subsequently received 6 cycles of adjuvant chemotherapy followed by pelvic radiation therapy. The hypercalcemic small cell carcinoma of the ovary is a rare disease of poor prognosis. Treatment approaches include surgery, chemotherapy with the addition of radiotherapy. PMID:24637019
Bahri, M; Lahmar, R; Ben Salah, H; Kallel, N; Ben Amar, M; Daoud, J
The authors describe the clinical and histologic findings in a case of Merkel cell carcinoma of the vulva, which was associated with squamous cell carcinoma in situ and lichen sclerosus. Electron microscopy of the tumor revealed membrane-bound granules. At postmortem examination, metastases from this primary skin tumor were found in the pelvic lymph nodes, in paraortic lymph nodes, in the liver, and in vertebral bodies. The case is unusual because Merkel cell tumors are usually found on the face or the extremities and seldom metastasize widely. PMID:6322075
Bottles, K; Lacey, C G; Goldberg, J; Lanner-Cusin, K; Hom, J; Miller, T R
Merkel cell carcinoma (MCC) is a rare but highly aggressive malignancy, which often has typical histopathologic and immunohistochemical (IHC) features. Sometimes the diagnosis is missed because of atypical histological or aberrant IHC findings. A case of MCC that showed irregular lobules of basaloid cells with keratotic areas on the initial shave biopsy is being reported. IHC showed positive staining for high-molecular weight cytokeratin but negative staining for cytokeratin 20, findings consistent with basal cell carcinoma. Subsequent excision specimen showed histopathologic features more typical of MCC. IHC still was negative for cytokeratin 20 but positive for synaptophysin. Review of the literature shows other examples of MCC with basal cell carcinoma-like features. Various other histopathologic differentiations of MCC include those that demonstrate squamous cell and eccrine carcinoma features and those that show melanocytic, lymphomatous, sarcomatous, muscular, and atypical fibroxanthoma-like features. Different histopathologic patterns and mimics of MCC are reviewed to help prevent dermatopathologists from misdiagnosing this aggressive tumor. PMID:24247583
Succaria, Farah; Radfar, Arash; Bhawan, Jag
Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Verrucous Carcinoma of the Oral Cavity
Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other\\u000a diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more than 300 U\\/ml was considered as diagnostic\\u000a value for PC and 30–299 U\\/ml as probable index for PC. The sensitivity of PCA for PC was 78.2% (43\\/55), and the specifity
Jiming Meng; Guoming Xu; Qian Shen; Hongfu Zhang; Yueqin Wu; Guangbi Yao
Clinically similar skin diseases can exhibit phenotypic mimicry as demonstrated here for alopecia neoplastica. An 89-year-old female patient had been treated for scalp eczema for several years until biopsy revealed pagetoid carcinoma. Her clinical history showed a mastectomy 20 years ago. For that reason the differential diagnosis was extramammary Paget's disease or epidermotropic metastasis of the breast carcinoma. Immunohistochemistry revealed positivity of MUC1, indicating that the latter is the case. PMID:15482303
Haas, N; Hauptmann, St
The incidence of lung cancer has exploded in this century. The disease is most commonly diagnosed in the 65-75 year age group but can occur as young as 30 years. Cigarette smoking is usually related to lung cancer in men and the risk of developing lung cancer increases with duration of smoking and the number of cigarettes smoked per day. The risk of developing lung cancer decreased to almost that of non smokers after 10-15 years of non smoking. People exposed to asbestos have an 80 fold increase in lung cancer if they smoke. Some increased risk is associated with exposure to radioactive materials--(uranium when mined underground), arsenic and chromium. Lung cancer is more common in city than in rural dwellers. Cell Types: Squamous 34%, Large Cell 28%, Adenocarcinoma and Bronchoalveolar 20%, Small Cell 17%, Mixed 1%. Clinical Presentations: Patients with lung cancer present with several symptoms, signs, and laboratory findings, depending upon the location, growth characteristics, and metabolic activity of the tumour. Asymptomatic: usually patients with solitary pulmonary nodules. Non-specific systemic symptoms: fatigue, weight loss and loss of appetite. Respiratory Symptoms: Haemoptysis, symptoms (and signs) of intrathoracic spread of tumour (hoarseness, pleuritis or pleural effusion, paralysed diaphragm, dysphagia, superior vena cava obstruction, Pancoast s syndrome. Symptoms from extrathoracic metastases: (mediastinal supraclavicular and neck), liver, brain, adrenals, bone and contralateral lung, in approximately that order. Systemic syndromes unassociated with metastatic spread of the primary tumour, often seen with the undifferentiated cell-types: Endocrinopathies (1. hypercalcemia, 2. Cushing s syndrome, 3. inappropriate secretion of antidiuretic hormone (SIADH), 4. gynecomastia, 5. carcinoid syndrome (rare); Neuromuscular disorders (1. myasthenic (Eaton-Lambert) syndrome, 2. peripheral neuropathy, 3. cerebellar degeneration); Connective-tissue syndromes (1. clubbing of fingers/toes (common), 2. hypertrophic pulmonary osteoarthropathy (rare), 3. dermatomyositis, 4. acanthosis nigricans, 5. non specific arthralgia). Diagnosis-The three requirements for diagnosis of lung cancer are: locating the tumour precisely, determining its specific histological cell type, assessing its extent (staging). The next diagnostic procedures are useful: sputum cytology, Pleural aspiration and biopsy, fibre optic bronchoscopy, needle aspiration biopsy. Surgery is the treatment of choice in NSCLC. Chemotherapy: it is the treatment of choice in those patients with small cell carcinoma with limited disease. The combination of chemotherapy with concurrent radiotherapy is now used. Prognosis for patients with lung cancer depends upon cell type, tumour size, location, spread, coexisting disease, and the patient s age. Numerous regimes of palliative radiotherapy and chemotherapy have been investigated as alternatives or adjuncts to surgery; results are often encouraging in the short term, poor in the long term. A great deal of clinical research continues in this area. PMID:10546465
Hepatocellular carcinoma (HCC) is one of the most common cancers in many parts of the world, however the molecular mechanisms underlying liver cell transformation remain obscure. A genome-wide scan of loss of heterozygosity (LOH) in tumors provides a powerful tool to search for genes involved in neoplastic processes. To identify recurrent genetic alterations in liver tumors, we examined DNAs isolated
Hisaki Nagai; Pascal Pineau; Pierre Tiollais; Marie Annick Buendia; Anne Dejean
Hidradenitis suppurativa or Verneuil's disease is usually a chronic, recurrent, suppurative and cicatricial disorder. It most often affects the skin of the axillae, groins and perineum, and less commonly the buttocks and upper thighs. A squamous cell carcinoma located in the hidradenitis-affected area is a rare complication. We present a review of the twenty-six published cases adding one of our
D. Pérez-Diaz; M. Calvo-Serrano; E. Mártinez-Hijosa; L. Fuenmayor-Valera; F. Muñoz-Jiménez; F. Turégano-Fuentes; E. Valle
The variable sensitivity of similar tumors to cytotoxic drugs from patient to patient would suggest a potential role for a reliable laboratory method to identify effective as well as ineffective chemotherapeutic agents. While the known moderately responsive nature of bladder carcinoma to available chemotherapeutic regimens would seem to make it an ideal model tumor to apply such laboratory approaches in
Philip J. Walther; David F. Paulson
In this clinical trial, 20 patients with recurrent, metastatic, or otherwise unresectable adrenocortical carcinoma who have not been previously treated with systemic therapies will receive IMC-A12 and mitotane to determine the safety of the combined therapy. If the combination is safe, an additional 102 patients will be randomly assigned to receive the combined treatment or mitotane alone.
A 25-month-old Chihuahua dog with no clinical signs was evaluated for high serum liver enzymes. Ultrasonography and computed tomography revealed a mass in the left hepatic medial lobe. The histological diagnosis reached using resected tissues was hepatocellular carcinoma (HCC). To the authors’ knowledge, this is the youngest dog diagnosed with HCC.
Teshima, Takahiro; Matsumoto, Hirotaka; Shigihara, Kae; Sawada, Harumi; Michishita, Masaki; Takahashi, Kimimasa; Koyama, Hidekazu
A variety of imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and angiography, are currently used in evaluating patients with chronic liver disease and suspected hepatocellular carcinoma (HCC). Further technological advancement will undoubtedly have a major impact on liver tumor imaging. Increased speed of data acquisition and consequently shorter scan times in CT and
Byung Ihn Choi
The American Association for the Study of Liver Diseases (AASLD) guidelines on the management of hepatocellular carcinoma (HCC) includes an algorithm to assist in the diagnosis of small liver nodules found on surveillance. The algorithm was developed on the basis of expert opinion. The two authors of the guidelines have since validated the algorithm. In this issue, the first external
Hepatocellular carcinoma (HCC) ranks as the third most common cause of death from cancer worldwide. Although major risk factors for the development of HCC have been defined, many aspects of the evolution of hepatocellular carcinogenesis and metastasis are still unknown. Suitable animal models are, therefore, essential to promote our understanding of the molecular, cellular and pathophysiological mechanisms of HCC and
Yan Li; Jin-Xuan Hou; Zhao-You Tang
Primary hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. However, the viral-chemical etiology as well as molecular mechanisms of HCC pathogenesis remains largely unknown. Recent studies in our laboratory have identified several potential factors that may contribute to the pathogenesis of HCC. Oxidative stress and chronic inflammation have been linked to an increased risk of liver cancer.
Xin W Wang; S. Perwez Hussain; Teh-Ia Huo; Chuan-Ging Wu; Marshonna Forgues; Lorne J Hofseth; Christian Brechot; Curtis C Harris
Nineteen patients with nervous system metastasis of hepatocellular carcinoma (HCC) were evaluated retrospectively. Nervous system metastasis was frequently initial presentation of HCC (seven out of 19 patients). Seven patients had metastases of the brain, of whom four had a stroke-like presentation. CT or MRI in these patients showed intracerebral hematomas in watershed areas. Enhancing lesion or edema adjacent to the
Manho Kim; Duk L Na; Seong Ho Park; Beom Seok Jeon; Jae-Kyu Roh
Transcatheter arterial chemoembolisation (TACE) using antiblastic agents in association with occlusion of tumour-feeding arteries seems currently to be the most suitable treatment for unresectable hepatocellular carcinomas (HCC) larger than 3 cm in diameter. From July 1989 to January 1991, 21 patients with HCC and a previous history of liver cirrhosis were treated by TACE. The drugs used were doxorubicin and
G. C. Ettorre; A. P. Garribba; G. Francisco; F. Mirizzi; S. Elba; A. Mossa; F. Martino
Transarterial radioembolisation with yttrium-90 (TARE-Y90), a catheter-directed therapy, has been used extensively in adults to treat primary and secondary hepatic malignancies. To our knowledge, the use of this palliative technique has not been described in children. We present two children with unresectable hepatocellular carcinoma (HCC) treated with TARE-Y90. PMID:23212597
Hawkins, Clifford Matthew; Kukreja, Kamlesh; Geller, James I; Schatzman, Carmen; Ristagno, Ross
The value of various radiographic methods (except laryngography) in laryngeal carcinoma was assessed in a material of 71 patients. Radiography proved of no value in T1 and T2 tumours if a satisfactory clinical examination could be performed but gave valuable information in recurrences as well as in T3 and T4 cases. PMID:1189963
Jorgensen, J; Jorgensen, K; Jensen, O M; Jensen, J T; Elbrond, O; Andersen, A P
Caspase-3 is a downstream effector cysteine protease in the apoptotic pathway. It is ubiquitously expressed in normal human tissues including the liver. Overexpression and loss of expression of caspase-3 has been reported in diverse human malignancies. However, expression of caspase-3 in hepatocellular carcinoma (HCC) has not been studied. Therefore, we studied its expression in four hepatoma cell lines and 22
Rajendra Persad; Chen Liu; Tsung-Teh Wu; Patrick S Houlihan; Anna M Diehl; Asif Rashid
Eight cases of acinar cell carcinoma of the exocrine pancreas were diagnosed in Japanese medaka (Oryzias latipes) from a pool of approximately 10,000 specimens used in a variety of carcinogenesis bioassays. Three cases occurred in specimens from control g...
J. W. Fournie W. E. Hawkins M. S. J. Battalora W. W. Walker
Background: The aim of this study was to evaluate the outcome of patients with Verrucous carcinoma (VC) of oral cavity treated at the Chung Gung Memory Hospital with respect to the tumor control rates after surgery, the risk of lymph node metastasis and the role of radiation therapy. Methods: Thirty-eight patients underwent primary treatment for VC of the oral cavity
Chung-Jan Kang; Joseph Tung-Chieh Chang; Tsung-Ming Chen; Chun-Ta Liao
Primary cutaneous mucinous carcinoma (PCMC) is a rare, slow growing, malignant neoplasm arising from the sweat glands. Lesions are most commonly seen on the head and neck, and frequently mistaken for metastases from more common primary sites, such as the breast, gastrointestinal tract, lung, ovary, or prostate. We present what we believe is the first reported case of PCMC involving the penis.
Robinson, Michael; Kelly, John; Biberdorf, Darren; McAuley, Iain
Objective The objective of our study was to identify characteristic features of invasive lobular carcinoma on mammography and ultrasound examinations Materials and methods This is a retrospective multicenter study of women with biopsy-proven invasive lobular carcinoma. All patients had undergone diagnostic sonomammography. The imaging findings were identified by experienced breast imagers. Final surgical pathology results were used as the reference standard. Results Thirty-two women ranging in age from 42 to 63 years old (mean age, 53 years), All had biopsy-proven invasive lobular carcinomas. Common features on mammogram included dense mass followed by architectural distortion; three cases showed breast asymmetry and one case was reported as normal. On ultrasound, common features included solid mass with spiculated margins, posterior shadowing, and perpendicular to the skin. Conclusion Although no specific features could be linked to invasive lobular carcinoma, care should be directed to subtle signs such as architectural distortion and breast asymmetry in order not to miss any lesions. The combination of mammographic and sonographic helps to decrease the relatively high false negative diagnosis of this type of breast cancer.
Kombar, Osama R; Fahmy, Dalia M; Brown, Mary V; Farouk, Omar; El-Damshety, Osama
Authors present the case of carcinoma adenoides cysticum, which was located in small salivary glands of palatum. After surgical treatment and radiotherapy during 3 years observation of the patient two new ca adenoides cysticum focus were noticed. It can give evidence of cancer multifocus of cancer recurrents. PMID:9454210
Wójtowicz, P; Sujkowska, U; Kukwa, A; Sobczyk, G; Misztela, T
Purpose Glycogen rich clear cell carcinoma (GRCC) of the breast is a rare subtype of invasive ductal carcinoma and involves a poor prognosis. In the literature, less than 150 cases have been reported. Many researchers have attempted to characterize GRCC according to electron microscope, flow cytometry, or clinical data. However, an organized study of the immunophenotype of GRCC has yet to be reported. Materials and Methods Here, we present three cases of GRCC and their immunohistochemical profiles. Results Histologically, all three cases contained periodic acid stain (PAS) positive and d-PAS labile granules in their clear cytoplasm. Case I showed positivity for only estrogen receptor (ER) and c-erbB2. Case II exhibited positivity for progesterone receptor and negativity for ER and c-erbB2. Case III presented with triple negative invasive carcinoma. The expression pattern of E-cadherin was concordant with epidermal growth factor receptor and c-kit, but discordant with ki-67. Among these three cases, p53-positive cases exhibited a low proliferative index (ki-67: 15%), while p53-negative cases showed a high proliferative index (ki-67: 50-60%). Conclusion In conclusion, the immunophenotype of GRCC is not uniform, but is similar to that of conventional ductal carcinoma.
Kim, Sung Eun; Koo, Ja Seung
Intratumoural hypoxia (low oxygen tension) is associated with aggressive disease and poor prognosis. Hypoxia-inducible factor-1 is a transcription factor activated by hypoxia that regulates the expression of genes that promote tumour cell survival, progression, metastasis, and resistance to chemo/radiotherapy. In addition to hypoxia, HIF-1 can be activated by growth factor-signalling pathways such as the mitogen-activated protein kinases- (MAPK-) and phosphatidylinositol-3-OH kinases- (PI3K-) signalling cascades. Mutations in these pathways are common in thyroid carcinoma and lead to enhanced HIF-1 expression and activity. Here, we summarise current data that highlights the potential role of both hypoxia and MAPK/PI3K-induced HIF-1 signalling in thyroid carcinoma progression, metastatic characteristics, and the potential role of HIF-1 in thyroid carcinoma response to radiotherapy. Direct or indirect targeting of HIF-1 using an MAPK or PI3K inhibitor in combination with radiotherapy may be a new potential therapeutic target to improve the therapeutic response of thyroid carcinoma to radiotherapy and reduce metastatic burden.
Burrows, Natalie; Babur, Muhammad; Resch, Julia; Williams, Kaye J.; Brabant, Georg
Context: Although pituitary tumors are common, pituitary carcinoma is very rare and is only diagnosed when pituitary tumor noncontiguous with the sellar region is demonstrated. Diagnosis is difficult, resulting in delays that may adversely effect outcome that is traditionally poor. Barriers to earlier diagnosis and management strategies for pituitary carcinoma are discussed. Evidence Acquisition: PubMed was employed to identify relevant studies, a review of the literature was conducted, and data were summarized and integrated from the author's perspective. Evidence Synthesis: The available data highlight the difficulties in diagnosis and management and practical challenges in conducting clinical trials in this rare condition. They suggest that earlier diagnosis with aggressive multimodal therapy may be advantageous in some cases. Conclusions: Although pituitary carcinoma remains difficult to diagnose and treat, recent developments have led to improved outcomes in selected cases. With broader use of molecular markers, efforts to modify current histopathological criteria for pituitary carcinoma diagnosis may now be possible. This would assist earlier diagnosis and, in combination with targeted therapies, potentially improve long-term survival.
