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At least 181 records · Page 10Linked to original sources
PubMed2000

Cervical sentinel lymph node biopsy for melanomas of the head and neck and upper thorax.

OBJECTIVE: To describe a clinical experience with sentinel lymph node biopsy (SLNB) of head and neck nodal basins for clinical stage I melanomas draining to these areas. DESIGN: Consecutive clinical case series with a mean follow-up of 10.7 months. SETTING: University tertiary care referral medical center. PATIENTS: Seventy patients with clinical stage I cutaneous melanoma who underwent SLNB of cervical and/or parotid lymph node basins. INTERVENTIONS: Patients underwent same-day preoperative technetium Tc 99m lymphoscintigraphy followed by SLNB using gamma probe and blue dye (66 patients) and blue dye alone (4 patients). Patients with histological evidence of tumor (here in after "positive") according to SLNB results underwent modified cervical completion lymph node dissection, including parotidectomy, as appropriate. Patients without histological evidence of tumor (hereinafter "negative") according to SLNB results were followed up clinically without undergoing completion lymph node dissection. MAIN OUTCOME MEASURES: The rates of SLNB success, SLNB positivity, completion lymph node dissection positivity, complications, and SLNB false-negative results were determined by clinical follow-up. RESULTS: Locations of melanomas in the 70 patients were the face (n = 20), neck (n = 14), ear (n = 9), scalp (n = 9), and upper thorax (n = 18). Locations of basins that underwent biopsy (n = 104) were in the cervical (n = 68), parotid (n = 19), and axillary (n = 17) regions. The mean Breslow thickness was 2.1 mm (range, 0.4-12.0 mm). Sentinel lymph node biopsy was successful in 103 basins (99%). The mean number of sentinel lymph nodes per basin was 2.5 (range, 1.0-8.0). Positive sentinel lymph nodes were found in 12 patients (17%) and 15 basins (14%). Sentinel lymph node biopsy results correlated with the American Joint Committee on Cancer tumor stage (P = .05) and a Breslow thickness of 1.23 mm or greater (P = .03). Additional tumor-containing nodes were noted in 5 (42%) of the 12 patients who underwent completion lymph node dissection, and these results correlated with the presence of multiple positive sentinel lymph nodes (P = .01). There were complications in 3 patients (4%) (seromas in 2 patients and temporary spinal accessory nerve paresis in 1 patient). One nodal recurrence in a basin that was negative according to SLNB results (SLNB with blue dye only) was noted (false-negative rate, 2%). The results of SLNB were accurate in 69 patients (99%). CONCLUSIONS: Sentinel lymph node biopsy using lymphoscintigraphy and blue dye to manage cutaneous melanomas draining to the head and neck nodal areas is reliable and safe. Sentinel lymph node biopsy results correlated with a Breslow thickness of 1.23 mm or greater and the American Joint Committee on Cancer tumor stage. Completion lymph node dissection is recommended after determining positive SLNB results.

Adolescent↗
PubMed1975

Dumbbell neuroblastomas in children.

A "dumbbell" neuroblastoma is a malignant neoplasm usually primary in the mediastinum or retroperitoneum with posterior extension through an intervertebral foramen to additional tumor within the spinal canal. Neurologic deficits are found in almost all cases. Nineteen patients with such tumors were reviewed with respect to diagnosis, management, and results. Treatment consisted of prompt laminectomy with total or subtotal excision of the extradural tumor. The primary tumor in the mediastinum or retroperitoneal area was removed at a second stage. All patients received postoperative radiation therapy. Eleven of the 17 patients observed more than two years are free of disease, a cure rate much higher than the overall experience with neuroblastoma. Substantial recovery of neurologic function occurred in most, but kyphoscoliotic deformities were a disturbingly frequent late complication.

Abdominal Neoplasms↗
PubMed1996

Cutaneous and subcutaneous masses of the chest wall: a fine-needle aspiration study.

Primary cutaneous and subcutaneous neoplasms of the chest wall are uncommon. However, metastatic tumors involving this region may be seen in local recurrence, widespread metastases, or as the first manifestation of an occult malignant neoplasm. We report a series of 81 fine-needle aspirations (FNA) of cutaneous and subcutaneous masses involving the chest wall of 45 males and 36 females (age range 32-89 yr, mean 63 yr). Sixty-nine patients (85%) have a previous history of malignancy. The most common sites of the primary malignancy are breast (n = 32, 46%), lung (n = 19, 26%), head and neck (n = 6, 9%). Of these 69 aspirates, 65 (94%) are malignant and consistent with patients' primaries; two (3%) are benign aspirates, and two (3%) are unsatisfactory for cytologic evaluation. The remaining 12 (15%) aspirates from patients with no previous history of malignancy reveal 10 (84%) occult malignancies, and two (16%) benign entities. The malignant cases consist of nine (90%) metastatic epithelial neoplasms of unknown primary origin, and one (10%) primary soft-tissue sarcoma. In summary, this study demonstrates that the majority of cutaneous and subcutaneous masses of the chest wall subjected to FNA are neoplastic. FNA is an effective technique for primary assessment of these lesions.

Adult↗
PubMed1968

Clinical factors determining curative tumor dose.

The dominant factor determining treatment policy, when considering radiotherapy of a neoplastic disorder, is the biologic nature of the tumor process in relation to its spatial configuration. This is also the important factor determining curative tumor dose. With the exception of very small tumors and certain important radiosensitive conditions, it is the effect on normal tissues which defines the limits of irradiation and which effectively determines the prescription of dosage. The relationship between dose and volume is basic to this discussion and is considered with particular reference to the integrity of mesenchyme. When comparing the radiosensitivities of tumor and host tissues, it is important to compare like with like. The ultimate effect on a tumor is measured functionally, in terms of suppressing the only function by which the tumour is recognized--its capacity for indefinite proliferation--and reflected in 5- and 10-year cure rates. The effects on normal tissues should therefore be similarly measured in dynamic terms of the final functional state rather than on any transient structural appearance. These features are considered in relation to three different clinical situations: certain radiosensitive tumors, accessible primary tumors of limited sensitivity, and large tumors situated deeply. It is emphasized that curative treatment requires careful clinical appraisal of all the relevant features in each individual patient. The state of both tumor and host reaction may change significantly during the period of treatment and there is no alternative to continuous clinical observation using all the ancillary aids available.

Carcinoma, Squamous Cell↗
PubMed1975

Breast cancer in brothers: case reports and a review of 30 cases of male breast cancer.

Two brothers with breast cancer are presented. One died 8 years after diagnosis and the other is presently living at 1 year with metastatic disease. The courses of 28 other previously unreported male patients with carcinoma of the breast are reviewed, and the possibility of male breast carcinoma being metastatic disease from the prostate is discussed. Useful etiologic information might be obtained from following the offspring of male breast cancer patients to see if they are at increased risk of developing the disease.

Adenocarcinoma↗