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Malignant Tumours (malignant + tumour)
Selected AbstractsHeterotransplantation Of A Human Malignant Tumour To "Nude" MiceAPMIS, Issue 5 2007Article first published online: 11 MAY 200 First page of article [source] Transient response of cardiac angiosarcoma to paclitaxelEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010E. CASTILLA md CASTILLA E., PASCUAL I., RONCALÉS F., AGUIRRE E. & RÍO A. DEL (2010) European Journal of Cancer Care19, 699,700 Transient response of cardiac angiosarcoma to paclitaxel Malignant tumours of the heart are a group of tumours with low incidence but very high mortality. Delays in diagnosis are common because of their multiple forms of presentation, and 80% present with metastases, further reducing the possibility for cure. We present here the case of a patient with primary cardiac angiosarcoma that highlights the misdiagnosis at clinical presentation, current diagnostic modalities and a possible new treatment using paclitaxel for cardiac angiosarcoma. [source] An analysis of oral and maxillofacial pathology found in adults over a 30-year periodJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 7 2006A. V. Jones Background:, The aim of this study was to determine the range of histologically diagnosed lesions in 44 000 oral and maxillofacial pathology specimens, from adults 17 years and older, submitted for diagnosis to our laboratory over a 30-year period (1973,2002). Materials:, All entries for specimens from the patients were retrieved and compiled into 12 diagnostic categories. Results:, During the period, 44 007 specimens comprised a male-to-female ratio of 0.9:1. The diagnostic category with the largest number of specimens was mucosal pathology (36.0%) followed by odontogenic cysts (13.8%). Malignant tumours accounted for 5.4% of all specimens and benign tumours 4.6%. Conclusion:, This survey showed that while the majority of diagnoses are benign, approximately one in 19 cases required major head and neck surgery for malignant disease. [source] Small bowel tumours: a 10 year experience in four sydney teaching hospitalsANZ JOURNAL OF SURGERY, Issue 9 2004David S. Rangiah Background: Small bowel tumours are uncommon and can have a long delay prior to diagnosis. The present study aims to compare the use of computed tomography (CT) and contrast small bowel series (SBS) in their diagnosis and to outline the clinical features of small bowel tumours. Methods: A retrospective, case note study was conducted between 1990 and 2000 in four Sydney teaching hospitals. The data collected included clinical features, investigations and tumour characteristics. Results: One hundred and sixty-six people with small bowel tumours were identified (91 malignant; 75 benign). Malignant tumours consisted of adenocarcinomas (31%), carcinoid tumours (12%), lymphomas (7%) and leiomyosarcomas (5%). Benign tumours consisted of adenomas (22%), hamartomas (13%), leiomyomas (4%), inflammatory polyps (4%) and hyperplastic polyps (2%) and a benign schwannoma (1%). Adenocarcinomas were mainly located in the duodenum (P < 0.001) and carcinoid tumours in the ileum (P < 0.001). Malignant tumours were associated with a higher proportion of symptoms (P < 0.01), signs (P < 0.001) and episodes of small bowel obstruction (P < 0.01). Abdominal CT scans demonstrated a greater sensitivity (87.7%) than SBS (72.9%) with a slightly improved sensitivity when both investigations were used (89.3%). Abdominal ultrasound had a lower sensitivity than both of the above investigations of 65%. Gastroduodenoscopy had a sensitivity of 90% for diagnosing duodenal tumours. Operative procedures were performed on 92 patients with a preoperative diagnosis made in 77%. Metastatic spread of malignant tumours was evident in 46%. The sites of spread were to lymph nodes (23%), liver (21%) and distant locations (2%) at diagnosis. Conclusions: Malignant small bowel tumours are more likely to produce symptoms and signs than benign tumours, particularly caused by small bowel obstruction. Abdominal CT is the best radiological investigation for small bowel tumours and has a slight complimentary effect with SBS in improving the chances of detection. Gastroduodenoscopy remains the best investigation of duodenal tumours. [source] 3461: Lacrimal gland: non-neoplastic and neoplastic lesions in Denmark 1974-2007ACTA OPHTHALMOLOGICA, Issue 2010S HEEGAARD Purpose To evaluate patient characteristics and incidence of lacrimal gland lesions in Denmark during the period 1974-2007. Methods All biopsied/surgically removed lacrimal gland lesions collected by the Danish pathological departments during the period 1974-2007 were identified by SNOMED codes. In each case age, gender, symptoms, clinical findings, treatment and follow-up were registered. All tumours were re-classified according to latest guidelines from WHO. Results 229 lacrimal gland lesions from 209 patients were identified during the 34-year period. In the study period 7 cases/year were registered (1.3 cases/million/year). Non-neoplastic lesions predominated with a total of 114 (50 %) with the most frequent being inflammation 63 (55%), normal lacrimal gland tissue 28 (25%) and dacryops 23 (20%). Benign tumours comprised a total of 45 (20%) with the most frequent tumour being pleomorphic adenoma 31 (69%). Malignant tumours constituted a total of 70 (31%). 