|
| ||
|
|
||
Carcinoma Metastatic (carcinoma + metastatic)
Kinds of Carcinoma Metastatic Selected AbstractsVulvar Squamous Cell Carcinoma Metastatic to Skin of the ForearmDERMATOLOGIC SURGERY, Issue 6 2003Adil Ceydeli MD No abstract is available for this article. [source] Surgery and Adjuvant Radiotherapy in Patients with Cutaneous Head and Neck Squamous Cell Carcinoma Metastatic to Lymph Nodes: Combined Treatment Should be Considered Best Practice,THE LARYNGOSCOPE, Issue 5 2005FRANZCR, Michael J. Veness MMed Abstract Objective: Patients with cutaneous squamous cell carcinoma (SCC) may develop metastatic SCC to nodes in the head and neck. Recent data support best outcome with the addition of adjuvant radiotherapy. This study aims to present further supportive evidence. Study Design: Retrospective chart review. Methods: Patients were identified with metastatic cutaneous SCC to nodes of the head and neck treated with surgery or surgery and adjuvant radiotherapy. Relapse and outcome were analyzed using Cox regression analysis. Disease-free survival and overall survival rates were calculated using Kaplan-Meier survival curves. Results: Between 1980 to 2000, 167 patients were treated with curative intent at Westmead Hospital, Sydney. Median age was 67 years (range, 34,95) in 143 men and 24 women with a minimum follow-up of 24 months. Patients underwent surgery (21/167; 13%), or surgery and adjuvant radiotherapy (146/167; 87%). The majority (98/167; 59%) of metastatic nodes were located in the parotid and/or cervical nodes. The remaining 69 (41%) had metastatic cervical nodes (levels I,V). Forty-seven patients (28%) had recurrences, with the majority (35/47; 74%) as locoregional failures. On multivariate analysis, spread to multiple nodes and single-modality treatment significantly predicted worse survival. Patients undergoing combined treatment had a lower rate of locoregional recurrence (20% vs. 43%) and a significantly better 5-year disease-free survival rate (73% vs. 54%; P = .004) compared to surgery alone. Conclusions: In patients with metastatic cutaneous head and neck SCC, surgery and adjuvant radiotherapy provide the best chance of achieving locoregional control and should be considered best practice. [source] Fine-needle aspiration biopsy diagnosis of prostate carcinoma metastatic to the breastDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2009Sara E. Monaco M.D. No abstract is available for this article. [source] Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodesHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2007FRANZCR, Michael J. Veness MMed (Clin Epi) Abstract Nonmelanoma skin cancers occur at an epidemic rate in Australia and are increasing in incidence worldwide. In most patients, local treatment is curative. However, a subset of patients will be diagnosed with a high-risk cutaneous squamous cell carcinoma (SCC) and are defined as patients at increased risk of developing metastases to regional lymph nodes. Patients with high-risk SCC may be identified based on primary lesion and patient factors. Most cutaneous SCC arises on the sun-exposed head and neck. The parotid and upper cervical nodes are common sites for the development of metastases arising from ear, anterior scalp, temple/forehead, or scalp SCC. The mortality and morbidity associated with high-risk cutaneous SCC is usually a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Patients with operable nodal disease have traditionally been recommended for surgery. The efficacy of adjuvant radiotherapy has previously been questioned based on weak evidence in the early literature. Recent evidence from larger studies has, however, strengthened the case for adjuvant radiotherapy as a means to improve locoregional control and survival. Despite this, many patients still experience relapse and die. Research aimed at improving outcome such as a randomized trial incorporating the addition of chemotherapy to adjuvant radiotherapy is currently in progress in Australia and New Zealand. Ongoing research also includes the development of a proposed new staging system and investigating the role of molecular factors such as the epidermal growth factor receptor. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] Metastatic acinic cell carcinoma in a neurofibroma mistaken for carcinosarcomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2005Michael L. Cohn MD Abstract Background. Tumor-to-tumor metastasis is a rare, but well-recognized, entity most commonly involving metastatic carcinoma to a mesenchymal neoplasm. We report a case of acinic cell carcinoma of the parotid gland metastatic to a neurofibroma. Methods and Results. A 55-year-old man with a history of a high-grade acinic cell carcinoma of the parotid was seen with a mass at the surgical site and metastatic foci in the scalp 10 months postoperatively. The resection specimen revealed a spindle cell lesion with metastatic foci of high-grade adenocarcinoma, initially diagnosed as a carcinosarcoma. The bland morphology and S-100,positive expression of the spindle cell lesion confirmed the diagnosis of neurofibroma. The