Hepatocellular carcinoma (HCC) generally develops as a consequence of underlying liver disease, most commonly viral hepatitis. The development of HCC follows an orderly progression from cirrhosis to dysplastic nodules to early cancer development, which can be reliably cured if discovered before the development of vascular invasion (typically occurring at a tumor diameter of approximately 2 cm). The identifiable population at
Sasan Roayaie; Manousos Konstadoulakis; Myron Schwartz
Squamous cell carcinoma of the larynx in children is a rare entity, only 21 cases have been reported in patients 10-years-old or younger. A 9-year-old girl presented because of dyspnea and mild hoarseness of one week duration. Laryngoscopy and bronchoscopy showed a supraglottic mass, which proved to be poorly differentiated squamous cell carcinoma. No neck nodes or systemic metastasis were present. The tumor regressed with radiation therapy (6400 rads) but local recurrence and lung metastasis were evident 6 weeks later. Chemotherapy was refused by the parents and the patient died in one month. It is believed that squamous cell carcinoma of the larynx in children parallels that of adults in many respects including response to treatment. However, our attempt to save the larynx by avoiding surgery and using radiotherapy alone was not successful. Squamous cell carcinoma of the larynx in children may be more aggressive than that of adults. The scarcity of cases impedes establishment of treatment protocols in children. Initial aggressive management using surgery, radiotherapy, and possibly chemotherapy may be warranted in children. PMID:3667100
Zalzal, G H; Cotton, R T; Bove, K
A comprehensive practical approach to the diagnosis, staging, and treatment of carcinoma of the prostate is presented. Prostatic cancer in the elderly patient is not a benign clinical condition. The approach is designed to minimize the morbidity of the disease process and to allow the patient to live as normal a life as possible. PMID:3830370
Keegan, G T; Coffield, K S; Singh, E O; Kroening, P M
The sinonasal undifferentiated carcinoma (SNUC) is an aggressive and rare neoplasm arising in the nasal cavity and the paranasal sinuses. To date, over 50 cases of histologically proven SNUCs have been reported since its original description in 1986. Presenting symptoms include facial pain, nasal obstruction, diplopia, epistaxis, proptosis, and periorbital swelling. The histologic features of this neoplasm include cohesive cells arranged in nests, ribbons, and trabeculae. The cells exhibit hyperchromatic nuclei and a high nuclear to cytoplasmic ratio. A brisk mitotic rate, tumor necrosis, and vascular invasion are prominent features. Confirming the diagnosis of SNUC at the light microscopic level can be challenging, since the microscopic differential diagnosis includes olfactory neuroblastoma, rhabdomyosarcoma, undifferentiated nasopharyngeal carcinoma (lymphoepithelioma), malignant lymphoma, malignant melanoma, and neuroendocrine (small cell undifferentiated; oat cell) carcinoma. Sinonasal undifferentiated carcinoma can be differentiated from these other neoplasms by correlating clinical, light microscopic, histochemical, immunohistochemical, and ultrastructural characteristics. Aggressive, multimodal therapy can provide the best opportunity for local control of this neoplastic process, but the optimal treatment has yet to be determined. PMID:10562893
Houston, G D; Gillies, E
Sinonasal undifferentiated carcinoma (SNUC) is an infrequent tumor described by Frierson et al. in 1986. Since its initial description, fewer than 100 patients have been reported. We present a case of a SNUC invading the orbit in a 57-year-old woman, for which the findings are documented by CT scan, light and electron microscopy. PMID:7711477
Ascaso, F J; Adiego, M I; Garcia, J; Royo, J; Valles, H; Palomar, A; Ramon y Cajal, S
To the question “Is axillary node staging required in patients with duct carcinoma in situ (DCIS) of the breast?” there are two possible responses: a short answer and a long one. The short answer is a simple and unambiguous “no.” By definition, neither DCIS nor any in situ cancer can possibly metastasize and the treatment is therefore local. The appropriate
Hiram S. Cody III; Nancy Klauber-DeMore; Patrick I. Borgen; Kimberly J. Van Zee
A 50-year-old non-smoking, hypertensive female, presenting with superior vena caval compression, was found to have giant cell carcinoma of the lung. She received intensive combination chemotherapy. However she died in the following 36 hours, as a consequence of refractory hypotension. PMID:7479474
Aziz, S A; Ahmad, M; Shah, A; Bhat, G M; Lone, A; Ahmad, K; Bano, H
Renal cell carcinoma can metastasize to any region of the body. We review a patient who presents fourteen years after initial resection of the primary tumor with distant metastatic disease. This included spread to the bladder and penis that manifested as frank haematuria and malignant priapism respectively. We discuss the mechanism of spread and the management options available.
Rajarubendra, Nieroshan; Pook, David; Frydenberg, Mark; Appu, Sree
The recurrence of hepatocellular carcinoma, the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide, represents an important clinical problem, since it may occur after both surgical and medical treatment. The recurrence rate involves 2 phases: an early phase and a late phase. The early phase usually occurs within 2 years after resection; it is mainly related to local invasion and intrahepatic metastases and, therefore, to the intrinsic biology of the tumor. On the other hand, the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment. Since recent studies have reported that early and late recurrences may have different risk factors, it is clinically important to recognize these factors in the individual patient as soon as possible. The aim of this review was, therefore, to identify predicting factors for the recurrence of hepatocellular carcinoma, by means of invasive and non-invasive methods, according to the different therapeutic strategies available. In particular the role of emerging techniques (e.g., transient elastography) and biological features of hepatocellular carcinoma in predicting recurrence have been discussed. In particular, invasive methods were differentiated from non-invasive ones for research purposes, taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor.
Colecchia, Antonio; Schiumerini, Ramona; Cucchetti, Alessandro; Cescon, Matteo; Taddia, Martina; Marasco, Giovanni; Festi, Davide
Lung tumors with rhabdoid features, included as variants of large cell carcinoma in the 1999 World Health Organization classification of lung tumors, are rare and have an aggressive clinical course. We report 11 patients with primary lung tumors with rhabdoid features and review the literature on this uncommon tumor. We examined samples from 7 primary (6 resections, 1 biopsy) and
Pheroze Tamboli; Tushar H Toprani; Mitual B Amin; Jung Sil Ro; Nelson G Ordóñez; Alberto G Ayala; Jae Y Ro
Hepatocellular carcinoma is among the most lethal and prevalent cancers in the human population. Despite its significance, there is only an elemental understanding of the molecular, cellular and environmental mechanisms that drive disease pathogenesis, and there are only limited therapeutic options, many with negligible clinical benefit. This Review summarizes the current state of knowledge of this, the most common and
Paraskevi A. Farazi; Ronald A. DePinho
Background. This study aims to clarify which patients would benefit by surgery for pulmonary metastases from colorectal carcinoma. Methods. A retrospective study was undertaken in 25 patients who had undergone complete resection. In all cases, prethoracotomy carcinoembryonic antigen (CEA) level was measured and mediastinal or hilar lymph nodes were histologically examined. Results. Overall 5-year survival was 39.2%. The 5-year survival
Masayoshi Inoue; Yahiro Kotake; Katsuhiro Nakagawa; Kiyohiro Fujiwara; Kenjiro Fukuhara; Tsutomu Yasumitsu
Carcinomatous change of commonly encountered, benign epidermoid cysts, is a very rare event. Two cases of squamous cell and one case of basal cell carcinoma arising in the cyst wall and invading adjacent dermis were diagnosed in three epidermoid cysts in a review of 386 cases. The frequency of carcinomatous change has been reported to be as much as 9%.
I. Öztek; L. Bas; E. Uçmakli; K. Dogruöz; F. Yavuz
Purpose Little is known about the clinicopathological features of early mucinous gastric carcinoma (MGC). The purpose of this study was to compare the clinicopathological features and prognosis between patients with early MGC and those with early nonmucinous gastric carcinoma (NMGC). Methods We reviewed the records of 2,732 patients diagnosed with gastric carcinoma who were treated surgically. There were 14 patients (0.5%) with early MGC and 958 with early NMGC. Results Early MGC patients had a higher prevalence of elevated type (71.4%) compared with early NMGC patients (29.5%). More early MGC patients had submucosal carcinoma, compared with early NMGC patients (78.6% vs. 64.1%). The overall 5-year survival of the patients with early MGC was 97.2% as compared with 92.7% for the patients with early NMGC (P < 0.01). The statistically significant prognostic parameters influencing the 5-year survival rate according to Cox's proportional hazard regression model were: age (risk ratio, 2.22; 95% confidence interval [CI], 1.62-3.04; P < 0.01); sex (risk ratio, 1.97; 95% CI, 1.42-2.73; P < 0.01); and lymph node metastases (risk ratio, 1.88; 95% CI, 1.28-2.77; P < 0.01). Conclusion Patients with early MGC had a better prognosis than those with early NMGC. Mucinous histology itself appears not to be an independent prognostic factor. Therefore, early detection is important for improving the prognosis for patients with gastric carcinoma regardless of tumor histology.
Ryu, Seong Yeob; Kim, Ho Gun; Lee, Jae Hyuk
Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Salivary Gland Adenoid Cystic Carcinoma; Stage IVA Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVA Salivary Gland Cancer; Stage IVB Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVC Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer
As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic mucoepidermoid carcinoma misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive jaundice, epigastric discomfort, and weight loss with slightly increased carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod carcinoma of liver by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060
Endocrine Cancer; Metastatic Gastrointestinal Carcinoid Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin; Thyroid Gland Medullary Carcinoma
Classifying intracystic papillary carcinoma under invasive or in situ ductal carcinoma is still a matter of debate. The purpose of this study was to explore the genomic relationship of this tumor to its concurrent invasive ductal carcinoma and ductal carcinoma in situ using array comparative genomic hybridization. Intracystic papillary carcinoma cases were classified into three categories: pure, with concurrent ductal carcinoma in situ or with concurrent invasive ductal carcinoma. Each component was dissected using laser capture microdissection. DNA was extracted and array comparative genomic hybridization was performed. The test of difference in copy number changes among the three tumors was carried out using CGHMultiArray. Intracystic papillary carcinoma clustered with four of five concurrent ductal carcinoma in situ cases and with two of two invasive ductal carcinoma cases. Intracystic papillary carcinoma showed the highest proportions of genome copy number aberration, followed by ductal carcinoma in situ, and then by invasive ductal carcinoma (P=0.06). Comparing intracystic papillary carcinoma with invasive ductal carcinoma vs without invasive ductal carcinoma, the former had 11q22.1-23.3 loss (P=0.031) and chr5 gain (P=0.085), and was enriched with matrix metalloproteinase genes. Comparing intracystic papillary carcinoma with ductal carcinoma in situ vs without ductal carcinoma in situ, the former had gain in 5q35.3 (P=0.041), 8q24.3 (P=0.041) and 21q13.2 to 21q13.31 (P=0.011). Comparing intracystic papillary carcinoma with ductal carcinoma in situ, the latter acquired a group of genes involved in cell adhesion and motility, whereas intracystic papillary carcinoma differentially expressed genes that are involved in papillary carcinomas of other organs (thyroid and kidney). We conclude that the overall molecular change in intracystic papillary carcinoma is closer to ductal carcinoma in situ than to invasive ductal carcinoma, which may explain the indolent behavior of this tumor. We offer herein a proposal of intracystic papillary carcinoma pathogenesis through its relation to invasive ductal carcinoma and ductal carcinoma in situ. PMID:23907150
Khoury, Thaer; Hu, Qiang; Liu, Song; Wang, Jianmin
Background Mitotic arrest deficiency protein 2 (MAD2) is a key component of spindle assembly checkpoint function, which mediates cell apoptosis through microtubule kinetics. Aberrant expression of MAD2 is believed to be associated with the development of chromosome instability. MAD2 also has a signihicant role in cellular drug resistance to taxane chemotherapeutic agents. Methods Expression of MAD2 and p53 was investigated using immunohistochemistry in 85 cases of ovarian carcinomas. Clinicopathological data including progression-free survival were analyzed. Results A significant (p=.035) association was observed between the grade of serous carcinoma and the expression level of MAD2. While low-grade serous carcinoma showed a low-level expression of MAD2, high-grade serous carcinoma showed a high-level expression of MAD2. We also determined that low-level expression of MAD2 was associated with reduced progression-free survival (PFS) (p=.016) in high-grade serous carcinoma. Conclusions MAD2 expression in ovarian carcinoma is related to the grade of serous carcinoma and PFS of high-grade serous carcinoma. Expression level of MAD2 detected by immunohistochemistry may serve as an indicator in predicting the response of microtubule-interfering chemotherapeutic agents.
Park, Po Eun; Jeong, Ji Yun; Kim, Sun Zoo
A 73-year-old female presented with an asymptomatic mass in the left buccal region that she had first noticed 4 years earlier. The tumor, which was located in the buccal space, was clinically diagnosed as a salivary gland tumor and treated by excision. Histopathological examination revealed a capsule of connective tissue consisting of three different histopathological neoplastic areas in a large, fibrous, hyalinizing stromal background. The neoplastic lesion contained two malignant and one benign element, with histological characteristics consistent with squamous cell carcinoma (SCC), salivary duct carcinoma (SDC) and pleomorphic adenoma (PA). The SCC nests showed no continuity with the buccal mucosa. Both the SCC and SDC nests were surrounded by non-atypical myoepithelial cells, suggesting that both components may have developed from transformation of metaplastic luminal epithelial cells of PA. The tumor was diagnosed as a non-invasive carcinoma (SCC and SDC) ex pleomorphic adenoma (Ca-ex-PA). There was no evidence of recurrence 16 months after operation. PMID:19467841
Nakamori, K; Ohuchi, T; Hasegawa, T; Hiratsuka, H
Neovascularization is a critical step in the growth, progression and metastasis of tumors. The degree of angiogenesis may correlate with disease stage and provide prognostic information in various neoplasms. Microvessel density was studied in 24 patients with severe cervical intraepithelial neoplasias, 15 patients with microinvasive carcinomas (International Federation of Gynecology and Obstetrics IA1) and 15 healthy controls who had undergone hysterectomy for benign conditions. The microvessel density (MVD) in microinvasive squamous cell carcinomas was 40 +/- 2.42 (mean +/- SD) and in squamous carcinomas in situ (CIS) 20.41 +/- 2.29 (p < 0.05). Among patients with CIS and controls (13.33 +/- 1.59) there was also a significant difference in the number of vessels (p < 0.05). No significant correlation was found in relation to depth of invasion and histological grade of the microinvasive carcinomas. It is concluded that microinvasive squamous cell cervical carcinoma is an angiogenetic disorder and it seems that the onset of angiogenesis is an early event, usually in a preinvasive stage. PMID:15032286
Sotiropoulou, M; Diakomanolis, E; Elsheikh, A; Loutradis, D; Markaki, S; Michalas, S
Basal cell carcinoma (BCC) is the most common cutaneous cancer. It seems that the most important prognostic factor is exposure to ultraviolet radiation (solar and artificial), correlated with other factors as well. In this article, we aimed to review basal cell carcinoma located in the axilla, referring to cases from our hospital. Axillary location of BCC is rare, with a very low number of cases quoted in the literature, compared to the high prevalence of basal cell carcinoma in the general population. During a period of two years, we detected only four cases of axillary basal cell carcinoma out of a total number of 921 cases diagnosed as BCC. We were interested in identifying certain factors involved in causing BCC, post-excision clinical evolution, histological type and aggressiveness of axillary basal cell carcinoma. Therefore, we quantified objectively the tumor and stromal expression of some immunological markers like: metalloproteinases MMP1, 3, 11, Ber-EP4 and Ki67. Histological types of tumors investigated here belong to the category of non-aggressive BCC, namely as nodular and superficial, although Ki67 index is greater than the average reported in the literature for this type of tumor. MMPs exhibited increased expression in tumors and stromal compartments, especially at the tumor invasion front, and was not associated with tumor ulceration or surrounding tissue remodeling-related changes. Our results confirm the literature data concerning the involvement of MMPs in BCC progression, whatever the tumor location is. PMID:24322039
Costescu, Monica; Coman, Oana Andreia; Tampa, M; Tudose, Irina; Coman, L; Georgescu, Simona Roxana
AIM--To investigate tumour in an axillary lymph node resembling micropapillary ductal carcinoma in situ. METHODS--Sections of tumour in the breast and axillary lymph node were stained with haematoxylin and eosin, and immunohistochemically with antibodies to basement membrane and myoepithelial cells. RESULTS--Tumour in both the breast and axillary lymph node contained areas resembling micropapillary ductal carcinoma in situ. Surrounding these islands, there was a band of eosinophilic material resembling basement membrane and spindle cells that in places appeared to lie outside the basement membrane. Micropapillary tumour at both sites showed weak and discontinuous staining for collagen IV and laminin. The spindle cells stained for alpha-smooth muscle actin, but not for S100. By contrast, immunohistochemistry showed complete rings of basement membrane and myoepithelial cells around definite ductal carcinoma in situ and normal breast lobules and ducts. CONCLUSIONS--Invasive primary and metastatic carcinoma of the breast can have a growth pattern resembling micropapillary ductal carcinoma in situ. Images
Lee, A H; Telfer, T P; Millis, R R
Metastases of esophageal carcinoma to the skeletal muscle are rare, but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT). A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases. Four patients had skeletal muscle metastases of esophageal carcinoma, including two patients with squamous cell carcinoma. In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases, muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma. In all cases, skeletal muscle metastases were the first manifestation of systemic disease. In three patients palliation was obtained with the combination of external beam radiation therapy, systemic chemotherapy or surgical resection. Skeletal muscle metastases are a rare complication of esophageal carcinoma.
Cincibuch, Jan; Myslivecek, Miroslav; Melichar, Bohuslav; Neoral, Cestmir; Metelkova, Iva; Zezulova, Michaela; Prochazkova-Studentova, Hana; Flodr, Patrik; Zlevorova, Miloslava; Aujesky, Rene; Cwiertka, Karel
Background: Merkel cell carcinoma is a high-grade neuroendocrine carcinoma of skin that is characterized by immature cells which, because of its striking morphologic similarity, may be confused with other small round blue cell tumors such as pulmonary small cell carcinoma or lymphoblastic leukemia/lymphoma. Immunohistochemistry is therefore paramount to ensuring accurate diagnostic distinction between these tumors. The aim of our study was to evaluate and compare the expression of PAX5 and Terminal deoxynucleotidyl transferase (TdT), in Merkel cell carcinoma and pulmonary small cell carcinoma. Design: PAX5 and TdT immunohistochemical stains were performed on 27 Merkel cell carcinomas and 10 pulmonary small cell carcinomas. Results: PAX5 was expressed in 24/27 (89%) Merkel cell carcinomas and 0/10 (0%) pulmonary small cell carcinomas. TdT was expressed in 21/27 (78%) Merkel cell carcinomas and 9/10 (90%) pulmonary small cell carcinomas. Conclusions: Our study confirms that PAX5 and TdT expression can be expressed in a high percentage of Merkel cell carcinomas and so when positive are not diagnostic of lymphoblastic leukemia/lymphoma. When dealing with metastatic lesions, PAX5 negativity would favor a diagnosis of pulmonary small cell carcinoma over Merkel cell carcinoma. In addition, TTF-1 negative pulmonary small cell carcinoma is to be differentiated from Merkel cell carcinoma.
Kolhe, Ravindra; Reid, Michelle D; Lee, Jeffrey R; Cohen, Cynthia; Ramalingam, Preetha
Eight out of nine patients with squamous cell carcinoma of skin have shown immunological reactivity against their own tumour cells by one or more tests with their sera or peripheral blood lymphocytes. The tests included membrane and cytoplasmic immunofluorescence, and, with cultured tumour, complement-dependent serum cytotoxicity and lymphocyte attack. One case examined in depth had an unusually conspicuous lymphocyte and plasma cell reaction on histological examination, and was positive by all four tests; a time-lapse cinephoto-micrographic record over seven days was obtained of the attack on the carcinoma cells in culture by the patient's lymphocytes. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9
Nairn, R. C.; Nind, A. P. P.; Guli, E. P. G.; Muller, H. K.; Rolland, J. M.; Minty, C. C. J.
Lung cancer is the leading cause of cancer death in men and women worldwide, with over a million deaths annually. Tobacco smoke is the major etiologic risk factor for lung cancer in current or previous smokers and has been strongly related to certain types of lung cancer, such as small cell lung carcinoma and squamous cell lung carcinoma. In recent years, there has been an increased incidence of lung adenocarcinoma. This change is strongly associated with changes in smoking behavior and cigarette design. Carcinogens present in tobacco products and their intermediate metabolites can activate multiple signaling pathways that contribute to lung cancer Carcinogenesis. In this review, we summarize the smoking-activated signaling pathways involved in lung cancer.