52 (74%) of these were primary tumours, 9 (13%) were secondary invading tumours, 8 (11%) were local recurrences and 1 (1%) was a distant metastasis. Primary malignant tumours comprised malignant lymphoma 25 (48%) and malignant epithelial tumours 27 (52%). The most frequent malignant tumour was adenoid cystic carcinoma comprising 14 (27%) of the primary malignant tumours. Conclusion Lacrimal gland lesions are rare and primarily benign. Treatment of malignant lacrimal gland tumours should be considered a specialist treatment. [source] Primary non-Hodgkin lymphoma of the humerus following traumatic injury: case reportHEMATOLOGICAL ONCOLOGY, Issue 3 2003V. Stemberga Abstract A case of primary non-Hodgkin lymphoma of the right humerus which occurred in a 21-year-old male patient after an impact to the right shoulder in a car accident in July 1983 is described. Seventeen years after the injury, due to a civil lawsuit, the biopsy material was revised. Immunohistochemical analysis showed CD20 and CD79a positivity on large pleomorphic cells, while small reactive lymphocytes were CD3, Bcl-2 and CD20 positive. Molecular analysis carried out with PCR revealed a monoclonal B-lymphocyte population. The diagnosis of diffuse large peripheral B cell lymphoma of the bone was confirmed. The present case concurs with the literature on primary bone lymphoma, in which the diagnostic problem, trauma-related presentation and an excellent prognosis of malignant tumour are emphasized. Copyright © 2003 John Wiley & Sons, Ltd. [source] Rhabdomyosarcoma of the mandible in a 6-year-old boyINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2006L. E. DAVIDSON Summary., Introduction., Rhabdomyosarcoma is an aggressive malignant tumour composed of neoplastic mesenchymal cells that infiltrate surrounding tissue structures, making their precise site of origin unclear. Although rare, this is highly aggressive and the most common soft-tissue neoplasm of the head and neck in children. Regrettably by the time most cases are initially seen, the patients already have large tumours, due to rapid tumour growth and delayed medical consultation. Case Report., This report describes a 6-year-old presenting with just such symptoms of facial swelling and pain but elicitation of further information and findings, including tooth mobility of 3 days duration, led to prompt referral and early treatment of an embryonal rhabdomyosarcoma. Conclusion., General dental practitioners are frequently presented with a child with a swollen face and pain. Experience would suggest a dental abscess to be the most likely cause with treatment as appropriate. However, all swellings in children, should be thoroughly investigated and reviewed as particularly in this age group, tumour growth is rapid while early diagnosis allows successful treatment with multimodality therapy. [source] Patient satisfaction after removal of skin lesionsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2007Y Rissin Abstract Background, Removal of skin lesions is one of the most common surgical procedures, with the number increasing progressively since the 1980s. Objective, We tried to evaluate the satisfaction level of patients after removal of skin lesions and to identify the factors influencing it. Study design, The study group consisted of 138 patients who had skin lesions removed by shaving or primary excision and closure. They were evaluated 1 year after the procedure. Two questionnaires were completed independently by the patient and the surgeon. Results, The main indication for the procedure was suspicion of malignancy, functional disturbance, or aesthetic reason. The satisfaction level (general and specific areas) for patients who had a malignant tumour removed was similar to those who had a benign tumour removed. Females were less satisfied than males (P = 0.05). Younger people were less satisfied with the aesthetic results (P = 0.007). Patients who had at least one significant side-effect were less satisfied than those who did not mention any side-effects (P = 0.038). The higher the level of patient satisfaction, the higher the level of surgeon satisfaction (P = 0.012). Conclusion, Skin lesions removal, although considered to be a minor procedure, leaves scars that sometimes disturb the patient. According to our study, the most prevalent population for dissatisfaction is females and young males. [source] Dermatofibrosarcoma protuberans: a population-based cancer registry descriptive study of 66 consecutive cases diagnosed between 1982 and 2002JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006D Monnier Abstract Background, Dermatofibrosarcoma protuberans (DFSP) is a rare malignant tumour of the skin, with an estimated incidence of 0.8 to five cases per 1 million people per year. Objective, To study epidemiological, immunohistochemical and clinical features, delay in diagnosis, type of treatment and outcome of DFSP from 1982 to 2002. Methods, Using data from the population-based cancer registry, 66 patients with pathologically proved DFSP were included (fibrosarcomatous DFSP were excluded). Each patient lived in one of the four departments of Franche-Comté (overall population of 1 million people) at the time of diagnosis. The