high-grade features of the carcinomatous foci and their similarity to the primary tumor confirmed the presence of a tumor-to-tumor metastasis. Conclusion. To our knowledge, this is the first reported case of acinic cell carcinoma metastatic to a neurofibroma, an important entity in the differential diagnosis of biphasic tumors of the head and neck. © 2004 Wiley Periodicals, Inc. Head Neck27: 76,80, 2005 [source] Transcervical superior mediastinal lymphadenectomy in the management of papillary thyroid carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2003Mark L. C. Khoo FRCS Abstract Aim. Surgery is the treatment of choice for lymph node metastases in papillary thyroid carcinoma. When adequately treated by surgical extirpation, the presence of lymph node involvement does not seem to have a negative impact on cure rates or survival. Surgical lymphadenectomy for metastatic papillary thyroid carcinoma has been well described for both the central and the lateral compartments of the neck. Superior mediastinal lymphadenectomy, however, has only sporadically been mentioned. We describe our experience with transcervical superior mediastinal lymphadenectomy (TSML) that avoids the morbidity of the traditional sternal split. Materials and Methods. This retrospective analysis included 30 patients (24 women and 6 men; age range, 17,72 years) who underwent TSML by the senior author (JLF) for papillary carcinoma metastatic to the superior mediastinum between 1985 and 1999. Histopathologic examination confirmed positive nodes in all the mediastinal dissections. All patients received postoperative I131. Results. All the patients are alive after a median follow-up of 5 years (range, 1,14 years). Twenty-nine of 30 patients remain free of disease, whereas one patient is alive with lung and bone metastases. No patient has had local or regional relapse. The only significant complication was a high incidence of temporary (70%) and later permanent (50%) hypoparathyroidism. Conclusions. TSML is a safe and effective treatment for superior mediastinal metastases in papillary thyroid carcinoma. © 2002 Wiley Periodicals, Inc. Head Neck 24: 000,000, 2002 [source] Refining indications for contemporary surgical treatment of renal cell carcinoma metastatic to the pancreasHPB, Issue 2 2009Aram N. Demirjian Abstract Background:, The pancreas is a rare location for metastatic disease, with only 2,11% of all pancreatic tumours being of non-primary origin. It is also uncommon for renal cell carcinoma (RCC) to metastasize to the pancreas (1,3% of cases) and, when it does, it typically occurs substantially after index nephrectomy. It is not known whether all pancreatic metastases need be resected because today's chemo- and biological therapies are increasingly effective in controlling advanced disease. Methods:, Six patients with a variety of symptoms are discussed. Four patients presented with recurrent gastrointestinal bleeding, ranging from occult to life-threatening in severity. Results:, The four patients with gastrointestinal bleeding had RCC metastases that had eroded into the duodenum and were successfully controlled by palliative pancreaticoduodenectomy or completion pancreatectomy. The other two patients were treated using different chemotherapeutic or biological agents. Conclusions:, Renal cell carcinoma metastases to the pancreas typically occur long after index nephrectomy. Although clinical presentation is variable, palliative resection should be reserved for those who develop complications, such as upper gastrointestinal bleeding, and, in other series, obstructive jaundice. Routine debulking resections do not appear to be indicated because current biological therapies effectively and reliably control disease over long periods. [source] Exercise-induced cholangitis and pancreatitisHPB, Issue 2 2005JOHN G. TOUZIOS Abstract Background. Cholangitis requires bactibilia and increased biliary pressure. Pancreatitis may be initiated by elevated intraductal pressure. The sphincter of Oddi regulates pancreatobiliary pressures and prevents reflux of duodenal contents. However, following biliary bypass or pancreatoduodenectomy, increased intra-abdominal pressure may be transmitted into the bile ducts and/or pancreas. The aim of this analysis is to document that cholangitis or pancreatitis may be exercise-induced. Methods. The records of patients with one or more episodes of cholangitis or pancreatitis precipitated by exercise and documented to have patent hepatico- or pancreatojejunostomies were reviewed. Cholangitis was defined as fever with or without abdominal pain and transiently abnormal liver tests. Pancreatitis was defined as abdominal pain, with transient elevation of serum amylase and documented by peripancreatic inflammation on computerized tomography. Results. Twelve episodes of cholangitis occurred in six patients who had undergone hepaticojejunostomy for biliary stricture (N=3), Type I choledochal cyst (N=2), or pancreatoduodenectomy for renal cell carcinoma metastatic to the pancreas (N=1). Four episodes of pancreatitis occurred in two patients who had undergone