Wen, Jing; Fu, Jian-Hua; Zhang, Wei; Guo, Ming
Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any area of the body, the most commonly involved area being the periorbital region. It does not entail a typical clinical presentation, which explains the often late diagnosis. The aim of this report is to outline the rarity of the disease and its atypical clinical description, since to this day, inguinal ulcers with clinical manifestation have not been reported. We present and discuss a case of sebaceous carcinoma with an unusual clinical presentation, in an elderly male patient. The precise approach to genital ulcers, as shown in this case, is a diagnostic challenge that requires a great deal of effort on the part of the clinician.
Lucares, David Oschilewski; Bernardes Filho, Fred; Vega, Hernando; Kac, Bernard Kawa; Pereira, Maria Rita; Nery, Jose Augusto da Costa
Intravenous extension occurs in many patients with renal cell carcinoma. Preoperative recognition is essential as venous involvement alters the surgical approach and clinical staging of the tumours. The venous extension of tumor has a characteristic arteriographic appearance, the recognition of which should prompt venacavography. Computerized body tomography (CBT) may also detect renal vein and caval extension and provide evidence of early ascites from the Budd Chiari syndrome associated with hepatic vein obstruction from intracaval tumor extension. However, it may be difficult to distinguish intracaval blood clot and tumor on the basis of CBT criteria alone. Of the four patients with intracaval growth of renal cell carcinoma, three received preoperative therapeutic tumor embolization, a procedure that carried no additional risk of tumor detachment and embolization. PMID:7407815
Kadir, S; Coulam, C M
The primary small cell carcinoma of the vagina is rare, and it is a highly aggressive malignancy with no consensus regarding the treatment of this tumor. The survival rate for patients treated in the early stages is around two years. We related the case report of a patient of 41 years with a vegetative and necrotic lesion in left vaginal wall, in middle and upper third, and involvement of parametrium in its proximal third and medium third. A biopsy showed a small cell undifferentiated carcinoma composed of epithelial cells with round nuclei, oval or elongated, hyperchromatic nuclei, with little distinct nucleoli, and scarce cytoplasm. Immunohistochemistry showed positivity for AE1/AE3, CD57, and chromogranin A. The patient received 6 cycles of chemotherapy with cisplatin and etoposide and radiotherapy, achieving complete response, with complete regression of the lesion. The patient had no sign of tumor recurrence and locoregional or distant metastases after 5 months of followup.
Oliveira, Rafael; Bocoli, Mayra Coelho; Saldanha, Joao Carlos; Murta, Eddie Fernando Candido; Nomelini, Rosekeila Simoes
The transition of epithelial cells to a mesenchymal phenotype is of paramount relevance for embryonic development and adult wound healing. During the past decade, the epithelial-mesenchymal transition (EMT) has been increasingly recognized to occur during the progression of various carcinomas such as hepatocellular carcinoma (HCC). Here, we focus on EMT in both experimental liver models and human HCC, emphasizing the underlying molecular mechanisms which show partial recurrence of embryonic programs such as TGF-beta and Wnt/ beta-catenin signaling, including collaboration with hepatitis viruses. We further discuss the differentiation repertoire of malignant hepatocytes with respect to the potential acquisition of stemness, and the involvement of the mesenchymal to epithelial transition, the reversal of EMT, in cancer dissemination and metastatic colonization. The strong evidence for EMT in HCC patients demands novel strategies in pathological assessments and therapeutic concepts to efficiently combat HCC progression. PMID:19852728
van Zijl, Franziska; Zulehner, Gudrun; Petz, Michaela; Schneller, Doris; Kornauth, Christoph; Hau, Mara; Machat, Georg; Grubinger, Markus; Huber, Heidemarie; Mikulits, Wolfgang
The transition of epithelial cells to a mesenchymal phenotype (EMT) is of paramount relevance for embryonic development and adult wound healing. During the past decade, EMT has been increasingly recognized to occur during the progression of various carcinomas such as hepatocellular carcinoma (HCC). Here we focus on EMT in both experimental liver models and human HCC, emphasizing the underlying molecular mechanisms which show partial recurrence of embryonic programs such as TGF-? and Wnt/?-catenin signaling including collaboration with hepatitis viruses. We further discuss the differentiation repertoire of malignant hepatocytes with respect to the potential acquisition of stemness, and the involvement of the mesenchymal to epithelial transition, the reversal of EMT, in cancer dissemination and metastatic colonization. The strong evidence for EMT in HCC patients demands novel strategies in pathological assessments and therapeutic concepts to efficiently combat HCC progression.
Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.
Hishikawa, Y.; Tanaka, S.; Miura, T.
Authors experienced a case of low grade mucoepidermoid carcinoma in 48-year-old female and a case of low grade central mucoepidermoid carcinoma in 51-year-old female, respectively. The former occurred in right mandibular angle and showed multilocular radiolucent area surrounded by sclerotic rim but perforation of cortical bone connected with tumor mass in oral cavity radiographically. The latter occurred in left mandibular angle and ramus. Radiographic feature showed large radiolucent area in left mandibular angle and ramus, and destruction of coronoid process but intact condylar process. The origin of the latter might be mucus secreting cells of lined epithelium in dentigerous epithelium. In two cases metastases were not found. PMID:2130125
Eyelid sebaceous carcinoma is a rare tumour with slow growth and it is one of the most aggressive malignancies of the eyelid. Death rate can reach 6%. The diagnosis is often delayed because it is confused with other periocular lesions. The authors describe a case with atypical presentation, regarding rapid growth rate and exophytic aspect. Female, 78 years, presenting lower eyelid tumour with 4 months of evolution. Ophthalmological examination showed a tarsal exophytic tumour (22 mm), non-adherent to bulbar conjunctiva. She was medicated topically for 3 months, with the diagnosis of chalazio. Total excision was performed for histological diagnosis. After diagnosis of sebaceous carcinoma with specific immunohistochemical markers, and without free tumour surgical limits, a second surgery was performed with a pentagon entire thickness excision. Being a rare tumour but with a considerable morbidity and mortality; early diagnosis and treatment is essential for a good prognosis and preservation of visual function. PMID:23125295
Alves, Samuel; Silva, Filipe; Ferreira, Mara; Cabral, João
The authors have examined eight patients operated at the Department of Surgery "B" of the G. Bosco Hospital (Torino) from 1980 to 1992 for gastric stump cancer. All patients were male of about 72 years who were subjected to resection: 5 for gastric ulcer and 3 for duodenal ulcer. During the first operation they used the same recanalization technique after gastric resection: the semi-oral distal gastric jejunal anastomosis created by Hofmeister-Finsterer. The second operation was the subtotal gastric resection made on 6 patients, total gastrectomy in 1 case and explorative laparotomy in an inoperable case. The average of free time from disease was 32 years while it is 24 years in literature. The mean survival was 40 months. The 5-year survival was about 33%. The authors conclude that carcinoma of the gastric stump has a worst prognosis then carcinoma in normal stomach. The subtotal resection has the same results as in total gastrectomy. PMID:7991194
Della Beffa, V; Fontana, D; Leli, R; Saroglia, G; Voghera, P
A 46-year-old male presented with progressive paraparesis and sensory impairment in both lower limbs since 2 months. He had urinary and bowel incontinence. On examination he had flaccid paraplegia with a sensory level at 11th dorsal vertebral level. Magnetic resonance imaging (MRI) scans of the lumbosacral spine showed an enhancing intramedullary lesion in the conus. The patient underwent excision of the conus mass. Histopathology confirmed the tumor to represent a poorly differentiated metastatic carcinoma from an unknown primary. A positron emission tomography-computed tomography (PET-CT) scan of the whole body revealed hypermetabolic activity in the hilum of the right lung confirmed to be a lung carcinoma on a CT-guided biopsy. The patient was undergoing chemoradiation at 1 month follow-up. The author's literature search has yielded only four other case reports of conus metastasis of which only one is in English literature. The present case report and review of literature are presented.
Mavani, Sandip B.; Nadkarni, Trimurti D.; Goel, Naina A.
Only three examples of acinic cell carcinoma of the larynx or trachea are found in the recent literature. A case of acinic cell carcinoma of the subglottic larynx and trachea was diagnosed and treated at the University of Virginia Medical Center. To our knowledge this is the first such case with a prior history of radiation to the neck. The patient is a 56-year-old woman who was irradiated for hyperthyroidism 46 years ago. When seen she also had parathyroid hyperplasia and multiple thyroid adenomas, conditions that frequently follow irradiation of the thyroid in children. These findings in this case support the concept that radiation may be responsible for inducing this tumor, which otherwise rarely occurs in this location. The use of electron microscopy was extremely useful in the diagnosis of this tumor. She was treated with total laryngectomy and right neck dissection and is now free of disease one year after surgery.
Reibel, J.F.; McLean, W.C.; Cantrell, R.W.
Squamous cell carcinoma and adenocarcinoma are types of esophageal cancer, one of the most aggressive malignant diseases. Since both histological types present entirely different diseases with different epidemiology, pathogenesis and tumor biology, separate therapeutic strategies should be developed against each type. While surgical resection remains the dominant therapeutic intervention for patients with operable esophageal squamous cell carcinoma (ESCC), alternative strategies are actively sought to reduce the frequency of post-operative local or distant disease recurrence. Such strategies are particularly sought in the preoperative setting. Currently, the optimal management of resectable ESCC differs widely between Western and Asian countries (such as Japan). While Western countries focus on neoadjuvant or definitive chemoradiotherapy, neoadjuvant chemotherapy followed by surgery is the standard treatment in Japan. Importantly, each country and region has established its own therapeutic strategy from the results of local randomized control trials. This review discusses the current knowledge, available data and information regarding neoadjuvant treatment for operable ESCC.
Baba, Yoshifumi; Watanabe, Masayuki; Yoshida, Naoya; Baba, Hideo
Small cell carcinoma of the cervix is a rare and a very aggressive tumour. Once being considered to be a rare type of squamous cell carcinoma, evidence has proven that most of the tumours express one or more markers of neuroendocrine differentiation. The behaviour of this rare malignancy is different from that of squamous cell carcinomas, with a high propensity for nodal and distant metastases. Hence, there is a need to highlight this histopathological entity.
V, Pavithra; Shalini, C.N. Sai; Priya, Shanmuga; Rani, Usha; Rajendiran, S; Joseph, Leena Dennis
Papillary thyroid carcinoma frequently metastasises to the regional neck lymph nodes. However, cervical lymph node metastases as sole manifestation of occult papillary thyroid carcinoma are observed rarely. The authors report the case of a 52-year-old man presenting for slowly enlarging neck region and shortness of breath, with an insidious history for 15 years. Thyroid imaging showed a goitre predominantly of the right lobe, but histopathological finding revealed a multi-centric thyroid papillary carcinoma with lymph node metastasis.
Simion, Nicolae Irinel; Muntean, Valentin
A 62-year-old man presented with rapidly growing tumour in the right parotid region with associated pain and facial nerve palsy. Based on the fine needle aspiration cytology report of high-grade mucoepidermoid carcinoma, parotidectomy was performed which showed features of salivary duct carcinoma. The smears were reviewed to identify the potential pitfalls in the cytological diagnosis of salivary duct carcinoma. PMID:18306594
Pai, Radha Ramachandra; Alwar, Vanamala; Rao, Vatsala Srinivas; Somayaji, Vasudeva
Adenosquamous carcinoma is a rare tumor with coexisting elements of infiltrating squamous cell carcinoma and adenocarcinoma. This tumor is reported to arise in different organs but rarely in the oesophagus. In most cases, it shows highly aggressive biological behaviour with high propensity to regional lymph-node metastasis and poor prognosis. We describe the management of a patient with an aggressive adenosquamous carcinoma of the esophagogastric junction. PMID:22668530
Francioni, F; Tsagkaropoulos, S; Telha, V; Barile La Raia, R; De Giacomo, T
Summary The case history of a 24-year-old woman with Gardner's syndrome [familial adenomatous polyposis (FAP)] and papillary thyroid carcinoma is presented, representing the 37th report of this association. Although FAP is transmitted as an autosomal dominant trait with similar penetrance in both sexes, thyroid carcinoma has been found almost exclusively in women (94.3%). The majority have been papillary carcinomas (88.5%),
Brenda Bell; Ernest L. Mazzaferri
Malignant neoplasms known to develop following external beam radiation include squamous cell carcinoma, osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma, mixed mullerian tumors, malignant schwannoma, myelogenous leukemia and angiosarcoma. Latency periods of many years characterize the onset of these tumors following the exposure. Cutaneous angiosarcoma following radiotherapy for breast carcinoma has been rarely documented, occurring up to 13 years postirradiation. Two cases of this entity are reported occurring 37 months postradiotherapy at the site of mastectomy performed for mammary duct carcinoma.
Otis, C.N.; Peschel, R.; McKhann, C.; Merino, M.J.; Duray, P.H.
Small cell carcinoma of the cervix is a rare and a very aggressive tumour. Once being considered to be a rare type of squamous cell carcinoma, evidence has proven that most of the tumours express one or more markers of neuroendocrine differentiation. The behaviour of this rare malignancy is different from that of squamous cell carcinomas, with a high propensity for nodal and distant metastases. Hence, there is a need to highlight this histopathological entity. PMID:24701511
V, Pavithra; Shalini, C N Sai; Priya, Shanmuga; Rani, Usha; Rajendiran, S; Joseph, Leena Dennis
Hypoxia-inducible factor 1a (HIF-1a) is upregulated by hypoxia and oncogenic signalling in many solid tumours. Its regulation and function in thyroid carcinomas are unknown. We evaluated the regulation of HIF-1a and target gene expression in primary thyroid carcinomas and thyroid carcinoma cell lines (BcPAP, WRO, FTC-133 and 8505c). HIF-1a was not detectable in normal tissue but was expressed in thyroid
N Burrows; J Resch; R L Cowen; R von Wasielewski; C Hoang-Vu; C M West; K J Williams; G Brabant
Prognosis of patients with renal carcinoma has improved since the advent of targeted therapies. These last years, due to the improvement of patients overall survival, the incidence of brain metastasis among renal carcinoma patients has increased. This worsens the prognosis of patients. The present revue aims to do a point on treatment of brain metastasis from renal carcinoma. It will address both locoregional (surgery, radiotherapy and stereotactic radiosurgery) and systemic (targeted therapies) treatments. PMID:22645282
Teghom, Corine; Giraud, Philippe; Menei, Philippe; Medioni, Jacques; Elaidi, Réza; Combe, Pierre; Oudard, Stéphane
While gallbladder carcinoma is occasionally associated with pancreaticobiliary maljunction, spontaneous necrosis of carcinoma\\u000a is extremely rare. We herein present a case of spontaneous necrosis of gallbladder carcinoma associated with direct invasion\\u000a of viable cancer cell nests to the muscularis propria and subserosal layer located beneath the primary nodules. A 65-year-old\\u000a Japanese man was admitted to a local hospital, complaining of
Yoichi Sakurai; Mitsutaka Shoji; Toshiki Matsubara; Masashi Suganuma; Shigeru Hasegawa; Hiroki Imazu; Masahiro Ochiai; Takahiko Funabiki; Makoto Urano; Yoshikazu Mizoguchi; Makoto Kuroda
This report discusses the new cytogenetic classification of renal cell carcinoma (RCC) and its biological and clinical significance.\\u000a It describes the four major types (clear cell, chromophil [papillary], chromophobe, and collecting duct) as well as rarer\\u000a entities, such as small cell carcinoma, cystic RCC, rhabdoid variant of RCC, and unclassified RCC. Sarcomatoid carcinomas\\u000a are a diverse group representing high-grade transformation
Jonathan W. Said; George Thomas; Amnon Zisman
Chronic esophageal candidiasis is an infection that is mostly seen in immunocompromised conditions, among which is chronic mucocutaneous candidiasis (CMC). Recently an association between CMC and esophageal carcinoma has been reported. Here we present two patients with chronic esophageal candidiasis who developed esophageal squamous cell carcinoma and we discuss the etiologic role of Candida-induced nitrosamine production, the loss of STAT1 function and impaired tumor surveillance and T-lymphocyte function in the development of esophageal carcinoma.
Delsing, C.E.; Bleeker-Rovers, C.P.; van de Veerdonk, F.L.; Tol, J.; van der Meer, J.W.M.; Kullberg, B.J.; Netea, M.G.
Hyalinizing clear cell carcinoma (HCCC) is a rare, recently described tumor of salivary gland origin. Differential diagnosis includes benign lesions as clear cell change in a pleomorphic adenoma or in oncocytoma and malignant tumors – i.e. epithelial-myoepithelial carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, clear cell acinic carcinoma, clear cell squamous carcinoma, clear cell malignant melanoma, clear cell odontogenic carcinoma, clear
Alessandra Rinaldo; Kathryn M. McLaren; Paolo Boccato; Arnold G. D. Maran
Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Salivary Gland Adenoid Cystic Carcinoma; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Salivary Gland Cancer; Stage IVA Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVA Salivary Gland Cancer; Stage IVB Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVC Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Tongue Cancer
Some of the mechanisms involved in neoplastic transformation and progression of laryngeal squamous cell carcinoma (LSCC) are discussed. Although tumor suppressor inactivation of p53 and p16 is common in these tumors (about 50% each), oncogenic activation is less well characterized. Cyclin D1 and epidermal growth factor receptor amplification have been reported in one-third and one-quarter of LSCCs, respectively, both related
Alfons Nadal; Antonio Cardesa
Positive familial history (first or second degree relative) for colorectal carcinoma (CRC) can be found in approximately 30%\\u000a of all newly diagnosed cases, but less than 5% will be due to a defined genetic category of hereditary CRC. Pathologic examination\\u000a of the biopsy or resection specimen can help in identification of unsuspected cases of certain forms of hereditary CRC due
Zoran Gatalica; Emina Torlakovic
Ductal carcinoma in situ (DCIS) represents a heterogenous group of lesions with variable malignant potential. Although it\\u000a is clearly pre-invasive, not all lesions progress to an invasive malignant disease. The significant increase in the frequency\\u000a of diagnosis is the result of both widespread use of screening mammography and better recognition among pathologists. Treatment\\u000a is controversial, but for several decades total
Sevilay Altintas; Manon T. Huizing; Eric Van Marck; Jan B. Vermorken; Wiebren A. Tjalma
OBJECTIVE:Hepatocellular carcinoma (HCC) is common in Asia, and the majority are not suitable for curative surgical treatment. We studied the natural history of untreated nonsurgical HCC to examine whether the prognosis has changed with improved supportive treatment and to identify factors affecting survival.METHODS:One hundred and six ethnic Chinese patients with HCC not amenable to curative treatment were managed symptomatically as
Yuk Pang Yeung; Chung Mau Lo; Chi Leung Liu; Benjamin C. Wong; Sheung Tat Fan; John Wong
An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery.