main data sources came from public and private pathology laboratories and medical records. The rules of the International Agency for Research on Cancer were applied. Results, The estimated incidence of DFSP in Franche-Comté was about three new cases per 1 million people per year. Male patients were affected 1.2 times as often as female patients were. The trunk (45%) followed by the proximal extremities (38%) were the most frequent locations. DFSP occurred mainly in young adults between 20 and 39 years of age. Mean age at diagnosis was 43 years, and the mean delay in diagnosis was 10.08 years. Our 66 patients initially underwent a radical local excision. Among them, 27% experienced one or more local recurrences during 9.6 years of follow-up. There was one regional lymph node recurrence without visceral metastases. These recurrences were significantly related to the initial peripheral resection margins. We observed a local recurrence rate of 47% for margins less than 3 cm, vs. only 7% for margins ranging from 3 to 5 cm [P = 0.004; OR = 0.229 (95%, CI = 0.103,0.510)]. The mean time to a first local recurrence was 2.65 years. Nevertheless, there was no death due to the DFSP course at the end of the follow-up, and the final outcome was favourable. Conclusion, Our study emphasizes the importance of wide local excision with margins of at least 3 cm in order to prevent local recurrence. However, the recent development of inhibitors of signal transduction by the PDGFB pathway should soon modify the surgical strategy, which is often too mutilating. [source] Successful treatment for advanced small cell carcinoma of the ovaryPEDIATRIC BLOOD & CANCER, Issue 6 2008Anne Christin MD Abstract Small cell carcinoma of the ovary is a rare and aggressive malignant tumour with a poor prognosis. The authors describe two females, 12 and 13 years old, who presented with advanced stage disease. They were treated with surgical resection, multiagent chemotherapy and high-dose chemotherapy followed by autologous bone marrow transplantation. They remain free of disease more than 9.5 and 14 years since the diagnosis. Pediatr Blood Cancer 2008;50:1276,1277. © 2008 Wiley-Liss, Inc. [source] Establishment of new severity ratings based on analysis of hospital-acquired pneumoniaRESPIROLOGY, Issue 2009Article first published online: 19 OCT 200 SUMMARY ,,The Japanese Respiratory Society issued its first guidelines for the management of hospital-acquired pneumonia in adults in 2002. Pathological and severity ratings were investigated based on the results of a national multicenter survey of hospital-acquired pneumonia, and the new severity ratings shown below were established (Fig. II-1). Figure II-1. Severity ratings. MRSA, Methicillin-resistant Staphylococcus aureus. ,,Severity ratings in the 2002 guidelines were based mainly on markers that predicted the effectiveness of antimicrobial treatment. In the current revision, severity is rated using markers that predict the prognosis of patients. ,,Five criteria were established as factors that predict prognosis: malignant tumour or immunocompromised status; decreased level of consciousness; FiO2 >35% required to maintain SpO2 >90%; age ,70 years in men or ,75 years in women; and oliguria or dehydration. ,,Two criteria were established as factors specifying the severity of the pneumonia itself: CRP ,200 mg/L and shadows infiltrating more than two-thirds the area of one lung on chest radiography. ,,Patients who satisfy up to two of the five criteria above to predict prognosis are classified in the mild group (Group A) if they do not satisfy either of the two criteria specifying severity of pneumonia, or in the moderate group (Group B) if they satisfy one or both of those two criteria. Patients who satisfy three or fewer of the five criteria to predict prognosis are classified in the severe group (Group C). ,,When the new severity ratings were applied to the results of the national multicenter survey of hospital-acquired pneumonia, the mortality rate was found to be 12.1% (101/834) in the mild group (Group A), 24.9% (69/277) in the moderate group (Group B) and 40.8% (98/240) in the severe group (Group C). Statistically-significant differences were seen between groups, and patient classification may be useful as an indicator of prognosis (Fig. II-2). Figure II-2. Number of cases and outcomes for each group. VAP, ventilator-assisted pneumonia. [source] Revision of the severity rating and classification of hospital-acquired pneumonia in the Japanese Respiratory Society guidelinesRESPIROLOGY, Issue 6 2008Masafumi SEKI Background and objective: Based on the results of a multicentre collaborative survey of hospital-acquired pneumonia (HAP) conducted in Japan, the severity rating and classification of pneumonia in the Japanese Respiratory Society guidelines for management of HAP were examined. Methods: Parameters for the severity classification were selected from the factors associated with prognosis in the HAP survey and in other previous reports. Depending on the presence of the parameters listed below, patients with HAP were stratified into those with high, moderate or low-risk. The high-risk group was defined as patients with three or more of the following risk factors: ,malignant tumour or immunocompromised status', ,impaired