pancreatoduodenectomy for ampullary carcinoma or chronic pancreatitis. Workup and subsequent follow-up for a median of 21 months have not documented anastomotic stricture. Each episode of cholangitis and pancreatitis was brought on by heavy exercise and avoidance of this level of exercise has prevented future episodes. Conclusion. Following biliary bypass or pancreatoduodenectomy, significant exercise may increase intra-abdominal pressure and cause cholangitis or pancreatitis. Awareness of this entity and behavior modification will avoid unnecessary procedures in these patients. [source] Merkel cell carcinoma metastatic to the stomachANZ JOURNAL OF SURGERY, Issue 1-2 2010Fausto Rosa MD No abstract is available for this article. [source] Managing patients with cutaneous squamous cell carcinoma metastatic to the axilla or groin lymph nodesAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2010Amy Goh ABSTRACT Cutaneous squamous cell carcinoma accounts for 20% of all non-melanoma skin cancer with a minority arising on the trunk and extremities. A small proportion will develop metastases to regional nodes of the axilla or groin. We performed a retrospective review of patients with metastatic cutaneous squamous cell carcinoma to the axilla and groin treated at Westmead Hospital, Sydney. The purpose of this study was to document the treatment and outcome of these patients. We identified 18 men and 8 women with a median age of 73 years. Median follow-up was 18.5 months. Median lesion size was 27 mm (range 3,130 mm) and median thickness was 7 mm (range 3,32 mm). Nine patients developed metastases to the groin, 14 to the axilla, 1 in the epitrochlear, and 2 to both the epitrochlear and axillary lymph nodes. All patients were treated with surgery +/, radiotherapy. Recurrence developed in seven patients (27%) with most developing distant metastases. Most (6/7) patients with recurrence died. Predicting patients that may develop nodal metastatic non-head and neck cutaneous squamous cell carcinoma is difficult. Following diagnosis, surgery remains the primary treatment and select patients with unfavourable features, such as extranodal spread, may benefit from the addition of adjuvant radiotherapy. [source] Snail, Slug, and Smad-interacting protein 1 as novel parameters of disease aggressiveness in metastatic ovarian and breast carcinoma,,CANCER, Issue 8 2005Sivan Elloul M.Sc. Abstract BACKGROUND It was demonstrated previously that the Snail family of transcription factors and Smad-interacting protein 1 (Sip1) regulate E-cadherin and matrix metalloproteinase 2 (MMP-2) expression, cellular morphology, and invasion in carcinoma. For the current study, the authors analyzed the relation between the expression of Snail, Slug, and Sip1; the expression of MMP-2 and E-cadherin; and clinical parameters in patients with metastatic ovarian and breast carcinoma. METHODS One hundred one fresh-frozen, malignant effusions from patients who were diagnosed with gynecologic carcinomas (78 ovarian carcinomas and 23 breast carcinomas) were studied for mRNA expression of Snail, Slug, Sip1, MMP-2, and E-cadherin using reverse transcriptase-polymerase chain reaction analysis. Snail mRNA and E-cadherin protein expression levels also were studied in ovarian carcinoma effusions using in situ hybridization and immunocytochemistry. The results were analyzed for possible correlation with clinicopathologic parameters in both tumor types. RESULTS E-cadherin mRNA expression was lower in breast carcinoma (P = 0.001), whereas Snail expression was higher (P = 0.003). The Snail/E-cadherin ratio (P < 0.001) and the Sip1/E-cadherin ratio (P = 0.002) were higher in breast carcinomas. Sip1 mRNA expression (P < 0.001) and Slug mRNA expression (P < 0.001) were correlated with the expression of MMP-2 in ovarian carcinomas. The Sip1/E-cadherin ratio was higher in primary ovarian carcinomas at the time of diagnosis compared with postchemotherapy ovarian carcinoma effusions (P = 0.003), higher in Stage IV tumors compared with Stage III tumors (P = 0.049), and higher in pleural effusions compared with peritoneal effusions (P = 0.044). In a univariate survival analysis of patients with ovarian carcinoma, a high Sip1/E-cadherin ratio predicted poor overall survival (P = 0.018). High E-cadherin mRNA expression predicted better disease-free survival (P = 0.023), with a similar trend for a low Slug/E-cadherin ratio (P = 0.07). High Snail mRNA expression predicted shorter effusion-free survival (P = 0.008), disease-free survival (P = 0.03), and overall survival (P = 0.008) in patients with breast carcinoma. CONCLUSIONS Transcription factors that regulate E-cadherin were expressed differentially in metastatic ovarian and breast carcinoma. Snail may predict a poor outcome in patients who have breast carcinoma metastatic to effusions. E-cadherin expression generally was conserved in effusions from patients with ovarian carcinoma, but the subset of patients with postulated Sip1-induced repression of this adhesion molecule had a significantly worse outcome. This finding was in agreement with the stronger suppression of