Gojska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech
AIM: To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary adenosquamous carcinoma (ASC) of the esophagus. METHODS: A total of 4015 patients with esophageal carcinoma underwent surgical resection between January 1995 and June 2012 at the Cancer Hospital of Shantou University Medical College. In 37 cases, the histological diagnosis was primary ASC. Clinical data were retrospectively analyzed from these 37 patients, who underwent transthoracic esophagectomy with lymphadenectomy. The ?2 or Fisher’s exact test was used to compare the clinicopathological features between patients with ASC and those with squamous cell carcinoma (SCC). The Kaplan-Meier and Log-Rank methods were used to estimate and compare survival rates. A Cox proportional hazard regression model was used to identify independent prognostic factors. RESULTS: Primary esophageal ASC accounted for 0.92% of all primary esophageal carcinoma cases (37/4015). The clinical manifestations were identical to those of other types of esophageal cancer. All of the 24 patients who underwent preoperative endoscopic biopsy were misdiagnosed with SCC. The median survival time (MST) was 21.0 mo (95%CI: 12.6-29.4), and the 1-, 3-, and 5-year overall survival rates were 67.5%, 29.4%, and 22.9%, respectively. In multivariate analysis, only adjuvant radiotherapy (HR = 0.317, 95%CI: 0.114-0.885, P = 0.028) was found to be an independent prognostic factor. The MST for ASC patients was significantly lower than that for SCC patients [21.0 mo (95%CI: 12.6-29.4) vs 46.0 mo (95%CI: 40.8-51.2), P = 0.001]. In subgroup analyses, the MST for ASC patients was similar to that for poorly differentiated SCC patients. CONCLUSION: Primary esophageal ASC is a rare disease that is prone to be misdiagnosed by endoscopic biopsy. The prognosis is poorer than esophageal SCC but similar to that for poorly differentiated SCC patients.
Chen, Shao-Bin; Weng, Hong-Rui; Wang, Geng; Yang, Jie-Sheng; Yang, Wei-Ping; Liu, Di-Tian; Chen, Yu-Ping; Zhang, Hao
Reconstituted influenza virus envelopes (virosomes) containing the viral hemagglutinin (HA) have attracted attention as delivery vesicles for cytosolic drug delivery as they possess membrane fusion activity. Here, we show that influenza virosomes can be targeted towards ovarian carcinoma cells (OVCAR-3) with preservation of fusion activity. This was achieved by incorporating poly(ethylene glycol) (PEG)-derivatized lipids into the virosome membrane. This PEG
Enrico Mastrobattista; Pieter Schoen; Jan Wilschut; Daan J. A Crommelin; Gert Storm
Spontaneous rupture of hepatocellular carcinoma (HCC) is a dramatic presentation of the disease. Most published studies are\\u000a from Asian centers, and North American experience is limited. This study was under-taken to review the experience of ruptured\\u000a HCC at a North American multidisciplinary unit. Thirty pa-tients presenting with ruptured HCC at a tertiary care center from\\u000a 1985 to 2004 were studied
Andrzej K. Buczkowski; Peter T. W. Kim; Stephen G. Ho; David F. Schaeffer; Sung I. Lee; David A. Owen; Alan H. Weiss; Stephen W. Chung; Charles H. Scudamore
Hepatocellular carcinoma (HCC) continues to represent a major worldwide problem. While treatments such as resection, transplantation and ablation may provide a chance for cure, these options are often precluded because of advanced disease presentation. Palliative treatments include transarterial embolization and systemic therapies. This review will summarize the state of the science for embolic therapies in HCC (conventional and drug-eluting chemoembolization, radioembolization), as well as discuss related topics including HCC staging, assessment of response and ongoing clinical trials.
Salem, Riad; Lewandowski, Robert J.
Primary tumors of the lung are uncommon in pediatric patients, particularly bronchioloalveolar carcinoma (BAC). An 11-year-old female suffering from back pain for 1 month was referred to Seoul St. Mary's Hospital for treatment of a pathologic fracture of the lumbar spine. Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV). During chemotherapy, most of the lung lesions regressed, with the exception of two nodules. Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.
Choi, Soo Hwan; Jeon, Hyun Woo; Oh, Woo Jin
\\u000a Over the last 25 years, liver transplantation has been established as a therapy for end stage liver disease. Liver transplantation\\u000a also appears to be an ideal treatment for unresectable hepatocellular carcinoma (HCC), since it provides the potential for\\u000a cure of both the HCC and the underlying liver disease. Although the early results of liver transplantation for HCC were disappointing,\\u000a emerging
Hiroyuki Furukawa; Satoru Todo
Systemic anticancer therapy for hepatocellular carcinoma (HCC) is limited by intrinsic drug resistance and accompanying liver\\u000a dysfunction. However, recent advances in molecular targeted therapy (MTT) have shed light on the treatment of advanced HCC.\\u000a A recent randomized, placebo-controlled trial demonstrated that sorafenib, a multi-target tyrosine kinase inhibitor, prolonged\\u000a overall survival and time-to-progression in patients with advanced HCC. This breakthrough highlights
Ying Chun Shen; Chiun Hsu; Ann Lii Cheng
Skin squamous cell carcinomas (SCCs) are arguably the second most common carcinoma of the skin and are responsible for the majority of non-melanoma skin cancer deaths. Gynecologist treated a Caucasian 56-years old female patient for genital wart with podophyllotoxin cream. She did not achieve complete response and therefore she has interrupted the therapy and the collaboration with the gynecologist. At the time of evaluation the lesion had a size of man's palm in anogenital region and showed characteristic features of neoplasm. The regional lymph nodes have produced infiltrated painful bubo. PCR analysis for HPV proved negative. Histopathology revealed well-differentiated squamous cell keratinizing carcinoma from the tumor as well as from the regional lymph node packet. Staging computed tomography scans proved negative and pelvis scans disclosed regional lymphadenopathy underlying the tumor. Palliative radiation therapy (by linear accelerator) was administered for the oversized tumor to the total TD 50.0Gy. The patient died 6 months after diagnostic assessment from cardio-respiratory failure. Staging computed tomography before her death did not disclose distinct metastases in her inner organs. Well-differentiated squamous cell keratinizing carcinoma could be growing endophytically affecting the underlying adipose tissue and musculature, with spreading into the regional lymph nodes. The rate of metastases into inner organs seems to vary according to the aggressiveness and metastatic behavior of each SCC. The case report calls for attention to the importance of collaboration among various specialists assisting in the diagnosis and management of skin neoplasm (Fig. 5, Ref. 12). Full Text in PDF www.elis.sk. PMID:22502759
Svecova, D; Havrankova, M; Weismanova, E; Babal, P
Summary Metastasis of a follicular thyroid carcinoma (FTC) to the skull is very rare. We present a case of solitary lytic skull metastasis of a FTC in a 30-year-old woman. The patient presented with bulging on the left side of the head. Neuro-imaging techniques showed a lesion with an osteolytic component in the left frontal region. After a left frontal
N. Özdemir; M. ?eno?lu; Ü. Dursun Acar; M. ?erefettin Canda
Cytogenetic study of 30 bladder carcinomas confirmed the heterogeneity and the complexity of the karyotypic picture in this type of tumor. Presence of numerical and/or structural chromosome aberrations was observed in all tumors. Clonal abnormalities were found in 19 cases. Chromosomes most frequently involved in changes were chromosome #1, #3 and #11(36.6%, 26.6%, and 20% of the cases respectively). Trisomy 7 and monosomy 9 were the sole abnormalities in one case each. PMID:3422046
Vanni, R; Scarpa, R M; Nieddu, M; Usai, E
Background. This study aims to clarify which patients would benefit by surgery for pulmonary metastases from colorectal carcinoma.Methods. A retrospective study was undertaken in 25 patients who had undergone complete resection. In all cases, prethoracotomy carcinoembryonic antigen (CEA) level was measured and mediastinal or hilar lymph nodes were histologically examined.Results. Overall 5-year survival was 39.2%. The 5-year survival rate for
Masayoshi Inoue; Yahiro Kotake; Katsuhiro Nakagawa; Kiyohiro Fujiwara; Kenjiro Fukuhara; Tsutomu Yasumitsu
A 52-year-old woman had a pathological fracture of the right femur. On histopathological examination bone metastasis from renal cell carcinoma was suspected. Abdominal computed tomography showed a heterogeneous mass (9.1 x 7.8 x 6.5 cm) in the left kidney and a cystic multilocular mass (12 x 10 cm) in the pelvis. Bone scintigraphy revealed an abnormal uptake in the left coracoid process, right third rib, and right distal femur and proximal tibia. Clinical diagnosis was left renal cancer with multiple bone metastases (cT2NOM1, stage IV) and a right ovarian tumor. We performed left radical nephrectomy and resection of right ovarian tumor by bilateral adnexectomy. On histopathological examination, the left kidney tumor was diagnosed as renal cell carcinoma (clear cell carcinoma with chromophobe component, G2 > G1). The ovarian tumor consisted of carcinoma of clear cell type (G2) that resembled components of left renal cell carcinoma, confirming the diagnosis of metastatic renal clear cell carcinoma to the ovary. Although she underwent immunotherapy with interferon, she died 10 months after nephrectomy. Metastasis to the ovary from renal clear cell carcinoma is very rare and only 18 cases have been reported in the literature. This rarity may be related to the difficulty of differential diagnosis between metastatic renal cell carcinoma to the ovary and primary ovarian clear cell carcinoma. Elaborate analysis of microscopic features and immunohistochemical profiles may help in the distinction of this metastatic lesion. PMID:17252974
Kato, Yuji; Numata, Atsushi; Wada, Naoki; Iwata, Tatsuya; Saga, Yuji; Hashimoto, Hiroshi; Kakizaki, Hidehiro
Tricholemmal squamous cell carcinoma is a rare variant of squamous cell carcinoma thought to follow a more benign course. The authors present the case of a 67-year-old man with a giant tricholemmal squamous cell carcinoma on his scalp. Further investigations demonstrated a skull destruction and cranial invasion. Curative treatment was impossible, but tumor mass reduction and wound closure by sandwich split-thickness skin mesh graft transplantation using a dermal template was performed. Problems of advanced squamous cell carcinoma on the scalp are discussed.
Bayyoud, Yousef; Kittner, Thomas; Durig, Eberhard
It is generally difficult to identify stage II endometrial carcinoma correctly. To differentiate cervical involvement, endocervical conization was performed on 31 patients with endometrial cancer between May 1982 and September 1983. The preoperative diagnosis of stage II endometrial carcinoma was confirmed by postoperative histologic examination. In stage I patients, there was no microscopic cervical involvement after the operation. Fractional curettage and hysteroscopy are commonly used to detect stage II endometrial carcinoma. However, these examinations may overlook cervical stromal invasion. Endocervical conization is a simple procedure and highly useful to detect cervical stromal involvement. We recommend the of endocervical conization combined with hysteroscopy to diagnose stage II endometrial carcinoma. PMID:6471397
Fukuda, K; Masubuchi, S; Masubuchi, K
Carcinomas from an odontogenic cyst are not common, yet when they occur, squamous cell carcinomas are the most often seen. Among these cysts, the malignancy of keratocysts or dentigerous cysts are most likely. In contrast, a malignant transformation of a radicular cyst to an intraosseous carcinoma is extremely rare. In this case report, an intraosseous carcinoma arising from an odontogenic cyst in a 26-year-old male patient is presented. This case report clearly demonstrates the importance of the clinician's awareness of the malignant potential of apparently innocuous cystic lesions. PMID:22921445
Bereket, Cihan; Bekçio?lu, Burak; Koyuncu, Mehmet; ?ener, ?smail; Kandemir, Bedri; Türer, Akif
Gall bladder carcinoma is the most common biliary tract cancer. Delayed presentation and early spread of tumor make it one of the lethal tumors with poor prognosis. Considering that simple cholecystectomy for T1 disease could offer a potential cure, it is increasingly needed to identify it at early stages. Identification of high-risk cases and offering prophylactic cholecystectomy can decrease the incidence of gallbladder carcinoma. With advances in diagnostic tools like contrast-enhanced endoscopic ultrasound, elastography, multidetctor CT, MRI, and PET scan, we can potentially diagnose gallbladder carcinoma at early stages. This paper reviews the various diagnostic modalities available and an algorithmic approach to early diagnosis of gallbladder carcinoma.
Vijayakumar, Abhishek; Vijayakumar, Avinash; Patil, Vijayraj; Mallikarjuna, M. N.; Shivaswamy, B. S.
Small cell carcinoma of the anus is a rare tumor that has been infrequently described in the literature. In contrast to squamous cell carcinoma, which is known to be associated with high-risk subtypes of human papillomavirus (HPV), the etiology of small cell carcinoma of the anal canal is not established. We present a case of a patient with small cell carcinoma of the anal canal in the setting of prior squamous dysplasia and carcinoma in situ. In conjunction with recently published data demonstrating the presence of HPV in tumor specimens from patients with small cell carcinoma of the anal canal, our patient’s clinical course suggests a possible link between HPV and this rare malignancy.
Edgar, Mark A.; Hawk, Natalyn N.; Sullivan, Patrick S.; Stapleford, Liza J.
To determine the differences between the cellular characteristics of thymic carcinoma and thymoma, immunohistochemical analysis with lymphocyte markers (CD1a, 3, 4, 5, 8, 10, 20, 21, 25, 30, 57, and 72) was performed on 23 thymic epithelial tumors other than lymphocytic thymoma: overt thymic carcinoma (OC, n = 7), atypical thymoma (n = 5), and typical thymoma (epithelial or mixed thymoma, n = 11). Among the surface antigens examined, CD5, a type of receptor molecule that signals cell growth in T cells, was expressed in neoplastic epithelial cells of the thymus, in OC (seven of seven) and atypical thymoma (two of five), but not in typical thymoma. Double labeling immunofluorescence demonstrated expression of CD5 in cytokeratin-positive cells. The CD5 molecule extracted from an OC tumor showed the same molecular size as that in the spleen, but CD72, a ligand of CD5 on the surface of B cells, was not found in the epithelial cells of OC or atypical thymoma. Expression of CD5 was not observed in carcinomas of other organs, such as lung (n = 15), breast (n = 4), esophagus (n = 6), stomach (n = 6), colon (n = 9), and uterine cervix (n = 3). CD5 is closely related to morphological changes in thymic epithelial tumors and may play a role in the evolution of OC through receptor-ligand interaction. Images Figure 1 Figure 2 Figure 3
Hishima, T.; Fukayama, M.; Fujisawa, M.; Hayashi, Y.; Arai, K.; Funata, N.; Koike, M.
Urothelial carcinoma of the bladder is a common malignancy that causes approximately 150,000 deaths per year worldwide. So far, no molecularly targeted agents have been approved for treatment of the disease. As part of The Cancer Genome Atlas project, we report here an integrated analysis of 131 urothelial carcinomas to provide a comprehensive landscape of molecular alterations. There were statistically significant recurrent mutations in 32 genes, including multiple genes involved in cell-cycle regulation, chromatin regulation, and kinase signalling pathways, as well as 9 genes not previously reported as significantly mutated in any cancer. RNA sequencing revealed four expression subtypes, two of which (papillary-like and basal/squamous-like) were also evident in microRNA sequencing and protein data. Whole-genome and RNA sequencing identified recurrent in-frame activating FGFR3-TACC3 fusions and expression or integration of several viruses (including HPV16) that are associated with gene inactivation. Our analyses identified potential therapeutic targets in 69% of the tumours, including 42% with targets in the phosphatidylinositol-3-OH kinase/AKT/mTOR pathway and 45% with targets (including ERBB2) in the RTK/MAPK pathway. Chromatin regulatory genes were more frequently mutated in urothelial carcinoma than in any other common cancer studied so far, indicating the future possibility of targeted therapy for chromatin abnormalities. PMID:24476821
During the last decade radiotherapy, in combination with chemotherapy, has become the treatment of choice in cure of anal carcinoma with preservation of anal function, and has replaced abdominoperineal resection (APR). From 1979-1990 54 patients with anal carcinoma were treated by radiotherapy. 24 patients received radiotherapy after APR (12 adjuvant, 12 after recurrence). 11 received palliative radiotherapy without prior APR. 19 patients were treated curatively, 17 of whom received a combination of external irradiation followed by interstitial iridium implantation in a split course regimen. 11 of the 19 patients received short simultaneous chemotherapy (mitomycin C and 5-fluorouracil). All 19 patients had a complete remission. 18/19 patients had no local recurrence after mean 14 months' follow-up. 2 patients developed regional recurrence. 3 patients died of other causes. Colostomy was necessary in 5/19 patients with anal necrosis which was dose-related. The maximum tolerated dose was 71.4 Gy. Our results support the recommendation in the literature of primary, curative, radiotherapy and chemotherapy of anal carcinoma with preservation of the anal sphincter. PMID:1439687
Thöni, A F; Greiner, R; Peyer, T; Leicht, E; Lampret, T; Feuz, J
Squamous cell carcinoma (SCC) of the pancreas is a controversial entity of uncertain origin, as the pancreas is entirely devoid of squamous cells. Cases of pancreatic carcinomas that exhibit primary squamous morphology are rarely described in the literature. We report a case of primary SCC of the pancreas in a 66-year-old woman with complaints of epigastric pain of five months duration. Imaging studies demonstrated a solid tumor in the body of the pancreas that invaded the superior mesenteric (SMA) and celiac arteries, as well as regional lymph nodes. Cytological examination of an endosonography-guided fine needle aspiration (EUS-FNA) specimen confirmed the diagnosis of well-differentiated SCC of the pancreas. On the basis of diagnosis and examinations prior to chemotherapy, we did not detect any SCC lesions that might have metastasized to the pancreas. Primary SCC of the pancreas is a rare entity that comprises 0.05% of all exocrine pancreatic carcinomas. The clinical profile and biological behavior of pancreas SCC are similar to typical pancreatic ductal adenocarcinomas. PMID:23725072
Nikfam, Sepideh; Sotoudehmanesh, Rasoul; Pourshams, Akram; Sadeghipour, Alireza; Sotoudeh, Masoud; Mohamadnejad, Mehdi
Metastatic tumors of the stomach are rare, with an incidence of 0.2%-0.7%, and they have been reported to result mainly from primary breast cancers, lung cancers, and melanoma. Further, among such metastatic tumors, the metastasis of renal cell carcinoma (RCC) to the stomach is an extremely rare disease, and it is usually reported in autopsy series. We report a rare case of metastatic gastric tumor derived from right renal carcinoma. Gastric endoscopy confirmed a large, polypoid, friable mass (type 1 tumor, about 7 cm in diameter) in the middle part of the stomach body. The mass was surgically excised and pathological examination showed that the gastric tumor was derived from a metastasis from the right kidney, because it was composed of malignant cells that were identical to those from the removed RCC. In addition, the tumor cells were immunoreactive for CD10, CD15, Ecadherin, early membrane antigen (EMA), and vimentin, but no reactivity was observed for cytokeratins 7 and 20 or c-KIT. Although gastric metastatic tumor derived from renal carcinoma is rare, the precise pre- and postoperative diagnosis may be important; thus, investigation for such metastatic tumors should be performed routinely in the follow up of patients who have been treated for RCC. PMID:19890698
Yamamoto, Daigo; Hamada, Yoshinori; Okazaki, Satoshi; Kawakami, Katsuhiro; Kanzaki, Seiichiro; Yamamoto, Chizuko; Yamamoto, Mitsuo
Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.