consciousness', ,requiring fraction of inspired oxygen (FiO2) >35% to maintain SaO2 >90%', ,man aged 70 years or older, or woman aged 75 years or older' and ,oliguria or dehydration.' The moderate-risk group was defined as patients with any of the secondary risk factors as follows: ,CRP , 200 mg/L' and ,extent of infiltration on CXR covers at least 2/3 of one lung'. The low-risk group was defined as all other patients. Results: Application of this classification scheme to the patients enrolled in the HAP survey revealed a mortality rate of 40.8% (98/240) in the high-risk group, which was significantly higher than the mortality rates in the moderate and low-risk groups: 24.9% (69/277) and 12.1% (101/834), respectively. Conclusion: These results indicate that it is possible to classify patients using these parameters as prognostic indicators. [source] Severe perineal pain after enterocystoplasty in bladder exstrophyBJU INTERNATIONAL, Issue 6 2004S.R. Phelps OBJECTIVE To describe a previously unreported complication (severe perineal pain) after bladder reconstruction and enterocystoplasty in patients with bladder exstrophy. PATIENTS AND METHODS The notes were reviewed retrospectively for four patients (two boys and two girls) with classical bladder exstrophy who had severe penile or perineal pain after bladder reconstruction. They were all continent and using intermittent catheterization. A range of conservative management failed and all patients subsequently required excision of their native bladders between 1997 and 2000. RESULTS All four patients had perineal or penile pain which began 4 months to 8 years after bladder augmentation. Investigations included plain abdominal X-ray, renal and bladder ultrasonography, computerized tomography of the pelvis, video-urodynamics and cysto-urethroscopy. When therapeutic interventions such as more frequent bladder washouts, analgesic and anticholinergic drugs, and cystolithotomy (two patients) were unsuccessful in alleviating the symptoms, all had their native bladder excised. Histological examination of the excised tissue showed neither normal urothelium nor enteric mucosa at the margins of the excision; two patients already had squamous metaplasia within what represented the bladder, and in the others squamous epithelium was present amongst the enteric mucosa. All four children were pain-free with a follow-up of 2,6 years. CONCLUSION All four patients developed severe referred bladder pain that was probably secondary to the abnormal retained bladder remnants. Cystectomy cured the pain and may also have removed a potential site of future malignant tumour. [source] 3461: Lacrimal gland: non-neoplastic and neoplastic lesions in Denmark 1974-2007ACTA OPHTHALMOLOGICA, Issue 2010S HEEGAARD Purpose To evaluate patient characteristics and incidence of lacrimal gland lesions in Denmark during the period 1974-2007. Methods All biopsied/surgically removed lacrimal gland lesions collected by the Danish pathological departments during the period 1974-2007 were identified by SNOMED codes. In each case age, gender, symptoms, clinical findings, treatment and follow-up were registered. All tumours were re-classified according to latest guidelines from WHO. Results 229 lacrimal gland lesions from 209 patients were identified during the 34-year period. In the study period 7 cases/year were registered (1.3 cases/million/year). Non-neoplastic lesions predominated with a total of 114 (50 %) with the most frequent being inflammation 63 (55%), normal lacrimal gland tissue 28 (25%) and dacryops 23 (20%). Benign tumours comprised a total of 45 (20%) with the most frequent tumour being pleomorphic adenoma 31 (69%). Malignant tumours constituted a total of 70 (31%). 52 (74%) of these were primary tumours, 9 (13%) were secondary invading tumours, 8 (11%) were local recurrences and 1 (1%) was a distant metastasis. Primary malignant tumours comprised malignant lymphoma 25 (48%) and malignant epithelial tumours 27 (52%). The most frequent malignant tumour was adenoid cystic carcinoma comprising 14 (27%) of the primary malignant tumours. Conclusion Lacrimal gland lesions are rare and primarily benign. Treatment of malignant lacrimal gland tumours should be considered a specialist treatment. [source] Intracranial germinoma: A rare but important differential diagnosis in children with growth retardationACTA PAEDIATRICA, Issue 3 2006Sven Gottschling Abstract Aim: Intracranial germinoma is a rare malignant tumour in childhood with an excellent prognosis under adequate therapy. Finding the right diagnosis at an early stage is difficult because of the slow-growing tumour and the resulting lack of clinical symptoms. Methods: Our patients with histologically secured germinoma were retrospectively assessed concerning growth retardation, pituitary hormone status, magnetic resonance imaging scan results and clinical symptoms to find out whether there is a leading parameter. Results: In all our patients, the leading symptom was growth retardation of at least 2 y before being diagnosed. Conclusion: Growth retardation seems to be a very early sign of germinoma in the suprasellar region. Therefore, early neuroradiological imaging combined with pituitary hormone status should be considered in every paediatric patient with a history of