E-cadherin by Snail and Sip1 in breast carcinoma effusions, a clinical condition associated with extremely poor survival. Cancer 2005. © 2005 American Cancer Society. [source] Effectiveness and cost of bisphosphonate therapy in tumor bone diseaseCANCER, Issue S3 2003Jean-Jacques Body M.D., Ph.D. Abstract BACKGROUND Tumor-induced osteolysis due to breast carcinoma and myeloma is responsible for a considerable morbidity that severely impairs patients'quality of life. Osteoclast-mediated bone resorption is reported to be increased markedly in patients with tumor bone disease and can be inhibited by bisphosphonate therapy. METHODS The incidence of skeletal complications and the effectiveness of bisphosphonate therapy in patients with breast carcinoma metastatic to bone or in those with myeloma were derived from large-scale, long-term, placebo-controlled trials with clodronate or pamidronate. To the authors' knowledge, there are few studies published to date evaluating the cost-effectiveness of bisphosphonate therapy, and the majority that do exist often are based on models and are applicable only to a particular health care system. RESULTS From the placebo groups of the above-mentioned trials, one can estimate that approximately 25,40% of the patients with breast carcinoma metastatic to bone will require radiotherapy for bone pain and approximately 17,50% will sustain incident vertebral fractures yearly. The incidence of complications is reported to be lower in myeloma patients. The prolonged administration of bisphosphonates reportedly can reduce the frequency of skeletal-related events by approximately 25,50%. Maximal efficacy appears to have been achieved with the current therapeutic schemes based on monthly intravenous infusions. Beneficial effects appear to be obtained more readily using the intravenous route rather than the oral route. The costs of bisphosphonate therapy appear to be higher than the cost savings from the prevention of skeletal-related events. The costs per quality of life-adjusted year have been estimated to be > $100,000, but more research is needed. Limited data suggest that zoledronic acid will not reduce treatment costs but the short infusion time will lead to substantial time savings for patients and for outpatient oncology facilities. CONCLUSIONS As is the case for many agents used in oncology, bisphosphonates remain a relatively expensive therapy. More studies are needed to evaluate their cost-effectiveness ratio correctly. A ceiling effect has been reached with current therapeutic schemes and tailoring therapy to the individual patient needs to be evaluated correctly to increase therapeutic effectiveness and improve quality of life further without increasing treatment costs. Cancer 2003;97(3 Suppl):859,65. © 2003 American Cancer Society. DOI 10.1002/cncr.11139 [source] Management of metastatic carcinoma of the uveal tract: an evidence-based analysisCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2007Gowri L Kanthan MBBS Abstract Uveal metastasis from carcinoma is the most common cause of ocular malignancy in adults and represents an increasing problem in the context of an ageing population and enhanced survival of stage IV cancer patients. The reported prevalence of clinically evident uveal metastases in carcinoma patients ranges from 2% to 9%, with breast and lung cancer together accounting for between 71% and 92% of cases. Most patients (66,97%) have a known history of cancer and, although the majority have metastatic lesions elsewhere, up to 33% may present with an isolated ocular metastasis. These lesions may progress rapidly and are potentially sight-threatening. Early diagnosis and appropriate timely treatment are therefore of paramount importance to maintain patients' quality of life. The diagnosis is usually clinical and detailed descriptions of symptomatology and physical characteristics are provided. In 21,50% of patients, involvement is bilateral. External beam radiotherapy (EBRT), chemotherapy, hormone and biological therapies, brachytherapy, transpupillary thermotherapy, laser photocoagulation/photodynamic therapy and enucleation are therapeutic modalities described in the literature for the management of uveal metastases. The strongest evidence favours timely EBRT for the management of sight-threatening uveal metastases. The published evidence supporting EBRT for sight-threatening uveal metastases was given a grade B (strong support for recommendation). Newer alternative therapies are emerging and may have a role in selected patients; however, there are unfortunately few large studies examining such treatments for carcinoma metastatic to the eye. The role of these modalities will be further clarified with the results of larger comparative trials. [source] Bowel carcinoma metastatic to the retinaCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2001Bruce M Hutchison FRCS ABSTRACT The case is presented of metastatic carcinoma to the retina in a 63-year-old woman with known disseminated large bowel carcinoma. The clinical appearance and angiographic features are discussed. [source] | ||||||||||||||||||||||