Sabolch, Aaron [University of Michigan Medical School, Ann Arbor, MI (United States); Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Griffith, Kent [Department of Biostatistics Unit, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI (United States); Hammer, Gary [Department of Internal Medicine, University of Michigan, Ann Arbor, MI (United States); Doherty, Gerard [Department of Surgery, University of Michigan, Ann Arbor, MI (United States); Ben-Josef, Edgar, E-mail: firstname.lastname@example.org [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)
The treatment of advanced renal cell carcinoma has been completely changed by the development of new therapeutic modalities during the past 3 years. In this time period six targeted agents have been approved for the treatment of advanced or metastatic disease. Phase 3 data support the use of sunitinib, bevacizumab plus interferon-? and pazopanib for patients with low and intermediate risk of clear-cell renal cell carcinoma. In the pivotal study of temsirolimus a significant longer overall survival compared with interferon-? in high-risk disease including non-clear-cell histology was observed. Patients pretreated with cytokines will benefit from sorafenib and pazopanib while everolimus has been shown to increase significantly progression-free survival after previous anti-angiogenesis therapy. In addition to these phase 3 data-based recommendations, several other factors have to be considered for treatment selection, for example, side effect profile and patients' comorbidities. Currently, the sequential use of the available targeted drugs and adjuvant treatment are the subject of ongoing clinical trials. However, medical treatment of renal cell carcinoma remains palliative and surgery remains the only curative approach in patients with localized, locally advanced and limited metastatic disease. PMID:21789079
Grimm, Marc-Oliver; Wolff, Ingmar; Zastrow, Stefan; Fröhner, Michael; Wirth, Manfred
Chronic granulomatous mastitis is known as a benign and relatively rare disorder that is often difficult to differentiate from breast carcinoma. We highlight the case of a 34-year-old woman who had recurrent episodes of right breast swelling and abscess for 8 years. These were proven to be chronic granulomatous mastitis by tissue biopsies on 3 different occasions. Her condition improved on similar courses of antibiotics and high-dose prednisolone. However, she subsequently developed progressive loss of vision due to an orbital tumour. She then underwent a craniotomy and left orbital decompression with excision of the tumour, which proved to be a metastatic carcinoma. A trucut biopsy of the right breast was then done and showed features consistent with an infiltrating ductal carcinoma. This case illustrates the possibility that chronic granulomatous mastitis could be a precursor for malignancy and the difficulty in differentiating one from the other. The possible mechanisms of development and the implications for future management are also discussed.
Luqman, Mazlan; Shahrun Niza, Abdullah Suhaimi; Saladina Jaszle, Jasmin; Nani Harlina, Md Latar; Sellymiah, Adzman; Rohaizak, Muhammad
Chronic granulomatous mastitis is known as a benign and relatively rare disorder that is often difficult to differentiate from breast carcinoma. We highlight the case of a 34-year-old woman who had recurrent episodes of right breast swelling and abscess for 8 years. These were proven to be chronic granulomatous mastitis by tissue biopsies on 3 different occasions. Her condition improved on similar courses of antibiotics and high-dose prednisolone. However, she subsequently developed progressive loss of vision due to an orbital tumour. She then underwent a craniotomy and left orbital decompression with excision of the tumour, which proved to be a metastatic carcinoma. A trucut biopsy of the right breast was then done and showed features consistent with an infiltrating ductal carcinoma. This case illustrates the possibility that chronic granulomatous mastitis could be a precursor for malignancy and the difficulty in differentiating one from the other. The possible mechanisms of development and the implications for future management are also discussed. PMID:22973142
Mazlan, Luqman; Suhaimi, Shahrun Niza Abdullah; Jasmin, Saladina Jaszle; Latar, Nani Harlina Md; Adzman, Sellymiah; Muhammad, Rohaizak
Tumors are heterogeneous collections of cells with highly variable abilities to survive, grow, and metastasize. This variability likely stems from epigenetic and genetic influences, either stochastic or hardwired by cell type-specific lineage programs. That differentiation underlies tumor cell heterogeneity was elegantly demonstrated in hematopoietic tumors, in which rare primitive cells (cancer stem cells (CSCs)) resembling normal hematopoietic stem cells are ultimately responsible for tumor growth and viability. Because of the compelling clinical implications CSCs pose—across the entire spectrum of cancers—investigators applied the CSC model to cancers arising in tissues with crudely understood differentiation programs. Instead of relying on differentiation, these studies used empirically selected markers and statistical arguments to identify CSCs. The empirical approach has stimulated important questions about “stemness” in cancer cells as well as the validity and stoichiometry of CSC assays. The recent identification of urothelial differentiation programs in urothelial carcinomas (UroCas) supports the idea that solid epithelial cancers (carcinomas) develop and differentiate analogously to normal epithelia and provides new insights about the spatial localization and molecular makeup of carcinoma CSCs. Importantly, CSCs from invasive UroCas (UroCSCs) appear well situated to exchange important signals with adjacent stroma, to escape immune surveillance, and to survive cytotoxic therapy. These signals have potential roles in treatment resistance and many participate in druggable cellular pathways. In this review, we discuss the implications of these findings in understanding CSCs and in better understanding how UroCas form, progress, and should be treated.
Brandt, William D.; Matsui, William; Rosenberg, Jonathan E.; He, Xiaobing; Ling, Shizhang; Schaeffer, Edward M.
Desmosomes are adhesive junctions of epithelial cells. Their expression may be altered or lost in carcinomas resulting in reduced cellular adhesiveness. The desmosomes of colorectal carcinomas have been studied by fluorescent antibody staining, immunoblotting and electromicroscopy. A series of 58 malignant specimens, comprised of primary tumours and metastases, were desmosome positive. There was no indication of a comparative reduction in desmosome expression that might give rise to reduced adhesiveness of tumour cells, although loss of polarised junctional distribution in poorly differentiated tumours might have such a consequence. Western blotting analysis of colorectal cancers and cultured carcinoma cells identified desmosomal polypeptides dp1 + 2, dg1 and dg2 + 3 with similar relative molecular weights to normal homologues. In addition, a polypeptide of 140,000 was recognised only in malignant epithelium by anti-dg2 + 3 antiserum. The significance of this polypeptide is not understood. Tumours and uninvolved epithelium were exposed to low extracellular [Ca2+] to test whether tumour desmosomes were of reduced stability. This caused much cellular degradation in tumours but some viable cell clumps possessed desmosomes resistant to disruption by low [Ca2+]. Desmosomes may thus have a positive role in metastasis by maintaining intercellular adhesion between metastasising cells. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8
Collins, J. E.; Taylor, I.; Garrod, D. R.
Urothelial carcinoma (UC) rarely metastasizes to the penis and skin. We report the case of a 73-year-old man with UC metastases to the corpus spongiosum and dermis of the distal penis. We also review the clinicopathologic characteristics and management options for UC metastasizing to the penis. The patient presented with priapism and edema of the genital region. This follows a 5-year history of urothelial carcinoma in situ that progressed to invasive cancer despite intravesical immunotherapy. Seventeen months prior to presentation, the patient underwent a radical cystectomy with adjuvant chemotherapy. The cystectomy specimen demonstrated a pT4a N2 M0 G3 UC and margins were positive for carcinoma in situ. Follow-up had been negative for recurrence until his presentation with priapism. Incisional biopsy of the glans revealed UC and radical penectomy was performed with negative margins. The penile specimen demonstrated extensive involvement of the corpus spongiosum by UC with lymphovascular invasion and subepidermal involvement. Three months after penectomy, the patient presented with inguinal nodal recurrence. Palliative radiotherapy was administered and the patient passed away eight months after surgery. PMID:22511441
Dason, Shawn; Sheikh, Adeel; Wang, Jing Gennie; Tauqir, Syeda; Davies, Timothy O; Shayegan, Bobby
Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer
Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Oral Cavity Squamous Cell Carcinoma; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary
We report two cases, with overlapping cyto-histological characteristics, of invasive neuroendocrine carcinoma of the breast with associated stromal features distinctive of carcinoma with osteoclastic giant cells. Fine-needle aspiration cytology showed monomorphic, medium-sized, mildly atypical neoplastic cells, with interspersed multinucleated giant cells and lympho-histiocytic components; hemosiderin deposits were also appreciable. Macroscopic features were typical of invasive carcinoma, but with unusual brown staining. Light microscopy revealed moderately differentiated invasive carcinoma mainly composed of solid sheets of round to polygonal medium-sized cells with a tendency to produce peripheral palisading (carcinoid-like morphology); osteoclast-like multinucleated giant cells, lymphocytes and histiocytes were dispersed only among tumour cells in the distinctive stroma of the carcinoma with osteoclastic giant cells; this stroma was characterised by reactive/fibroblastic features, hypervascularization, extravasated blood cells and hemosiderin deposits that gave rise to the typical staining seen macroscopically. Immunohistochemically, cancer cells were diffusely positive for the neuroendocrine marker synaptophisin with partial chromogranin and NSE staining; the ostoclastic giant cell and histiocyte component were strongly positive for CD68. Both cases also had lymph node metastases; the epithelial neoplastic cells, with regards to neuroendocrine markers, were overlapping to the primitive tumour, the histiocytic/giant cell component appeared present, although with a lower degree, while the distinctive stroma was absent. Breast neuroendocrine carcinomas, associated with multinucleated giant cells and stroma typical of the carcinoma with osteoclastic-like cells, to our knowledge, have not been reported. PMID:18841823
Pagani, A; Iandolo, M
Background. Renal cell carcinoma (RCC) has unpredictable and diverse behavior. The classic triad of hematuria, loin pain, and abdominal mass is uncommon. At time of diagnosis, 25%-30% of patients are found to have metastases. Bones, lungs, liver, and brain are the frequent sites of metastases. RCC with metastasis to the head and neck region and thyroid gland is the rarest manifestation and anaplastic carcinoma behaving metastatic thyroid mass is an extremely rare presentation of RCC. Case Presentation. A 56-year-old Saudi man with past history of right radical nephrectomy 5 years back presented with 3 months history of rapid increasing neck mass with dysphagia, presenting like anaplastic thyroid carcinoma. Tru-cut biopsy turned out to be metastatic renal cell carcinoma. Patient was treated with radiation therapy 30?Gy in 10 fractions to mass. Patient died 4 months after the discovery of anaplastic thyroid looking metastasis. Conclusion. Rapidly progressing thyroid metastases secondary to RCC are rare and found often unresectable which are not amenable to surgery. Palliative radiotherapy can be considered for such patients. PMID:23662243
Riaz, Khalid; Tunio, Mutahir A; Alasiri, Mushabbab; Elbagir Mohammad, Asim Ali; Fareed, Muhammad Mohsin
Background. Renal cell carcinoma (RCC) has unpredictable and diverse behavior. The classic triad of hematuria, loin pain, and abdominal mass is uncommon. At time of diagnosis, 25%–30% of patients are found to have metastases. Bones, lungs, liver, and brain are the frequent sites of metastases. RCC with metastasis to the head and neck region and thyroid gland is the rarest manifestation and anaplastic carcinoma behaving metastatic thyroid mass is an extremely rare presentation of RCC. Case Presentation. A 56-year-old Saudi man with past history of right radical nephrectomy 5 years back presented with 3 months history of rapid increasing neck mass with dysphagia, presenting like anaplastic thyroid carcinoma. Tru-cut biopsy turned out to be metastatic renal cell carcinoma. Patient was treated with radiation therapy 30?Gy in 10 fractions to mass. Patient died 4 months after the discovery of anaplastic thyroid looking metastasis. Conclusion. Rapidly progressing thyroid metastases secondary to RCC are rare and found often unresectable which are not amenable to surgery. Palliative radiotherapy can be considered for such patients.
Riaz, Khalid; Tunio, Mutahir A.; AlAsiri, Mushabbab; Elbagir Mohammad, Asim Ali; Fareed, Muhammad Mohsin
Background: Germline BRCA1 mutations of sporadic ovarian cancers are presumed to be rare events, except among specific populations. To date, the status of germline BRCA1 muta- tions in Taiwanese with primary epithelial ovarian carcinoma (PEOC) is still unknown. In this study, we tried to answer part of this question. Methods: Sixty-four patients documented with PEOC, four patients with family history
Peng-Hui Wang; Wen-Yuann Shyong; Hsien-Hsiung Lee; Wen-Ying Tsai; Chi-Yue Wu; Chiou-Chung Yuan
Secretory carcinoma is a rare but distinct subtype of breast carcinoma, with characteristic histomorphology and generally favorable prognosis. Although it was originally described as a juvenile breast carcinoma, occurring in young children, most cases have been reported in adults of both sexes. As the name implies, the characteristic histomorphology is the presence of a large amount of intracellular and extracellular, eosinophilic secretion material that stains positive for periodic acid-Schiff. Most tumors stain positive for S100 and negative for estrogen receptor, progesterone receptor, and ERBB2 (formerly HER2/neu) (ie, triple negative). In addition, some secretory carcinomas demonstrate a basal-like immunoprofile. Recent studies have shown the characteristic molecular feature: a balanced translocation t(12;15), resulting in an ETS variant 6-neurotrophic tyrosine kinase receptor type 3 (ETV6-NTRK3) fusion gene encoding a chimeric tyrosine kinase. Although rare events of axillary lymph node or distant metastases have been documented, the prognosis is generally excellent. The methods of surgical treatment and the role of adjuvant therapy, particularly for young patients, remain controversial. PMID:22129193
Vasudev, Pooja; Onuma, Kazuya
Renal cell carcinoma (RCC) with rhabdoid morphology (RCC-RM) is a recently described variant of RCC, which has an aggressive biologic behavior and poor prognosis, akin to sarcomatoid RCC. The current World Health Organization classification of RCC does not include the rhabdoid phenotype as a distinct histologic entity. The aim of this study is to investigate whether RCC-RM represents a dedifferentiation
Jennifer R. Chapman-Fredricks; Loren Herrera; Jorge Bracho; Carmen Gomez-Fernandez; Raymond Leveillee; Luis Rey; Merce Jorda
The treatment of patients with differentiated carcinoma of the thyroid is a controversial subject. This article discusses the authors' approach in the clinical practice. A description of the various types of papillary and follicular carcinoma is presented. Diagnostic tests, biologic behavior, and management are reviewed.34 references.
Block, B.L.; Spiegel, J.C.; Chami, R.G. (Wright State Univ. School of Medicine, Dayton, OH (USA))
Histopathologic changes ranging from simple cystic hyperplasia to carcinomain situmay be observed in adenomyotic foci in patients with endometrial carcinoma. These changes can be an area of concern and physicians should be aware of their clinicopathologic significance. We studied a total of 94 patients, including endometrial carcinoma with (28 patients) and without adenomyosis (56 patients), and control group of adenomyosis
Metin Taskin; Thomas A. Lallas; Maria Shevchuk; Hugh R. K. Barber
Objective: To measure the lipid peroxidation and endogenous antioxidant enzyme status in oral carcinoma and the protective role of exogenous antioxidants. Meterial and methods: 20 new cases of histologically proven oral squamous cell carcinoma, 20 of leukoplakia and 20 age and sex matched healthy conrols were included. Intra oral pH of patients and controlled were measured by quantitative litmus paper
Khanna R; Thapa PB; Khanna HD; Khanna S; Khanna AK; Shukla HS
To conclude, bilateral breast metastases from the undifferentiated carcinoma of nasopharynx are rare. Breast metastases are commonly confused with the more common primary carcinoma of breast. Diagnosis is based on the core needle biopsy of the lesion which is helpful in the appropriate treatment planning of the patient.
Vaishnav, Kavita Umesh; Pandhi, Shikha; Shah, Tejal Shamik; Chaudhry, Aarti
More than half of all colorectal carcinomas are known to exhibit an activated mitogen-activated protein kinase pathway. The NF1 gene, a negative regulator of KRAS, has not previously been examined in a series of colorectal cancer. In the present study, primary colorectal carcinomas stratified according to microsatellite instability status were analyzed. The whole coding region of NF1 was analyzed for
Terje Ahlquist; Irene Bottillo; Stine A. Danielsen; Gunn I. Meling; Torleiv O. Rognum; Guro E. Lind; Bruno Dallapiccola; Ragnhild A. Lothe
Adenoid cystic carcinoma with heavy bone destruction. Case report. The adenoid cystic carcinoma is one of the most common malignant neoplasms of salivary gland origin. Approximately 50% is located in minor salivary glands, with preference on the palate, others in parotid and submandibular glands. It is more frequent between the fifth and seventh decades of life, rarely appears before 20
Orlando Yoris; Ligia Pérez Castro; Jonny Armas; Campo E. Pérez
Abstrad Tumors derived from a Li-Fraumeni syndrome cancer- susceptible family were examined for expression of the retinoblastoma susceptibility gene (RB). Whereas RB expression was normal in a primary breast carcinoma and its metastases from one member of this family, overexpression of RB was found in an adrenocortical carcinoma from another family member. This was in contrast to normal RB expression
Sally Warneford; Megan Townsend; Peter B. Rowe; Luciano Dalla-Pozza; Geoff Symonds
The pathological, cytological, and clinical features of vulvar intraepithelial neoplasia (VIN) are described. The rate of progression of VIN III to an invasive carcinoma is very low and spontaneous regression can occur. These features prevent the drawing of a direct analogy between vulvar and cervical intraepithelial neoplasia. The concept of microinvasive carcinoma of the vulva is discussed, and it is
C H Buckley; E B Butler; H Fox
Adenosquamous carcinoma is rare, accounting for 3%-4% of all pancreatic carcinoma cases. These tumors are characterized by the presence of variable proportions of mucin-producing glandular elements and squamous components, the latter of which should account for at least 30% of the tumor tissue. Recently, several reports have described cases of adenosquamous carcinoma of the pancreas. However, as the number of patients who undergo resection at a single institute is limited, large studies describing the clinicopathological features, therapeutic management, and surgical outcome for adenosquamous carcinoma of the pancreas are lacking. We performed a literature review of English articles retrieved from Medline using the keywords 'pancreas' and 'adenosquamous carcinoma'. Additional articles were obtained from references within the papers identified by the Medline search. Our subsequent review of the literature revealed that optimal adjuvant chemotherapy and/or radiotherapy regimens for adenosquamous carcinoma of the pancreas have not been established, and that curative surgical resection offers the only chance for long-term survival. Unfortunately, the prognosis of the 39 patients who underwent pancreatic resection for adenosquamous carcinoma was very poor, with a 3-year overall survival rate of 14.0% and a median survival time of 6.8 mo. Since the postoperative prognosis of adenosquamous carcinoma of the pancreas is currently worse than that of pancreatic adenocarcinoma, new adjuvant chemotherapies and/or radiation techniques should be investigated as they may prove indispensible to the improvement of surgical outcomes. PMID:19058301
Okabayashi, Takehiro; Hanazaki, Kazuhiro
Primary de novo intraosseous carcinoma is a rare neoplastic lesion which commonly occurs in the jaws. It is an epithelial odontogenic malignancy arising from odontogenic epithelial residues in the bone rather than from a preexisting epithelial lesion. In the present case report, the clinical, radiological and histological features of primary de novo intraosseous carcinoma are discussed and its aggressiveness and local invasiveness are highlighted.
Nandimath, Kirty; Naikmasur, Venkatesh G.; Babshet, Medha
The laparoscopic cholecystectomy of gall bladder carcinoma may have unfortunate consequences because of tumor cell dissemination. In this case report a female patient is presented, where histologically a gallbladder carcinoma was surprisingly diagnosed after laparoscopic cholecystectomy because of symptomatic cholecystectomy. 2 weeks after the first operation tumor cell clusters were found in the laparoscopy tracts. PMID:8585349
Hentsch, S; Senkal, M; Ernst, R; Junker, K
Breast carcinoma is known to metastatize to all organs. In order to understand the patterns of spread and natural courses, this review summarizes detailed studies of patients with various stages of the disease. After treatment of early breast carcinoma (stage I, II, and some III), the recurrent lesion can be classified as local, regional, distant, or combinations thereof. The sites
Yeu-Tsu Margaret Lee
A laryngocele is an abnormal dilatation of the laryngeal saccule. The relationship between layngoceles and laryngeal carcinoma is still debated. We present the case of a 45-year-old male patient with bilateral asymptomatic laryngocele and laryngeal squamous cell carcinoma. We discuss the possible etiopathogenetic influence of increased intralaryngeal pressure with preoperative CT and explorative findings, and the current literature is reviewed.