secondary growth retardation. [source] Phaeochromocytoma, new genes and screening strategiesCLINICAL ENDOCRINOLOGY, Issue 6 2006Anne-Paule Gimenez-Roqueplo Summary Following recent advances in the genetics of phaeochromocytomas and paragangliomas, the members of the European Network for the Study of Adrenal Tumours (ENS@T) Phaeochromocytoma Working Group have decided to share their genotyping data and to propose European recommendations for phaeochromocytoma/functional paraganglioma (PH/FPGL) genetic testing. Germline DNA from 642 patients was analysed by ENS@T teams. In 166 patients (25·9%) the disease was familial and caused by germline mutations in VHL (56), SDHB (34), SDHD (31), RET (31) or NF1 (14), causing von Hippel-Lindau disease, SDHB- or SDHD-PH/FPGL syndromes, multiple endocrine neoplasia type 2 (MEN 2) and type 1 neurofibromatosis (NF1), respectively. In almost 60% of inherited cases it was possible to formulate a probable genetic diagnosis based on family history and/or typical syndromic presentation. Genetic testing revealed mutations in 12·7% of cases with an apparently sporadic presentation. Several clinical characteristics, such as young age at onset, the presence of bilateral, extra-adrenal or multiple tumours or a malignant tumour, should be seen as indications for genetic testing. The ENS@T Phaeochromocytoma Working Group recommends the genetic testing of all patients with PH and FPGL and suggests a practice algorithm for the management of their exploration. [source] The diagnostic value of on-site cytopathological evaluation and cell block preparation in fine-needle aspiration cytology of liver massesCYTOPATHOLOGY, Issue 5 2006K. Ceyhan Objective:, The aims of this study were to evaluate the typing accuracy of conventional smear (CS), cell block (CB) preparations and combined use of both procedures (CS + CB) for the diagnosis of hepatic malignancies and to determine whether immediate on-site cytopathological evaluation improves the diagnostic yield of liver fine-needle aspiration cytology (FNAC). Methods:, Ultrasound-guided FNABs were performed on 323 consecutive cases with liver masses between December 2002 and December 2004. Histologically and/or clinically correlated 167 cases were included in the study. Preliminary FNAB results, results of CS, CB, and combined use of CS and CB were compared regarding diagnostic sensitivity, specificity, and accuracy for the diagnosis of malignancy. Subtyping accuracies of different methods were also compared. Results:, The sensitivity of on-site cytopathological examination and CS were both 92.8%. The sensitivity of CS + CB was slightly better than that of CB (93.5% versus 84.8%). Specificity of all procedures was achieved 100%. Diagnostic accuracy of on-site cytopathological evaluation, CS, CB, and CS + CB were 93.9%, 93.9%, 87.2%, and 94.5%, respectively. A specific subtype diagnosis of malignant tumours could be rendered accurately on the basis of preliminary diagnosis in 71%, CS in 75.4%, CB in 78.3% and combined approach in 92% of cases. In terms of typing accuracy, 87.5% of HCCs, 93.2% of adenocarcinomas, 92.3% of neuroendocrine carcinomas, 100% of lymphomas and 100% of other malignant tumours were correctly subclassified in the final cytopathological diagnosis. The agreement between preliminary diagnosis and final cytopathological diagnosis was 77.2%. Conclusion:, With use of on-site cytopathological evaluation and combined use of CS and CB, the diagnostic accuracy of liver tumours approaches 100% and also significantly improve diagnostic and subtyping accuracy of liver malignancies. [source] Stereotactic biopsy and cytological diagnosis of solid and cystic intracranial lesionsCYTOPATHOLOGY, Issue 3 2003L. M. Collaço Cytological smears from 115 consecutive cases of stereotactic biopsies of intracranial lesions were reviewed. Ninety-five lesions were solid and 20 cystic. Material from 90 solid and 13 cystic lesions was sent both for cytological and histological examination. In 66 of the solid lesions, the cytological diagnosis was confirmed by histology (five were benign lesions and 61 malignant tumours: 56 primary brain tumours, three metastases and two lymphomas). In 24 cases with discrepant cytology and histology, the histology was inconclusive or insufficient in 14 cases, while cytology established the diagnosis of astrocytoma grade II (seven cases), metastases (two cases), gliosis (one case) and benign (four cases). Necrosis of tumour type was observed cytologically in six patients representing glioblastoma (two cases), anaplastic astrocytoma (one case), lymphoma (one case) and normal brain (two cases) histologically. Three cases reported cytologically as benign were primary brain tumour (two cases) and gliosis (one case). One smear of a glioblastoma was insufficient for cytological diagnosis. Cystic lesions were cytologically benign in 17 cases and malignant in three cases. Histology from the cyst wall confirmed the malignant diagnosis in three cases and showed tumour in six more cases, a benign process (two cases), changes induced by radiotherapy for arteriovenous malformation (one case) and insufficient material (one case). In conclusion, cytology from solid brain lesion allows an accurate diagnosis and subtyping of tumours in a majority of cases, and can thus