Yucel Akbas; Murat Ünal; Yavuz Selim Pata
Hepatocellular carcinoma arises in patients as a consequence of long-standing preexisting liver illnesses, including viral hepatitis, alcohol abuse, or metabolic disease. In such preexisting liver diseases, TGF-? plays an important role in orchestrating a favorable microenvironment for tumor cell growth and promoting epithelial-mesenchymal transition (EMT). TGF-? signaling promotes hepatocellular carcinoma progression by two mechanisms: first, via an intrinsic activity as an autocrine or paracrine growth factor and, second, via an extrinsic activity by inducing microenvironment changes, including cancer-associated fibroblasts, T regulatory cells, and inflammatory mediators. Although there is an increasing understanding on how TGF-? signaling is associated with tumor progression in hepatocellular carcinoma, it is not clear whether TGF-? signaling is limited to a certain subgroup of patients with hepatocellular carcinoma or is a key driver of hepatocellular carcinoma during the entire tumorigenesis of hepatocellular carcinoma. Inhibitors of the TGF-? signaling have been shown to block hepatocellular carcinoma growth and progression by modulating EMT in different experimental models, leading to the clinical investigation of the TGF-? inhibitor LY2157299 monohydrate in hepatocellular carcinoma. Preliminary results from a phase II clinical trial have shown improved clinical outcome and also changes consistent with a reduction of EMT. PMID:24638984
Giannelli, Gianluigi; Villa, Erica; Lahn, Michael
A case of metastatic lobular carcinoma of the breast in conjunction with osteopoikilosis is described. Widespread diffuse sclerotic bone lesions were identified on radiographs in a patient with breast carcinoma. In addition computed tomography demonstrated discrete spherical areas of increased density throughout the skeleton manifest typically by osteopoikilosis. No systemic symptoms were evident, blood parameters were normal and the lesions
J. G. Kennedy; J. R. Donahue; H. Aydin; B. H. Hoang; A. Huvos; C. Morris
The prognostic value of nuclear DNA content in papillary thyroid carcinoma was studied retrospectively in 90 patients. Eighty survived for at least 10 years, and 10 died, of papillary thyroid carcinoma, between 6 months and 12 years after diagnosis. Clinical data as well as morphological tumor characteristics were examined. DNA measurements in morphologically identified single tumor cells were performed either
Kenneth Cohn; Martin Bfickdahl; Gun Forsslund; Gert Auer; Göran Lundell; Torsten Löwhagen; Eva Tallroth; Jan-Silvester Willems; Anders Zetterberg; Per-Ola Granberg
To clarify the role of human papillomavirus (HPV) in penile cancer we evaluated the prevalence of HPV DNA in different histological subtypes of penile carcinoma, dysplasia, and condyloma using a novel, sensitive SPF10 HPV polymerase chain reaction assay and a novel genotyping line probe assay, allowing simultaneous identification of 25 different HPV types. Formalin-fixed, paraffin-embedded tissue samples were collected from the United States and Paraguay. HPV DNA was detected in 42% cases of penile carcinoma, 90% cases of dysplasia, and 100% cases of condyloma. There were significant differences in HPV prevalence in different histological cancer subtypes. Although keratinizing squamous cell carcinoma and verrucous carcinoma were positive for HPV DNA in only 34.9 and 33.3% of cases, respectively, HPV DNA was detected in 80% of basaloid and 100% of warty tumor subtypes. There was no significant difference in HPV prevalence between cases from Paraguay and the United States. In conclusion, the overall prevalence of HPV DNA in penile carcinoma (42%) is lower than that in cervical carcinoma (?100%) and similar to vulvar carcinoma (?50%). In addition, specific histological subtypes of penile cancer—basaloid and warty—are consistently associated with HPV, however, only a subset of keratinizing and verrucous penile carcinomas is positive for HPV DNA, and thus these two tumor groups seem to develop along different pathogenetic pathways.
Rubin, Mark A.; Kleter, Bernard; Zhou, Ming; Ayala, Gustavo; Cubilla, Antonio L.; Quint, Wim G. V.; Pirog, Edyta C.
Metastasis of carcinoma to the testes is rare. A case of caecal carcinoma presenting as testicular hydrocele is reported. The possibility of secondary tumour should be considered when a testicular mass or hydrocele arises in a patient above the age for primary testes tumour and the clinical picture suggests involvement of other organs. PMID:3354286
Højgaard Rasmussen, H; Schrøder, P
Sera from seven patients with bronchogenic carcinoma and cerebellar dysfunction were tested for anti-Purkinje cell antibodies (APCA) by indirect immunofluorescence and indirect immunoperoxidase reaction. Specific APCA as described in paraneoplastic cerebellar degeneration (PCD) were not detected in any of these patients or in control patients. The lack of APCA in patients with bronchogenic carcinoma and their presence in association with
K. Wessel; C. Budde-Steffen; H. Wiethölter; H. C. Diener; J. Dichgans
A 16-year-old North American girl with a prior history of a bladder calculus removed by open cystolithotomy 8 years earlier, subsequently had squamous cell carcinoma of the bladder along the site of the previous incision. The authors believe that this child is the youngest documented patient with squamous cell carcinoma of the bladder not associated with schistosomiasis. PMID:11101751
Sung, J D; Koyle, M A
It is well established that invasive urothelial carcinoma, involving the urinary bladder and renal pelvis, has marked propensity for divergent differentiation. In recent years, several ‘variant’ morphologies have been described and most have been recognized in the 2004 World Health Organization Classification. These histological variants of urothelial carcinoma have clinical significance at various levels, including diagnostic, that is, awareness of
Mahul B Amin
Bone metastases are rare in primary hepatocellular carcinoma (HCC). Spinal cord compression (SCC) due to bone metastases occur commonly in patients with lung and breast carcinomas, and metastatic HCC is an unusual cause of SCC. Spinal cord compression is an oncologic emergency and treatment delays can lead to irreversible consequences. Thus, the awareness that SCC could be a potential complication
Dinesh Chandra Doval; Komal Bhatia; Ashok Kumar Vaid; Keechelat Pavithran; Jai Bhagwan Sharma; Digant Hazarika; Amarnath Jena
Objectives. To determine the proportion of renal cell carcinomas that are discovered serendipitously, and to compare the tumor stages of symptomatic versus incidental tumors.Methods. We reviewed the charts of 131 consecutive patients who had a nephrectomy for renal cell carcinoma between 1989 and 1993. We excluded from the numerator any patients with abdominal pain or mass related to the tumor,
Mary Jayson; Holt Sanders
Follicular neoplasms of the thyroid gland include benign follicular adenoma and follicular carcinoma. Currently, a follicular carcinoma cannot be distinguished from a follicular adenoma based on cytologic, sonographic, or clinical features alone. The pathogenesis of follicular carcinoma may be related to iodine deficiency and various oncogene and/or microRNA activation. Advances in molecular testing for genetic mutations may soon allow for preoperative differentiation of follicular carcinoma from follicular adenoma. Until then, a patient with a follicular neoplasm should undergo a diagnostic thyroid lobectomy and isthmusectomy, which is definitive treatment for a benign follicular adenoma or a minimally invasive follicular cancer. Additional therapy is necessary for invasive follicular carcinoma including completion thyroidectomy, postoperative radioactive iodine ablation, whole body scanning, and thyrotropin suppressive doses of thyroid hormone. Less than 10% of patients with follicular carcinoma will have lymph node metastases, and a compartment-oriented neck dissection is reserved for patients with macroscopic disease. Regular follow-up includes history and physical examination, cervical ultrasound and serum TSH, and thyroglobulin and antithyroglobulin antibody levels. Other imaging studies are reserved for patients with an elevated serum thyroglobulin level and a negative cervical ultrasound. Systemic metastases most commonly involve the lung and bone and less commonly the brain, liver, and skin. Microscopic metastases are treated with high doses of radioactive iodine. Isolated macroscopic metastases can be resected with an improvement in survival. The overall ten-year survival for patients with minimally invasive follicular carcinoma is 98% compared with 80% in patients with invasive follicular carcinoma.
Purpose: To assess the impact of fractionation schedule, chemotherapy, and tumor location on local control and survival in patients treated with definitive irradiation for carcinoma of the pharyngeal walls.Methods and Materials: Between May 1971 and December 1991, 74 patients with previously untreated squamous cell carcinoma of the pharyngeal walls (excluding nasopharynx, tonsil, and pyriform sinus) were treated with radical megavoltage
Linyee Chang; Kenneth R. Stevens; William T. Moss; Carol M. Marquez; Harper D. Pearse; James I. Cohen
Twenty-seven patients with advanced bronchogenic carcinoma were treated with vindesine, 3 mg/m2/week. Twenty-three patients were evaluable for response. Two of six patients with small-cell carcinoma and one of 17 patients with non-small-cell carcinoma had partial responses. Two other patients with non-small-cell carcinoma had minor responses. The duration of the responses was 2-4 months. Neurologic toxicity occurred in 14 patients and was mild except in two patients. There was a median hemoglobin fall of 2.2 g/dl and a median leukocyte nadir of 2800/microliter during vindesine therapy. Thrombocytopenia occurred in 2 patients and mild thrombocytosis occurred in 10 patients. Seven patients experienced phlebitis or cellulitis at the site of drug administration which could be prevented with small doses of intravenous methylprednisolone. These results suggest that vindesine is well tolerated and possesses some activity in patients with previously treated bronchogenic carcinoma. PMID:6282107
Vogelzang, N J; Peterson, B A; Kennedy, B J; Vosika, G J; Conroy, J A
Patient: Female, 72 Final Diagnosis: Renal cell carcinoma Symptoms: — Medication: — Clinical Procedure: — Specialty: Oncology Objective: Challenging differential diagnosis Background: Lithium salts are widely used in the treatment of affective disorders of the bipolar type. Lithium is a nephrotoxic substance which can cause both acute and chronic renal disease, including cyst formation. Cysts appear to predispose the kidney to renal cell carcinoma. Case Report: A case of renal cell carcinoma in a background of acquired cystic disease due to chronic lithium toxicity is described. Conclusions: Kidneys with multiple cysts are at risk of renal cell carcinoma. Although it is difficult to determine if long term Lithium use renal cell carcinoma, patients leads to the development of on long-term lithium therapy should undergo regular renal function and imaging tests.
Zardawi, Ibrahim; Nagonkar, Santoshi; Patel, Purvish
The frequency and appearance of bone abnormalities in patients with medullary carcinoma of the thyroid were compared with those of patients with other thyroid carcinomas. Only in patients with medullary carcinoma the following abnormalities were found: dolichocephaly, prognathism, anterior chest deformity, bone cysts. Schmorl nodes, spina bifida, slipped femoral epiphysis, pes cavus and marfanoid body build. Not only patients with medullary carcinoma of the thyroid as part of multiple endocrine neoplasia, but also patients with otherwise unrelated medullary carcinoma had bone defects. The cause of the bone abnormalities is probably a defect of a stem cell in the embryonal neural crest rather than a sustained effect on bone tissue of the tumor produced calcitonin. PMID:6263059
Three cases of papillary serous carcinoma of the endometrium ( PSCE ) have been studied by transmission electron microscopy, and the ultrastructural findings compared with those in classical "endometrioid" carcinoma of the endometrium ( CECE ) and papillary serous carcinoma of the ovary ( PSCO ). PSCE possesses many ultrastructural features in common with both CECE and PSCO , as well as with clear cell carcinoma of the endometrium, emphasizing the close relationship existing among these different tumors of Müllerian origin. The only useful ultrastructural distinguishing features between serous and endometrioid carcinomas of similar histologic grade are more numerous secretory granules in the former and prominent paranuclear microfilaments and tonofilaments in the latter. Despite its lack of ultrastructural distinctiveness, the clinical behavior of PSCE justifies its consideration as a unique clinicopathologic entity. PMID:6724787
Sato, N; Mori, T; Orenstein, J M; Silverberg, S G
Malignant tumor originated from external auditory canal (EAC) is very rare with an annual incidence of around 1 per million. Pathologically, squamous cell carcinoma is incidentally most common, and adenoid cystic carcinoma, basal cell carcinoma, and melanoma follow in decreasing order. Due to the rarity of malignant tumor of EAC, there is no widely accepted treatment modality yet. But basal cell carcinoma, known to be less aggressive tumor, can be removed with a minimal safety margin and have better treatment results. Recently we experienced a case of basal cell carcinoma in the EAC, confined in the cartilaginous portion of EAC, presenting with intermittent otorrhea for several years. The patient was treated with a sleeve resection of the EAC with a safety margin reconstructed with a split-thickness skin graft. No tumor recurrence or complication was noted in the first postoperative year.
Lee, Beom-Jun; Bae, Seong-Cheon; Lee, Jae-Hong
Rhinophyma, final stage of rosacea is considered as benign pathology. We present the case of a patient with basal cell carcinoma diagnosed on rhinophyma. The removal of all cutaneous nasal unit and its analysis has diagnosed the presence of three basal cell carcinomas and two in situ squamous cell carcinomas. Reconstruction was performed by full-thickness skin graft. The literature reports a few cases of association between rhinophyma and skin cancers but none ever reported the simultaneous presence of basal cell carcinoma and squamous cell carcinomas. The low number of articles does not reveal statistically significant relationship between rhinophyma and skin cancer, which would consider the rhinophyma as a risk factor. Monitoring of these patients should be as rigorous as possible and surgical care requires histologic analysis not to omit the presence of cancerous lesions. PMID:22209650
Qassemyar, A; Corbisier, N; Poiret, G; Mortier, L; Martinot-Duquennoy, V; Guerreschi, P
Renal cell carcinoma (RCC) is the most common malignancy of the kidney and consists of multiple subtypes. The sarcomatoid variety, while previously considered a distinct histologic subtype, is now categorized as a form of dedifferentiated carcinoma. When present, it is associated with a significant decrease in patient survival due to its rapid growth and intrusive behavior. Preoperative knowledge of this diagnosis may be beneficial to clinicians in order to modify treatment options and follow-up protocols. This report describes a case of sarcomatoid renal cell carcinoma in which the patient initially presented with flank pain. We then discuss the clinical features of sarcomatoid renal cell carcinoma and its imaging appearance on computed tomography (CT), and succinctly review the subtypes of renal cell carcinoma and their imaging characteristics.
Reiter, Michael; Schwope, Ryan; Clarkson, Arthur
Basosquamous carcinoma of the skin is a relatively rare cutaneous neoplasm that has significant metastatic potential and a metastatic rate greater than that of basal cell and squamous cell carcinoma. We describe the use of lymphatic mapping and sentinel lymph node biopsy in a 63-year-old man after identification of basosquamous carcinoma. Sentinel lymph node biopsy, which is a standard tool to detect regional lymphatic metastasis in cutaneous melanoma, has been rarely employed to detect lymphatic metastasis of basosquamous carcinoma. The approach was successful in detecting a regional lymphatic metastasis of two nodal basins with minor morbidity. Sentinel lymph node biopsy may be useful for certain high-risk lesions of basosquamous carcinoma.
Kovacevic, Predrag; Visnjic, Milan; Jankovic, Dimitrije; Binic, Ivana; Jankovic, Aleksandar; Ilic, Ivan
Solid papillary carcinomas (SPCs) are uncommon tumors composed of circumscribed large cellular nodules separated by bands of dense fibrosis. The aim of this study was to further elucidate the characteristics of SPC, the types and significance of invasive carcinomas associated with these tumors, and the long-term clinical outcome. Fifty-eight SPCs were analyzed (mean follow-up, 9.4 years). Cases were divided into three groups: 1) SPC only (32.7%), 2) SPC with extravasated mucin (8.6%), and 3) SPC with invasive components (58.7%) consisting of neuroendocrine-like (29.5%), colloid (23.5%), ductal not otherwise specified (14.5%), lobular (3%), tubular (3%), or mixed (26.5%). The mean age was 72 years. All were estrogen receptor positive and 86% were histologic grade 1. The total size of the tumor measured 0.3 to 15 cm. In the group with invasive carcinoma, the size of invasion was 0.1 to 4 cm. Axillary nodes were involved in 13% of the cases (6 of 46); all of these had an invasive component in the primary tumor. Local recurrence was seen in 5 patients, all from the group with invasive carcinoma. Overall, 11.7% died of their tumor, 1 to 4 years after diagnosis (mean, 2.3 years); none of them belongs to the group of noninvasive SPC. Five of the 6 patients who died of tumor had invasive components. The sixth patient who died with "metastatic signet-ring cell carcinoma" at 10 years was in the group of patients with SPC with extravasated mucin where the SPC lesion had prominent signet-ring cell features. In conclusion, SPCs are heterogeneous lesions that arise in older women and have an indolent behavior. Lymph node and distant metastases are uncommon and generally limited to cases with (conventional) invasive components. PMID:16625097
Nassar, Hind; Qureshi, Hina; Adsay, N Volkan; Volkanadsay, N; Visscher, Daniel
Primary urethral carcinoma (PUC) is a rare malignancy accounting for <1% of genitourinary cancers, with a predilection for men and African-Americans. The sites and histology of urethral carcinoma vary by gender and anatomical location. Squamous cell carcinoma is most common among both genders but adenocarcinomas are noted in 15-35% of cases among women. Obstructive or irritative symptoms and haematuria are common modes of presentation. Clinical evaluation includes cystourethroscopy with biopsy and examination under anaesthesia. Magnetic resonance imaging provides a highly effective method to image the primary tumour while def?ning the potential involvement of surrounding structures. Most tumours are localised, with regional metastases to nodal sites seen in up to 30% of cases in both genders, while distant metastases at presentation are rare (0-6%), but occur in up to 40% of cases with recurrent disease. Among men, the two most important prognostic factors are disease location and stage. Low-stage tumours (T1-2) and tumours involving the fossa navicularis or the penile urethra have a better prognosis than higher stage tumours (>T2 or N+) and lesions involving the bulbomembranous urethra. In women, in addition to stage and location, the size of the tumour has also prognostic implications. While surgery and radiation therapy (RT) are of benefit in early stage disease, advanced stage PUC requires multimodal treatment strategies to optimise local control and survival. These include induction chemotherapy followed by surgery or RT and concurrent chemoradiation with or without surgery. The latter strategy has been used successfully to treat other human papillomavirus-related cancers of the vagina, cervix and anus and may be of value in achieving organ preservation. Given the rarity of PUC, prospective multi-institutional studies are needed to better define the optimal treatment approach for this disease entity. PMID:24447439
Dayyani, Farshid; Hoffman, Karen; Eifel, Patricia; Guo, Charles; Vikram, Raghu; Pagliaro, Lance C; Pettaway, Curtis
Pituitary carcinoma is characterized by the presence of a metastatic lesion(s) in a location non-contiguous with the original pituitary tumor. The mechanism(s) of malignant transformation are not known. A 15 year-old male was diagnosed in 1982 with a pituitary macroadenoma and acromegaly (random GH 67 ng/ml and no suppression by oral glucose). His prolactin was normal between 18 and 23 ng/ml. Transcranial resection in July 1983 was followed by radiation therapy. The tumor was immunopositive for GH and prolactin. The proliferation MIB-1 index was 0-1 %. With aqueous Octreotide 100 mcg 4× daily both GH and IGF-1 became normal. The patient was lost to follow-up and was treated by his local physician. In 2001, his IGF-1 level was 1271 ng/ml, and his random GH was 1.8-2.4 ng/ml by ILMA despite progressive increase in the dose of Sandostatin LAR to 140 mg/month in divided doses. Prolactin remained normal or minimally increased between 15 and 25 ng/ml. In 2009 he was diagnosed with the tumor in the location of left endolymphatic sac. Histological examination showed low grade pituitary carcinoma strongly immunopositive for prolactin but negative for GH. MIB-1 antibody labeled 0-5 % cells. In 2012 endoscopic resection of the pituitary tumor remnant was attempted. Immunohistochemical stains were strongly immunopositive for both prolactin and GH, similar to his original pituitary tumor. The MIB-1 proliferation index was low from 0 to 1 %. To our knowledge this is the first case of pituitary carcinoma in the endolymphatic sac region. The dichotomy between the cell population of the pituitary lesion (GH/prolactin producing) and the metastasis (purely prolactin-producing) may suggest that the metastatic pituitary lesion derived from a clone distinct from the original one. PMID:23645293
Balili, Irida; Sullivan, Steven; McKeever, Paul; Barkan, Ariel
Background: The nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome, is a rare dermatological disease inherited according to an autosomal dominant pattern. From the dermatological point of view, the most evident characteristic of the syndrome is the early onset of multiple basal cell carcinomas (BCCs). An ideal treatment of BCCs of the NBCCS does not exist. Objective:
Massimo Caccialanza; Serena Percivalle; Roberta Piccinno
We present a case of hepatoid carcinoma of the abdominal skin in a male Wistar rat. Histopathologically, this carcinoma resembled human hepatocellular carcinoma with respect to trabecular-sinusoidal structures. Carcinoma tissues contain numerous eosinophilic globules and crystals, and in this case, we found the characteristic eosinophilic globules in the hepatoid carcinoma cells and the crystals in the extracellular portions. Vivid carcinoma cells full of eosinophilic globules were present near the necrotic areas in tumor tissue, wherein quadrate crystals unstained with eosin were observed. PAS staining after diastase digestion revealed that the globules were PAS positive and diastase resistant. In addition, we found that the hepatoid carcinoma cells were immunoreactive for alpha-1-antitrypsin (anti-A1AT) antibody with the globules and crystals staining peripherally, and a central unstained region. Ultrastructural study of intracytoplasmic globules and extracellular crystals revealed that the fringe of each globule and crystal had no limiting membrane and showed the same level of electron density. These findings suggest that the characteristic crystals in this tumor may have originated from the globules that were emitted from the carcinoma cells after their death as a result of saturation with intracytoplasmic globules. PMID:19536619
Sutoh, Mihoko; Chiba, Mitsuru; Kasai, Kosuke; Miura, Tomisato; Nozaka, Hiroyuki; Washiya, Kiyotada; Okusawa, Etsuko; Oyama, Naoto; Tsutaya, Chikako; Tsushima, Megumi; Terayama, Yuriko; Funyu, Tomihisa; Sato, Tatsusuke
Purpose To review the treatment of metastatic renal cell carcinoma (RCC), including the use of new targeted therapies.\\u000a \\u000a \\u000a \\u000a Methods A search of MEDLINE (1966 to August 2008) and American Society of Clinical Oncology Meeting abstracts (2005 to May 2008) was\\u000a preformed using the search terms bevacizumab, everolimus, interferon-alfa (IFN-?), interleukin-2 (IL-2), sorafenib, sunitinib,\\u000a temsirolimus, and RCC. Articles most pertinent to the treatment
David J. Reeves; Chin Y. Liu
A case of a 30-year-old female patient diagnosed with mucinous tubular and spindle cell carcinoma (MT&SCC) of her left kidney of the basis of an abdominal ultrasound scan performed when nonspecific pain is presented. The histopathology report revealed a classic type of MT&SCC. Photographs of histopathological samples are shown. Nephrectomy was applied as sole treatment. A follow-up of six years confirmed surgery to be a sufficient approach. The discussion presents a review of up to date world literature concerning the histopathological features, prognosis, and treatment of MT&SCC.