be used to choose type of therapy. In cystic brain tumours, however, examination of the cystic fluid, is often inconclusive and a biopsy from the cyst wall should be performed if there is clinical or radiological suspicion of tumour. [source] CA9 level in renal cyst fluid: a possible molecular diagnosis of malignant tumoursHISTOPATHOLOGY, Issue 7 2009Guorong Li Aims:, The preoperative differentiation of malignant renal cystic tumours from benign lesions is critical, and it remains a common diagnostic problem. The aim was to examine if the Carbonic anhydrase 9 (CA9) level in cyst fluid can provide a molecular diagnosis of malignant cyst. Methods and results:, Twenty-eight patients with a cystic renal mass were included. Fine-needle aspiration was performed to obtain the fluid. Postoperative pathology confirmed that there were 16 cystic renal cell carcinomas. Twelve benign cystic tumours were used as controls. One hundred microlitres of supernatant of cyst fluid was used to measure the CA9 protein level, which was measured by an enzyme-linked immunosorbent assay technique. CA9 was strongly detected and considered as positive in the cyst fluid of all 16 cystic malignant tumours (>1000 pg/ml), whereas its expression was negative in 11/12 benign cystic tumours (<300 pg/ml). The difference in percentages of positive CA9 between malignant and benign renal cystic tumours was significant (P < 0.001). Conclusion:, The fluid of malignant cystic renal tumours contains a high level of CA9 protein. The measurement of CA9 level in cyst fluid may be used as a molecular diagnosis for differentiation between malignant and benign renal cystic masses. [source] A fibrotic focus is a prognostic factor and a surrogate marker for hypoxia and (lymph)angiogenesis in breast cancer: review of the literature and proposal on the criteria of evaluationHISTOPATHOLOGY, Issue 4 2007G G Van den Eynden A fibrotic focus is a scar-like area in the centre of a carcinoma and can be regarded as a focus of exaggerated reactive tumour stroma formation. Although modern surgical pathology uses different histopathological and molecular markers to assess the aggressiveness and predict the behaviour of malignant tumours, markers reflecting stromal cell behaviour and interactions between epithelial cells and stromal cells are scarce. In this review we summarize all studies investigating the value of a fibrotic focus as a prognostic factor and as a surrogate marker for hypoxia and (lymph)angiogenesis in patients with breast cancer. These data show that a fibrotic focus can be used as a practical, easily assessable and reproducible integrative histological prognostic parameter in breast cancer. We propose a consensus methodology to assess the fibrotic focus in breast cancer. [source] Open versus laparoscopic resection for liver tumoursHPB, Issue 6 2009Thomas Van Gulik Abstract Background:, The issue under debate is whether laparoscopic liver resections for malignant tumours produce outcomes which are comparable with conventional, open liver resections. Methods:, Literature review on liver resection and laparoscopy. Results:, There are no randomized controlled trials (RCTs) published that provide any evidence for the benefits of laparoscopic liver resections for liver tumours. In case,control series reporting short-term outcomes, laparoscopic liver resection has been shown to have the advantage of a reduced length of hospital stay. There are as yet, however, no adequate long-term survival studies demonstrating that laparoscopic liver resection is oncologically equivalent to open resection. Discussion:, The challenge for the near future is to test the oncological integrity of laparoscopic liver resection in controlled trials in the same way that we have learned from the RCTs carried out in laparoscopic resection for colorectal cancer. It is likely that laparoscopic liver resection will then have to compete with fast-track, open liver resection. Already, concerns have been raised regarding the learning curve required to master the techniques of laparoscopic liver resection. [source] MNS16A minisatellite genotypes in relation to risk of glioma and meningioma and to glioblastoma outcomeINTERNATIONAL JOURNAL OF CANCER, Issue 4 2009Ulrika Andersson Abstract The human telomerase reverse transcriptase (hTERT) gene is upregulated in a majority of malignant tumours. A variable tandem repeat, MNS16A, has been reported to be of functional significance for hTERT expression. Published data on the clinical relevance of MNS16A variants in brain tumours have been contradictory. The present population-based study in the Nordic countries and the United Kingdom evaluated brain-tumour risk and survival in relation to MNS16A minisatellite variants in 648 glioma cases, 473 meningioma cases and 1,359 age, sex and geographically matched controls. By PCR-based genotyping all study subjects with fragments of 240 or 271 bp were judged as having short (S) alleles and subjects with 299 or 331 bp fragments as having long (L) alleles. Relative risk of glioma or meningioma was estimated with logistic regression adjusting for age, sex and country. Overall survival was analysed using Kaplan,Meier estimates and equality of survival distributions using the log-rank test and Cox proportional hazard ratios. The MNS16A genotype was not associated with risk of occurrence of glioma, glioblastoma (GBM) or meningioma. For GBM there were median survivals of 15.3, 11.0 and 10.7 months for the LL, LS and SS genotypes, respectively; the hazard ratio for having the LS genotype compared with the LL was significantly increased HR 2.44 (1.56,3.82) and having the SS genotype versus the LL was nonsignificantly increased HR 1.46 (0.81,2.61). When comparing the LL versus having one of the potentially functional variants LS and SS, the HR was 2.10 (1.41,3.1). However, functionality was not supported as there was no trend towards increasing HR with number of S alleles. Collected data from our and previous studies regarding both risk and survival for the MNS16A genotypes are contradictory and warrant further investigations. © 2009 UICC [source] Osteoprotegerin (OPG),a potential new role in the regulation of endothelialcell phenotype and tumour angiogenesis?INTERNATIONAL JOURNAL OF CANCER, Issue 8 2006Simon S. Cross Abstract The progression of cancer depends on the establishment of a tumour blood supply, and therefore tumour angiogenesis has been identified as a major target for new anticancer agents. Recent reports have suggested that osteoprotegerin (OPG) is involved in the control of endothelial cell survival through the inhibition of the activity of tumour necrosis factor- (TNF) related apoptosis-inducing ligand (TRAIL). The role of OPG in human tumour development and angiogenesis is currently unknown. In the present study we demonstrate the ability of OPG to support endothelial cell survival, as well as the formation of cord-like structures in vitro using a matrigel tubule formation assay. Investigation of various human cancers demonstrated endothelial OPG expression in 59% of malignant tumours (n = 512), but in contrast, OPG was absent in endothelial cells associated with benign tumours and normal tissues (n = 178). In a series of 400 breast tumours, endothelial OPG expression was associated with high tumour grade and certain histological types. Our data show a clear separation in endothelial OPG expression between malignant tumours and nonmalignant tissues, supporting a potential biological role for this molecule in the development and/or maintenance of the tumour vasculature. This is the first study to report the proangiogenic effects of OPG in vitro, as well as correlating expression of OPG by tumour endothelial cells with clinicopathological data in human tumours. © 2005 Wiley-Liss, Inc. [source] Neutrophils: key mediators of tumour angiogenesisINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 3 2009Simon Tazzyman Summary It is now well known that most malignant tumours contain a significant amount of leucocytic infiltrates the presence of which has, on many occasions, been linked to poor patient prognosis. These leucocyte populations are recruited to tumours by chemotactic factors released by either viable or necrotic tumour cells, or by cells within the tumour stroma. In recent times, most studies have analysed the role that tumour-associated macrophages (TAM) have on tumour progression. However, there is now increasing evidence to show that neutrophils also actively participate in this process. Whilst there are some data to suggest that neutrophil-derived factors can promote genetic mutations leading to tumourigenesis, or secrete factors that promote tumour cell proliferation; there is now substantial evidence to show that neutrophils, like TAM, significantly affect tumour angiogenesis. In this review, we discuss the likely mechanisms by which neutrophils are recruited into the tumour and then elaborate on how these cells may induce tumour vascularization by the secretion of powerful pro-angiogenic factors. We also discuss possible future chemotherapeutic strategies that are aimed at limiting tumour angiogenesis by inhibiting neutrophil recruitment. [source] Peutz,Jeghers syndrome in a 14-year-old boy: case report and review of the literatureINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2005C. M. PEREIRA Summary., Peutz,Jeghers syndrome (PSJ) is a relatively rare but well-recognized condition, with a prevalence of approximately one in 120 000 births in the USA. It is generally inherited as an autosomal dominant trait, although 35% of cases are new mutations. This disorder is characterized by melanocytic macules on the hands, feet, peri,oral skin and oral mucosa, and multiple gastrointestinal hamartomatous polyps. People with PSJ have an increased risk for developing a variety of malignant tumours. The aim of the present study was to report one case of PSJ in a 14-year-old boy with mucocutaneous pigmentation associated with duodenal hamartomatous polyps. [source] Opaque maxillary antrum: A pictorial reviewJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2005A Whyte Summary The demonstration of an opaque antrum on a plain radiograph or cross-sectional imaging leads to consideration of an extensive differential diagnosis. Relevant clinical details narrow the differential and include the patient's age, signs and symptoms, a history of recent trauma, prior surgery or dental treatment. Computed tomography remains the most useful technique in coming to a specific diagnosis. Magnetic resonance imaging adds specificity in a few selected situations