Dudek, Magdalena; Ligaj, Marcin; Kalinowski, Tomasz; Demkow, Tomasz
Hepatitis C virus (HCV), a hepatotropic virus, is a single stranded-positive RNA virus of ~9,600 nt. length belonging to the Flaviviridae family. HCV infection causes acute hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). It has been reported that HCV-coding proteins interact with host-cell factors that are involved in cell cycle regulation, transcriptional regulation, cell proliferation and apoptosis. Severe inflammation and advanced liver fibrosis in the liver background are also associated with the incidence of HCV-related HCC. In this review, we discuss the mechanism of hepatocarcinogenesis in HCV-related liver diseases.
Kanda, Tatsuo; Yokosuka, Osamu; Omata, Masao
Background We hypothesized that hepatocellular carcinoma (HCC) patients with higher Body Mass Index (BMI) might have more microvascular invasion (MVI) in their tumors. Methods Records from 138 consecutive patients who underwent surgery at Columbia University Medical Center from January 1, 2002 to January 9, 2008 were evaluated. Results 40 patients (29%) had MVI, including 14% with BMI <25, 31% with BMI = 25–30, and 40% with BMI >30 (p = .05). However, only maximum alpha-fetoprotein was significantly associated with overall mortality in a Cox model. Conclusions MVI was associated with obesity. A better understanding of the mechanism of this association may lead to interventions for the treatment and prevention of HCC.
Siegel, Abby B.; Wang, Shuang; Jacobson, Judith S.; Hershman, Dawn L.; Lim, Emerson A.; Yu, Jeanette; Ferrante, Lauren; Devaraj, Kalpana M.; Remotti, Helen; Scrudato, Shannon; Halazun, Karim; Emond, Jean; Dove, Lorna; Brown, Robert S.; Neugut, Alfred I.
The brain is an exceedingly rare site of metastasis in medullary thyroid carcinoma (MTC). A 50-year-old female who had a history of micro-MTC 11 years prior developed a cerebellar metastasis which was incidentally discovered. Imaging revealed a right cerebellar hemispheric mass with contrast enhancement on CT scans. Histopathologic exam demonstrated a metastatic tumour composed of nodules and sheets of large tumour cells with abundant cytoplasm. Immunohistochemistry confirmed the origin from a MTC. This case report highlights the unique features of an unusual metastatic brain tumour, which followed an indolent course for a long time despite multiple distant metastases.
Borcek, P; Asa, S L; Gentili, F; Ezzat, S; Kiehl, T-R
The brain is an exceedingly rare site of metastasis in medullary thyroid carcinoma (MTC). A 50-year-old female who had a history of micro-MTC 11 years prior developed a cerebellar metastasis which was incidentally discovered. Imaging revealed a right cerebellar hemispheric mass with contrast enhancement on CT scans. Histopathologic exam demonstrated a metastatic tumour composed of nodules and sheets of large tumour cells with abundant cytoplasm. Immunohistochemistry confirmed the origin from a MTC. This case report highlights the unique features of an unusual metastatic brain tumour, which followed an indolent course for a long time despite multiple distant metastases. PMID:22802478
Börcek, P; Asa, S L; Gentili, F; Ezzat, S; Kiehl, T-R
Mantle cell lymphoma (MCL) is a mature B-cell non-Hodgkin lymphoma. After the (11;14) translocation was identified as its constant finding in 1992, MCL was recognized as a separate subgroup of non-Hodgkin lymphoma (NHL). In MCL, extranodal involvement may be observed in the bone marrow, the spleen, the liver, and the gastrointestinal system (GIS). Cases of MCL that present with a massive and solitary rectal mass are rare in the literature. In this case report, our aim was to present an MCL patient with a rarely observed solitary rectal involvement mimicking rectal carcinoma and to discuss treatment options for this patient.
Atay, Hilmi; Y?ld?z, Levent; Bektas, Ahmet; Turgut, Mehmet
Pilonidal sinus is a long-standing chronic inflammatory condition consisting of a sinus tract from the skin-lined orifice extending into subcutaneous tissue, with hairs attached to the wall of the tract and projecting outside of the opening. Penile location is rare, and differential diagnosis with severe balanoposthitis, epidermal cysts, and neoplasms can be difficult. We report a rare case of pilonidal cyst located between coronal sulcus and prepuce which, due to its ulcerated aspect and absence of a tract with projecting hairs, simulated a penile carcinoma.
Cormio, Luigi; Sanguedolce, Francesca; Massenio, Paolo; Di Fino, Giuseppe; Carrieri, Giuseppe
\\u000a Hepatocellular carcinoma (HCC) is a major type of liver cancer. It is the third leading cause of cancer-related death worldwide.\\u000a MicroRNAs (miRNAs), a class of small non-coding RNAs, are aberrantly expressed in HCC. The genomic instability, transcriptionally\\u000a regulation, and epigenetic alteration have been identified to contribute to the abnormal expression of miRNAs in HCC. Moreover,\\u000a deregulation of miRNAs not only
Junfang Ji; Xin Wei Wang
Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.
Gomaa, Asmaa Ibrahim; Khan, Shahid A; Toledano, Mireille B; Waked, Imam; Taylor-Robinson, Simon D
Malignancy is a common cause of disseminated intravascular coagulation and usually presents as a chronic disorder in solid organ tumours. We present a rare case of recurrent acute disseminated intravascular coagulation in neuroendocrine carcinoma after manipulation, firstly, by core biopsy and, later, by cytotoxic therapy causing a release of procoagulants and cytokines from lysed tumour cells. This is reminiscent of tumour lysis syndrome where massive quantities of intracellular electrolytes and nucleic acid are released, causing acute metabolic imbalance and renal failure. This case highlights the potential complication of acute disseminated intravascular coagulation after trauma to malignant cells. PMID:23139666
Teh, Ru-Wen; Tsoi, Daphne T
Subungual tumors are rare in general. Of all tumors, subungual squamous cell carcinoma (SSCC) is the most frequent one. Protean clinical presentations and the lack of awareness of the disease are responsible for an incorrect or delayed diagnosis and subsequent delayed treatment. We have reported here four patients with SSCC who were previously wrongly diagnosed with a benign process and treated unsuccessfully for years. We would like to highlight the need of a biopsy in chronic or recurrent nail lesions that fail to respond to a previous conservative treatment in order to rule out SSCC.
Batalla, Ana; Feal, Carlos; Roson, Elena; Posada, Celia
Transarterial chemoembolization (TACE) is considered as the standard therapy for patients with intermediate-stage hepatocellular carcinoma. However, given the high heterogeneity of this population, no common strategy or protocol standardization has been defined yet. In the last few years TACE treatment has been combined with sorafenib systemic therapy, reporting overall positive results both in terms of safety and efficacy. This systematic review presents and critically discusses the evidence available on the use of TACE in combination (concomitant or sequential) with sorafenib, focusing also on clinical trials currently ongoing to better define an optimal therapeutic strategy for this group of patients. PMID:24850249
Cabibbo, Giuseppe; Tremosini, Silvia; Galati, Giovanni; Mazza, Giancarlo; Gadaleta-Caldarola, Gennaro; Lombardi, Giuseppe; Antonucci, Michela; Sacco, Rodolfo
A 64-year-olf woman has been treated by chemotherapy for a uterine cervical carcinoma with known pathological lymph nodes in the abdomen and in the thorax. She is admitted in our Intensive Care Unit for fever and cardiac tamponade attributed to a large pericardial effusion. No diagnostic could be concluded from the analysis of the liquid or the pericardial biopsy. Complementary investigations are performed and the differential diagnosis of pericardial effusion is discussed in the context of a neoplastic disease. PMID:18069518
Vokaer, B; Machiels, J P; Vansnick, F; Castaigne, C; Feoli, F; Dediste, A; Sculier, J P
The recent identification of agents that have significantly influenced the therapy of clear cell renal carcinoma and the decreasing size of renal masses, usually detected serendipitously, have led to a resurgence in imaging for this condition. Although structural methods continue to be used routinely for identification of renal masses, functional and molecular techniques are showing considerable promise in their ability to characterize unique features of the renal cancer phenotype. This article discusses the evolving role of molecular imaging in the evaluation of renal cancer, including current and future applications. PMID:18992614
Perini, Rodolfo; Pryma, Daniel; Divgi, Chaitanya
To evaluate incidence of scalene node metastases from carcinoma of the cervix, 20 patients had scalene fat-pad node biopsy. All cases were staged according to FIGO criteria and abdominal lymph nodes were studied by CT and lymphangiography. Scalene node metastases were found in 2 patients with clinically suspicious node and pelvic and paraaortic nodes involvement. Seven patients had sinus histiocytosis in scalene node biopsy and this seems related to a more favourable prognosis. From this study it appears that scalene node biopsy is not a routine procedure and should be performed in all patients with palpable supraclavicular masses or when paraortic nodes are involved. PMID:3391207
Trinci, M; Raffetto, N; Petrozza, V; Melis, M; Biagini, C
Gastric carcinoma is classified into intestinal type carcinoma (IC) and diffuse type carcinoma (DC). Intestinal type carcinoma usually tends to metastasize to the liver and DC to the peritoneal cavity. However, discrepant cases are sometimes seen: IC with peritoneal metastasis or DC with liver metastasis. We studied the relationship between histological type and metastatic site with special reference to these
M Mori; H Sakaguchi; K Akazawa; M Tsuneyoshi; K Sueishi; K Sugimachi
Hereditary papillary renal carcinoma (HPRC) is characterized by multiple, bilateral papillary renal carcinomas. Previously, we demonstrated missense mutations in the tyrosine kinase domain of the MET proto-oncogene in HPRC and a subset of sporadic papillary renal carcinomas. In this study, we screened a large panel of sporadic papillary renal carcinomas and various solid tumors for mutations in the MET proto-oncogene.
Laura Schmidt; Kerstin Junker; Noboru Nakaigawa; Tracy Kinjerski; Gregor Weirich; Maria Miller; Irina Lubensky; Hartmut PH Neumann; Hiltrud Brauch; Johann Decker; Cathy Vocke; James A Brown; Robert Jenkins; Stephane Richard; Ulf Bergerheim; Bernard Gerrard; Michael Dean; W Marston Linehan; Berton Zbar
Background. Metaplastic breast carcinomas (MBC) are rare primary breast malignancies characterized by the co-existence of carcinoma with non-epithelial cellular elements. They can be classified as monophasic spindle cell (sarcomatoid) carcinoma, biphasic carcinosarcoma, adenocarcinoma with divergent stromal differentiation (osseous, chondroid and rarely rhabdoid) as well as adenosquamous and pure squamous cell carcinomas. There is a paucity of information on clinically relevant
P. J. Barnes; R. Boutilier; D. Chiasson; D. Rayson
BRAF mutation is seen in a variety of human neoplasms including cutaneous malignant melanoma, papillary thyroid carcinoma, colorectal carcinoma, non-small cell lung carcinoma, pleomorphic xanthoastrocytoma, and others. Currently, there are 2 commercially available monoclonal antibodies for the detection of BRAF V600E mutation; however, a full and practical comparison of their performance in various tumor types on an automated staining platform has not been done. We investigated their sensitivity and specificity in detecting the BRAF V600E mutation in a series of 152 tumors including 31 malignant melanomas, 25 lung carcinomas, 32 gastrointestinal carcinomas, 23 thyroid carcinomas, 35 gliomas, and 6 other malignancies. In this series, the concordance rate between immunohistochemistry (IHC) and mutational analyses was 97% (148/152) for VE1 and 88% (131/149) for anti-B-Raf. The sensitivity and specificity were 98% (60/61) and 97% (88/91) for monoclonal VE1 and 95% (58/61) and 83% (73/88) for anti-B-Raf, respectively. There were 4 cases with discordant IHC and mutational results for monoclonal VE1 in contrast to 18 cases for anti-B-Raf. Our studies showed that IHC with monoclonal VE1 has a better performance compared with anti-B-Raf in an automated staining platform and confirmed that clone VE1 provides excellent sensitivity and specificity for detecting the BRAF V600E mutation in a variety of tumor types in a clinical setting. PMID:24071017
Routhier, Caitlin Ann; Mochel, Mark C; Lynch, Kerry; Dias-Santagata, Dora; Louis, David N; Hoang, Mai P
Sarcomatoid carcinoma (SC) is a rare primary malignant tumor in which both carcinomatous and sarcomatous elements occur. It can occur in many different organs and anatomical locations, such as the skin, thyroid gland, bone, urinary tract, breast, pancreas, liver and other areas. Of them, pulmonary sarcomatoid carcinoma (PSC) is a rare malignant cancer composed of sarcoma and sarcoma-like tumors with spindle or giant cell features. Here a case of a 75-year-old Chinese man with a six-month history of cough and hemoptysis is reported. Chest X-ray showed a tumor shadow in the left lung field. Chest computed tomography (CT) scan showed a lobulated mass in his left hilum and even the left pulmonary artery. Pleomorphic interstitial cells were found by bronchoscopic brushing. To establish a definitive diagnosis for PSC, a left pneumonectomy was performed. The pathological stage was IIB (pT2N1M0) based on the tumor node metastasis (TNM) staging system. The tumor's pathology, histology, immunohistochemistry and treatment methods are discussed.
Shen, Xiao-yong; Lin, Zhi-feng; Ruan, Zhen; Huang, Hai-long; Ju, Chao-qiang; Wang, Jin
The purpose of this study was to investigate the relationship between cyclin D1 expression and clinicopathological parameters in patients with prostate carcinoma. We assessed cyclin D1 expression by conventional immunohistochemistry in 85 patients who underwent radical prostatectomy for prostate carcinoma and 10 normal prostate tissue samples retrieved from autopsies. We measured nuclear immunostaining in the entire tumor area and based the results on the percentage of positive tumor cells. The preoperative prostate-specific antigen (PSA) level was 8.68±5.16 ng/mL (mean±SD). Cyclin D1 staining was positive (cyclin D1 expression in >5% of tumor cells) in 64 cases (75.4%) and negative (cyclin D1 expression in ?5% of tumor cells) in 21 cases (including 15 cases with no immunostaining). Normal prostate tissues were negative for cyclin D1. Among patients with a high-grade Gleason score (?7), 86% of patients demonstrated cyclin D1 immunostaining of >5% (P<0.05). In the crude analysis of cyclin D1 expression, the high-grade Gleason score group showed a mean expression of 39.6%, compared to 26.9% in the low-grade Gleason score group (P<0.05). Perineural invasion tended to be associated with cyclin D1 expression (P=0.07), whereas cyclin D1 expression was not associated with PSA levels or other parameters. Our results suggest that high cyclin D1 expression could be a potential marker for tumor aggressiveness.
Pereira, R.A.; Ravinal, R.C.; Costa, R.S.; Lima, M.S.; Tucci, S.; Muglia, V.F.; Reis, R.B. Dos; Silva, G.E.B.