and is required in conjunction with CT in the staging of malignant tumours. [source] Long-term results after reconstruction of full thickness scalp defects with a dermal regeneration templateJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2010J Faulhaber Abstract Objective, Large scalp defects in which the pericranium has to be resected can be reliably reconstructed using Integra®. In the present study, we retrospectively analysed the long-term outcome of our patients. Methods, Nineteen patients were included who had received Integra® dermal regeneration template for treatment of full thickness scalp defects after resection of various malignant tumours. All patients were followed up with a mean follow-up time of 31 months (14,72). Results, All transplants were on almost equal levels with the surrounding skin. Cosmetic results were acceptable and scars were stable. Nodal ultrasound status was negative in all patients. During the follow-up period of up to 72 months, no local recurrences were observed. One patient with a leiomyosarcoma received radiotherapy after transplantation. In the irradiated area, multiple small regular-shaped round ulcerations and later on partial necrosis of the transplant occurred when the patient developed renal failure 29 months after the initial operation. Five patients died of disease not related to the primary skin tumour. All other patients are alive and free of disease without any complications. Conclusion, After reconstruction of full thickness scalp defects with Integra®, the cosmetic results are appealing and we observed no local recurrences during the follow-up period. [source] Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectraNMR IN BIOMEDICINE, Issue 4 2006Anne R. Tate Abstract A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours,glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone. Copyright © 2006 John Wiley & Sons, Ltd. [source] Clinical significance of vascular endothelial growth factor in patients with primary lung cancerRESPIROLOGY, Issue 2 2002IZUMI KISHIRO Objective: Vascular endothelial growth factor (VEGF) is an angiogenesis factor closely associated with the growth and metastasis of malignant tumours. Methodology: In the present study, we measured plasma VEGF levels in 20 normal subjects (N), 35 patients with benign lung diseases (B), 28 patients with untreated advanced lung cancer (NT) and 10 patients with treated lung cancer (T). In addition, we measured the VEGF levels in pleural effusions from five patients with primary lung cancer and two patients with active infectious diseases. Vascular endothelial growth factor was measured by ELISA. Results: The mean (±SD) plasma VEGF level in NT patients (160.8 ± 177.4 pg/mL) was fivefold higher than that in other patient groups (T, 17.7 ± 4.9 pg/mL; B, 28.3 ± 17.6 pg/mL) and the N group (14.9 ± 7.0 pg/mL; P < 0.01). Vascular endothelial growth factor from lung cancer pleural effusions (17 526.0 ± 22 498.2 pg/mL) was 25-fold higher than that from patients with active infectious diseases (665.5 ± 259.0 pg/mL). Conclusions: Plasma VEGF may be a good clinical indicator for the assessment of primary lung cancer and pleural effusion VEGF in primary lung cancer is higher than pleural effusion VEGF in patients with inflammatory diseases. [source] Over-expression of polycomb group protein EZH2 relates to decreased expression of p16INK4a in cholangiocarcinogenesis in hepatolithiasis,THE JOURNAL OF PATHOLOGY, Issue 2 2008M Sasaki Abstract Polycomb group protein EZH2 and Bmi1 are reportedly involved in the progression of malignant tumours. We examined the participation of EZH2 in multi-step cholangiocarcinogenesis in hepatolithiasis with respect to tumour suppressor gene p16INK4a. We examined 20 hepatolithiatic livers with intrahepatic cholangiocarcinoma (ICC) and 10 histologically normal livers. Neoplastic biliary lesions were classified into biliary intraepithelial neoplasm (BilIN-1, 2 and 3) and invasive carcinoma. We selected 15 foci of invasive carcinoma, 8 BilIN-3 (carcinoma in situ), 12 BilIN-2 (high-grade dysplasia), 32 BilIN-1 (low-grade dysplasia) and 37 non-neoplastic biliary epithelia from these livers. Expression of p16INK4a, EZH2 and Bmi1 were surveyed in these foci. P16INK4a promoter methylation was examined in microdissected tissues. Taking advantage of two cell lines of CC (HuCTT-1 and TFK-1) and small interfering RNA (siRNA), the effects of the knockdown of EZH2 on p16INK4a methylation of CC cells were examined. Expression of p16INK4a, which was frequent in BilIN1, was decreased in BilIN-2/3 and invasive carcinoma, while EZH2 expression showed step-wise increase from BilIN-1, -2 and -3 to invasive carcinoma (p < 0.01). P16INK4a promoter hypermethylation was related to aberrant expression of EZH2. The knockdown of EZH2 in cultured CC cells decreased p16INK4a methylation and decreased binding of EZH2 to the p16INK4a gene promoter. The latter suggested that direct binding of EZH2 is involved in the regulation of the p16INK4a gene. Our data suggest that over-expression of EZH2 may induce hypermethylation of p16INK4a promoter followed by decreased expression of p16INK4a in the multi-step cholangiocarcinogenesis through intraepithelial neoplasm in hepatolithiasis. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||