Purpose To evaluate the potential of targeted photoacoustic imaging as a non-invasive method for detection of follicular thyroid carcinoma. Experimental Design We determined the presence and activity of two members of matrix metalloproteinase family (MMP), MMP-2 and MMP-9, suggested as biomarkers for malignant thyroid lesions, in FTC133 thyroid tumors subcutaneously implanted in nude mice. The imaging agent used to visualize tumors was MMP activatable photoacoustic probe, Alexa750-CXeeeeXPLGLAGrrrrrXK-BHQ3. Cleavage of the MMP activatable agent was imaged after intratumoral and intravenous injections in living mice optically, observing the increase in Alexa750 fluorescence, and photoacoustically, using a dual wavelength imaging method. Results Active forms of both MMP2 and MMP-9 enzymes were found in FTC133 tumor homogenates, with MMP-9 detected in greater amounts. The molecular imaging agent was determined to be activated by both enzymes in vitro, with MMP-9 being more efficient in this regard. Both optical and photoacoustic imaging showed significantly higher signal in tumors of mice injected with the active agent than in tumors injected with the control, non-activatable, agent. Conclusions With the combination of high spatial resolution and signal specificity, targeted photoacoustic imaging holds great promise as a noninvasive method for early diagnosis of follicular thyroid carcinomas.
Levi, Jelena; Kothapalli, Sri-Rajashekar; Bohndiek, Sarah; Yoon, Joon-Kee; Dragulescu-Andrasi, Anca; Nielsen, Carsten; Tisma, Aleksandra; Bodapati, Sunil; Gowrishankar, Gayatri; Yan, Xinrui; Chan, Carmel; Starcevic, Daniela; Gambhir, Sanjiv Sam
In order to find out the genes involved in the tumorigenesis of laryngeal carcinoma, we analyzed 18 laryngeal carcinoma with comparative genomic hybridization. Results show that each one has different degree of variances, included gains and losses of partial and whole chromosome. Each case has 12.9 abnormal regions averagely; losses are more than gains, equal to 7.2 and 5.7 per case respectively. Main regions are gains in chromosomes 3q (78%), 5p (61%), 11q (56%), 1q (50%), 8p (44%), 8q (39%) and 15q (39%), and losses of 3p (70%), 5q (78%), 9p (67%), 13q (50%), 1p (44%) and 14q (39%). There are many specific gains and losses in several chromosomes,especially the increase of copy number karyotype in 1p13-21(8/18), 3p21-23 (14/18), 5p21-22 (14/18), 9p12-pter (10/18) and 13q21-31 (8/18), while the decrease in 1q11-21 (11/18), 3q15-21 (12/18), 8p22-24 (6/18), 11q12-13 (8/18), 15q21-23 (7/18), 18p11 (8/18) are the characteristic varieties. These results suggest that there are oncogene, tumor suppressor gene and other associated genes involved in the tumorigenesis. PMID:15490869
Shang, Chao; Fu, Wei-Neng; Xu, Zhen-Ming; Li, Fu-Cai; Huang, Dai-Fa; Sun, Kai-Lai
Hepatocellular carcinoma is the fifth most common cancer in men and the seventh in women, as is diagnosed in more than half a million individuals worldwide every year. In Portugal, its incidence and mortality rates are low compared to other types of cancers. In Brazil, in the city of São Paulo, according to data released by the Brazilian Unified Health System (Sistema Único de Saúde - SUS), the incidence of primary liver cancer was 2.07/100,000 inhabitants. Although the vast majority of cases (85%) mainly affect developing countries, especially where infection by hepatitis B virus (HBV) is endemic, the incidence in developed countries is increasing. This pathology is associated with several risk factors, not only environmental but also genetic, generating an increasing interest in attaining a better understanding of this disease, which is still associated with very late diagnosis and poor prognosis. Of the available treatments, few patients benefit from their scanty advantages, increasingly stimulating research of new forms of treatment against this disease. This review aimed to briefly but fully identify risk factors, molecular and biochemical pathways, pathophysiology, diagnosis, and possible clinical approaches of hepatocellular carcinoma. PMID:24041910
Gomes, Marcos António; Priolli, Denise Gonçalves; Tralhão, José Guilherme; Botelho, Maria Filomena
Nasopharyngeal carcinoma is endemic in Asia and is etiologically associated with Epstein–Barr virus. Radiotherapy is the primary treatment modality. The role of systemic therapy has become more prominent. Based on multiple phase III studies and meta-analyses, concurrent cisplatin-based chemoradiotherapy is the current standard of care for locally advanced disease (American Joint Committee on Cancer manual [7th edition] stages II–IVb). The reported failure-free survival rates from phase II trials are encouraging for induction + concurrent chemoradiotherapy. Data from ongoing phase III trials comparing induction + concurrent chemoradiotherapy with concurrent chemoradiotherapy will validate the results of these phase II studies. Intensity-modulated radiotherapy techniques are recommended if the resources are available. Locoregional control exceeding 90% and reduced xerostomia-related toxicities can now be achieved using intensity-modulated radiotherapy, although distant control remains the most pressing research problem. The promising results of targeted therapy and Epstein–Barr virus-specific immunotherapy from early clinical trials should be validated in phase III clinical trials. New technology, more effective and less toxic chemotherapy regimens, and targeted therapy offer new opportunities for treating nasopharyngeal carcinoma.
Zhang, Lu; Chen, Qiu-Yan; Liu, Huai; Tang, Lin-Quan; Mai, Hai-Qiang
During the progression of epithelial cancer, cells usually lose epithelial characteristic features and gain a mesenchymal phenotype. Cervical cancer is a common female malignancy worldwide. Despite the generally good prognosis for early-stage cervical cancer patients, many patients still die as a result of metastasis and recurrence. Epithelial-mesenchymal transition (EMT) has been implicated in the metastasis of primary tumors and provides molecular mechanisms for cervical cancer metastasis. Here we provide an up-to-date overview regarding the program of EMT in cervical cancer. In the stepwise progression of cervical cancer, human papilloma viral proteins contribute to the cell transformation and the conversion of typical epithelial cells to the epithelial carcinoma cells with hybrid epithelial and mesenchymal characteristics. Molecules related to the EMT program of cervical cancer cells are summarized in this review paper. Several soluble factors acting on their cognate receptors stimulate the mesenchymal transition of cervical epithelial cells. Ion transport system as well as cytoskeletal modulators also stimulate the progression of EMT program in cervical carcinoma cells. Transcriptional factors such as Snail, Twist1, Twist2, and six1 homeoproteins are involved in the complicated regulation and cervical cancer metastasis. Among the various signalings associated with EMT program, Snail is a central transcription factor which governs EMT program. In contrast to tumor promoters, several tumor suppressors such as SFRP1/2 and LMX-1A have been reported to suppress tumorigenesis as well as metastatic spread through inhibiting the EMT program.
Lee, Mei-Yi; Shen, Meng-Ru
Adenoid cystic carcinoma (ACC) is a rare malignancy that can occur in multiple organ sites and is primarily found in the salivary gland. While the identification of recurrent fusions of the MYB-NFIB genes have begun to shed light on the molecular underpinnings, little else is known about the molecular genetics of this frequently fatal cancer. We have undertaken exome sequencing in a series of 24 ACC to further delineate the genetics of the disease. We identified multiple mutated genes that, combined, implicate chromatin deregulation in half of cases. Further, mutations were identified in known cancer genes, including PIK3CA, ATM, CDKN2A, SF3B1, SUFU, TSC1, and CYLD. Mutations in NOTCH1/2 were identified in 3 cases, and we identify the negative NOTCH signaling regulator, SPEN, as a new cancer gene in ACC with mutations in 5 cases. Finally, the identification of 3 likely activating mutations in the tyrosine kinase receptor FGFR2, analogous to those reported in ovarian and endometrial carcinoma, point to potential therapeutic avenues for a subset of cases. PMID:23778141
Stephens, Philip J; Davies, Helen R; Mitani, Yoshitsugu; Van Loo, Peter; Shlien, Adam; Tarpey, Patrick S; Papaemmanuil, Elli; Cheverton, Angela; Bignell, Graham R; Butler, Adam P; Gamble, John; Gamble, Stephen; Hardy, Claire; Hinton, Jonathan; Jia, Mingming; Jayakumar, Alagu; Jones, David; Latimer, Calli; McLaren, Stuart; McBride, David J; Menzies, Andrew; Mudie, Laura; Maddison, Mark; Raine, Keiran; Nik-Zainal, Serena; O'Meara, Sarah; Teague, Jon W; Varela, Ignacio; Wedge, David C; Whitmore, Ian; Lippman, Scott M; McDermott, Ultan; Stratton, Michael R; Campbell, Peter J; El-Naggar, Adel K; Futreal, P Andrew
Renal cell carcinomas (RCCs) represent one of the ten leading cancer entities with an increasing incidence especially in the western world. Unfortunately, about 25% of the patients develop metastatic RCC (mRCC) associated with a most unfavorable prognosis. In the recent years, various new agents targeting VEGF or VEGF receptor (VEGFR) or the mTOR pathway have been approved for the treatment of mRCC with significant prolongation of progression-free survival and, in part, of overall survival (OS). Targeting the mTOR kinase is an interesting option for mRCC. Temsirolimus, one of the available mTOR inhibitors, has been approved as a single agent in poor-risk mRCC patients based on the pivotal Phase III trial showing a significant superiority in OS versus IFN-? or temsirolimus + IFN-?, which has been verified by a pivotal Phase III trial. The benefit has been shown for clear cell carcinoma and papillary RCC as well. For poor prognosis patients, temsirolimus improves median survival by 3.6 months. In second-line treatment compared with sorafenib following first-line treatment with sunitinib temsirolimus showed a relative progression-free survival benefit for patients with nonclear cell RCC with temsirolimus. The median OS for the temsirolimus group was 12.27 and 16.64 months for the sorafenib group. In 2007, the US FDA granted approval for temsirolimus for the treatment of advanced RCC. PMID:24313573
Bergmann, Lothar; Maute, Luise; Guschmann, Michael
Adenoid cystic carcinoma (ACC) is a rare malignancy that can occur in multiple organ sites and is primarily found in the salivary gland. While the identification of recurrent fusions of the MYB-NFIB genes have begun to shed light on the molecular underpinnings, little else is known about the molecular genetics of this frequently fatal cancer. We have undertaken exome sequencing in a series of 24 ACC to further delineate the genetics of the disease. We identified multiple mutated genes that, combined, implicate chromatin deregulation in half of cases. Further, mutations were identified in known cancer genes, including PIK3CA, ATM, CDKN2A, SF3B1, SUFU, TSC1, and CYLD. Mutations in NOTCH1/2 were identified in 3 cases, and we identify the negative NOTCH signaling regulator, SPEN, as a new cancer gene in ACC with mutations in 5 cases. Finally, the identification of 3 likely activating mutations in the tyrosine kinase receptor FGFR2, analogous to those reported in ovarian and endometrial carcinoma, point to potential therapeutic avenues for a subset of cases.
Stephens, Philip J.; Davies, Helen R.; Mitani, Yoshitsugu; Van Loo, Peter; Shlien, Adam; Tarpey, Patrick S.; Papaemmanuil, Elli; Cheverton, Angela; Bignell, Graham R.; Butler, Adam P.; Gamble, John; Gamble, Stephen; Hardy, Claire; Hinton, Jonathan; Jia, Mingming; Jayakumar, Alagu; Jones, David; Latimer, Calli; McLaren, Stuart; McBride, David J.; Menzies, Andrew; Mudie, Laura; Maddison, Mark; Raine, Keiran; Nik-Zainal, Serena; O'Meara, Sarah; Teague, Jon W.; Varela, Ignacio; Wedge, David C.; Whitmore, Ian; Lippman, Scott M.; McDermott, Ultan; Stratton, Michael R.; Campbell, Peter J.; El-Naggar, Adel K.; Futreal, P. Andrew
Nasopharyngeal carcinoma is an unique head and neck cancer. It is common among the southern Chinese and is closely associated with the Epstein Barr virus (EBV). To diagnose the disease in its early stage is infrequent as the symptoms are usually trivial and patients only present in late stages. Testing the blood for elevated EBV DNA has now become a screening test for the high risk group of patients, aiming to diagnose the disease in its early stages. Imaging studies, positron emission tomography scans in addition to clinical examination provide information on the extent of the disease. The confirmation of the disease still depends on endoscopic examination and biopsy. Radiotherapy with or without chemotherapy has been the primary treatment modality. The application of intensity modulated radiotherapy and the use of concomitant chemoradiation have improved the control of nasopharyngeal carcinoma together with the reduction of long term side effects. The early detection of residual or recurrence tumor in the neck or at the primary site has allowed delivery of salvage treatment. The choice of the optimal surgical salvage, either for neck disease or primary tumor depends on the extent of the residual or recurrent disease. The outcome of these patients have improved with the application of the appropriate surgical salvage.
Kwong, Dora L. W.
Glucose metabolism is affected by various pathologic states including tumors. In this project, glucose turnover and recycling rates in 11 patients with colorectal carcinoma were measured using a double-labelled 3-3H and 1-14C glucose injection technique. Fasting blood glucose, lactate, pyruvate, alanine, glycerol, 3-hydroxybutyrate, acetoacetate, plasma cortisol, and plasma insulin concentrations were also measured. No patient in the study had a history of diabetes mellitus or endocrine disorders, nor any abnormal liver function tests. The findings demonstrated a significantly elevated glucose turnover rate in patients with Dukes C and D lesions in comparison to patients with Dukes B lesions. Cori recycling rates were not significantly different between Dukes B vs. Dukes C and D patients. There were no differences between Dukes B and Dukes C and D patients in any of the metabolites measured. Furthermore, there were no significant differences in glucose turnover or recycling rates as a function of pre-illness weight loss. These data suggest that, when colorectal carcinoma extends beyond the limits of the bowel wall, glucose metabolism is significantly altered.
Kokal, W A; McCulloch, A; Wright, P D; Johnston, I D
Several lines of evidence suggest that defects in telomere maintenance play a significant role in the initiation of genomic instability during carcinogenesis. Although the general concept of defective telomere maintenance initiating genomic instability has been acknowledged, there remains a critical gap in the direct evidence of telomere dysfunction in human solid tumors. To address this topic, we devised a multiplex PCR-based assay, termed TAR (telomere-associated repeat) fusion PCR, to detect and analyze chromosome end-to-end associations (telomere fusions) within human breast tumor tissue. Using TAR fusion PCR, we found that human breast lesions, but not normal breast tissues from healthy volunteers, contained telomere fusions. Telomere fusions were detected at similar frequencies during early ductal carcinoma in situ and in the later invasive ductal carcinoma stage. Our results provide direct evidence that telomere fusions are present in human breast tumor tissue and suggest that telomere dysfunction may be an important component of the genomic instability observed in this cancer. Development of this robust method that allows identification of these genetic aberrations (telomere fusions) is anticipated to be a valuable tool for dissecting mechanisms of telomere dysfunction.
Tanaka, Hiromi; Abe, Satoshi; Huda, Nazmul; Tu, LiRen; Beam, Matthew J.; Grimes, Brenda; Gilley, David
A 69-year-old female presented to our institution with epigastralgia and abdominal distension. Upper gastrointestinal series revealed a 5?cm ulcerative lesion with irregular margins and elevated distinct borders from the angle to the pyloric ring. Gastroendoscopy revealed a Borrmann type 2 tumor. Several biopsied specimens revealed proliferation of small and heterogeneous cancer cells with rich chromatin and fibrous septum with rich vessels at connective tissues, which was confirmed as gastric endocrine cell carcinoma (ECC) on immunostaining with chromogranin and synaptophysin. Furthermore, other specimens revealed atypical cells forming glandular structures, which were confirmed as well-differentiated tubular adenocarcinomas. Distal gastrectomy with D2 lymph node dissection and Billroth I reconstruction was performed. Pathological examination of the gross specimen revealed that adenocarcinoma comprised <10% of all cancer cells. Close analysis of ECC revealed a mixture of small and large cells. According to the WHO 2010 classification of gastrointestinal neuroendocrine tumors, this gastric tumor was diagnosed as neuroendocrine carcinoma. The patient was administered adjuvant chemotherapy with cisplatin and etoposide. One year following surgery, follow-up abdominal CT revealed multiple liver metastases. The patient received the best supportive care but eventually died 18 months after surgery. Here we present this case of gastric ECC coexistent with adenocarcinoma.
Yusuke, Nomura; Maeda, Tetsuo; Naba, Kazuyoshi
Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer and its incidence has increased in recent decades. Most cSCCs are successfully treated by surgery, but local and distant metastases develop in approximately 5% of cases; this proportion is higher in certain forms of cSCC with high-risk factors, namely: tumor size >2cm, depth >2mm, Clark level ?IV, perineural invasion, lymphovascular invasion, poor differentiation, certain histologic subtypes (desmoplastic or adenosquamous carcinoma, invasive Bowen disease, or a cSCC arising in areas of chronic inflammation), immunosuppression, human papillomavirus infection, high-risk anatomic location (pinna of the ear, labial mucosa), expression of certain tumor genes, and inadequate tumor resection. The latest TNM (tumor, lymph node, metastasis) classification of cSCC published by the American Joint Committee on Cancer (AJCC) in the seventh edition of its Cancer Staging Manual now incorporates several of these risk factors to improve disease staging. We review all the factors currently considered to be markers of poor prognosis in cSCC and analyze the new AJCC classification and the different treatment options for high-risk cSCC. PMID:22261673
Nuño-González, A; Vicente-Martín, F J; Pinedo-Moraleda, F; López-Estebaranz, J L
We present our findings in a case of primary neuroendocrine carcinoma (NEC) of the lacrimal gland and a case of primary Merkel cell carcinoma (MCC) of the eyelid. An 86-year-old man noticed a swelling of the left upper eyelid three months earlier. We performed excision biopsy and histopathological examination indicated that he had a primary NEC of the left lacrimal gland. He underwent chemotherapy followed by excision including the clinically visible margins and 50?Gy radiotherapy of the surgical margins. He had neither recurrence nor metastasis for 6 months since the last radiotherapy. An 80-year-old man noticed a nodule in the right upper eyelid and was referred to our hospital because the size was increasing rapidly. A complete surgical excision of the margins of the tumor was performed with histopathological confirmation of negative margins. The final diagnosis was a primary MCC of the right upper eyelid. After surgery, he underwent 50?Gy radiotherapy on the neck to prevent metastasis. No recurrence or metastasis was found for two years. Although primary NEC of the ocular adnexa is extremely rare, the tumor has high malignancy and readily metastasizes. Thus, combined therapy including surgery, radiotherapy, and/or chemotherapy is needed for complete management of NEC.
Yamanouchi, Daisuke; Nakamura, Yosuke; Yotsukura, Jiro; Asanagi, Kaoru; Baba, Takayuki; Nizawa, Tomohiro; Kishimoto, Takashi; Yonemori, Yoko; Ota, Satoshi; Yamamoto, Shuichi
The Tanzania Cancer Registry at Muhimbili Medical Centre, Dar es Salaam, Tanzania was reviewed for squamous cell carcinoma of the skin in non-albino African subjects. The data was analysed for age, sex, site and predisposing factors. Our results were then compared with studies previously carried out in Tanzania, elsewhere in Africa and also on Blacks in America. Squamous cell carcinoma of the skin was found to be a common malignancy, and the commonest skin cancer. Its peak was in the 40-49 years age group though it could occur in children under five years of age. The most affected site was the lower limb, followed by the head and the neck. The penis in the male and the vulva in the female were the third most affected sites. The scalp and the lip were more affected in females than males. Chronic trauma, chronic ulcers, and scars were the main predisposing risk factors to the lower limb and the scalp, while ultra violet radiation to the head and neck, and smegma of the uncircumcised penis were thought to be predisposing risk factors. PMID:1308840
Amir, H; Mbonde, M P; Kitinya, J N