SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Cerebral metastases of testicular malignant lymphomas have been reported. In this case a testicular metastasis secondary to a primary cerebral malignant lymphoma is presented. This unusual case does not correspond to the known metastatic pattern of malignant lymphoma.
Non-small cell lung cancer is characterized by a specific metastatic pattern. The mechanism for organ-specific metastasis is poorly understood, although evidence has suggested that the chemokine stromal derived factor-1 (CXCL12) and its cognate receptor CXCR4 may regulate breast cancer metastasis. We hypothesized that the CXCL12-CXCR4 biological axis is important in mediating non-small cell lung cancer metastases. Our results indicate that both non-small cell lung cancer tumor specimens resected from patients and non-small cell lung cancer cell lines express CXCR4, but not CXCL12. Non-small cell lung cancer cell lines undergo chemotaxis in response to CXCL12. CXCL12-CXCR4 activation of non-small cell lung cancer cell lines showed intracellular calcium mobilization and mitogen-activated protein kinase activation with enhanced extracellular signal-related kinase-1/2 phosphorylation without change in either proliferation or apoptosis. Target organs in a murine model that are the preferred destination of human non-small cell lung cancer metastases elaborate higher levels of CXCL12 than does the primary tumor, and suggest the generation of chemotactic gradients. The administration of specific neutralizing anti-CXCL12 antibodies to severe combined immunodeficient mice expressing human non-small cell lung cancer abrogated organ metastases, without affecting primary tumor-derived angiogenesis. These data suggest that the CXCL12-CXCR4 biological axis is involved in regulating the metastasis of non-small cell lung cancer.
AIMS AND BACKGROUND: The surgical removal of lung metastases is controversial: some authors have reported good results in terms of prognosis and disease-free interval in patients affected by multiple metastases. Recently, percutaneous hyperthermic tissue ablation (HTA) has been used under CT guidance in solitary peripheral pulmonary tumors attached or close to the parietal pleura. METHODS AND STUDY DESIGN: We report the first intraoperative HTA of a lung metastasis from colorectal carcinoma, which might pave the way for possible future application of the procedure in patients with multiple pulmonary metastases. A 64-year-old patient affected by a rectal cancer was treated by abdominal perineal amputation followed by two lines of chemotherapy. After two years two lesions appeared in the lower left pulmonary lobe and another in the lower right lobe. The patient was monitored by three-monthly thoracic and abdominal CT. The lesions were stable for one year, but in the last two months one of the suspected metastases in the left lung increased from 1 to 2 cm. This was an indication for surgical removal. A mini posterolateral thoracotomy was performed. Thanks to complete collapse of the lung with manual squeezing of the parenchyma, ultrasonography provided satisfactory visualization of the two lesions. A frozen biopsy of the larger lesion was obtained which confirmed its metastatic nature. Ultrasound-guided HTA of the larger metastasis (2 cm) was performed. Final US demonstrated the change in the metastatic pattern. The two lesions were eventually removed by wedge resection using a TA 90 stapler. Histological examination of the two lesions confirmed the coagulative necrosis of the treated metastasis. No morbidity or pulmonary problems were recorded.
PURPOSE: Several studies have reported clinical behavior and chemotherapy resistance in leiomyosarcomas, but these studies did not differentiate between soft tissue leiomyosarcomas (LMS) and malignant gastrointestinal stromal tumors (GIST). Multidrug resistance (MDR) has been associated with the expression of P-glycoprotein (P-gp), multidrug resistance protein (MRP(1)), and lung resistance protein (LRP). The aim of the present study was to compare LMS and GIST with respect to clinical outcome and MDR parameters. PATIENTS AND METHODS: Clinical outcome was evaluated in 29 patients with a primary deep-seated LMS and 26 patients with a primary malignant GIST. Paraffin-embedded material, available for 26 patients with LMS and 25 with GIST, was used for immunohistochemical detection of P-gp, MRP(1), LRP, and c-kit. RESULTS: Mean overall survival (OS) was 72 months for LMS patients and 31 months for GIST patients (P: <.05). Metastases occurred in 16 (59%) of 27 assessable LMS patients and in 10 (56%) of 18 assessable GIST patients. LMS predominantly metastasized to the lungs (14 of 16 patients), whereas GIST tended to spread to the liver (five of 10 patients) and the abdominal cavity (three of 10 patients; P: <.001). P-gp and MRP(1) expression was more pronounced in GIST than in LMS (P: <.05): the mean percentage of P-gp expressing cells was 13.4% in patients with LMS and 38.4% in patients with GIST, and the mean percentage MRP(1) expressing cells was 13.3% in patients with LMS and 35.4% in patients with GIST. LRP expression did not differ between LMS and GIST. c-kit was expressed in 5% of the LMS patients and in 68% of the GIST patients. CONCLUSION: LMS patients have a better survival than GIST patients, and the metastatic pattern is different. Expression of MDR proteins in LMS is less pronounced than in GIST.
Carcinoma of the penis has a well documented metastatic pattern, regional lymph nodes being the predominant site of involvement. Distant metastasis is extremely rare, with a reported incidence of 1-10%. Osseous metastasis is even rarer and no case of metastasis to the spine has been reported previously. We present a case of carcinoma of the penis metastasizing to the spine.
We report a 17-year-old boy with chondroblastic osteosarcoma initially found in left proximal tibia. He received surgical resection and chemotherapy. However, a lung metastasis was found 4 years later. Despite intensive chemotherapy, the metastatic osteosarcoma of lung continued to invade the ribs and later into retroperitoneum and liver. The metastatic pattern of chondroblastic osteosarcoma of tibia directly to the chest and then into the abdomen is unusual.
Peritoneal dissemination has an unfavorable impact on the prognosis of pancreatic cancer, and a peritoneal dissemination model was created in hamsters by using an experimental pancreatic cancer to clarify its pathological characteristics. PGHAM-1, a cancer cell line we established from BOP induced pancreatic cancer in Syrian golden hamsters, was inoculated into the abdominal cavity of Syrian golden hamsters. After inoculation, sequential changes in the diaphragm, omentum, and parietal peritoneum, and the metastatic patterns of the PGHAM-1 cells were morphologically investigated by macroscopical, microscopical, and ultrastructural observation. The cancer cells were easily absorbed at the stomata in the diaphragm and milky spots in the omentum, which were absorptive lymphatic structures, and lymphatic metastasis occurred 4 days after inoculation. In the parietal peritoneum, however, the cancer cells attached to and proliferated on the parietal peritoneum where mesothelial cells had exfoliated and the basement membrane was exposed. This process was comparatively time-consuming, and metastasis occurred in the parietal peritoneum at 7 days after inoculation. This study suggested that there might be two patterns of peritoneal dissemination of hamster pancreatic cancer. One route is lymphatic metastasis via stomata in the diaphragm and milky spots in the omentum, and the other is direct metastasis on the parietal peritoneum; each metastasis forms independently.
A 60-year-old female patient presenting with anemia was found to have a left-sided renal tumor and a contralateral adrenal mass of 2 cm in diameter. Imaging studies for metastases were negative. Nephrectomy along with contralateral adrenalectomy was performed and histology disclosed renal cell carcinoma stage pT3a pNO G2 with solitary contralateral adrenal metastasis. In a survey of the literature, 24 previous cases of renal cancer with solitary contralateral adrenal metastasis were identified. The most probable biological pathway to explain this peculiar metastatic pattern is transpulmonal passage of circulating cancer cells and seeding in the adrenal gland on the basis of a particular susceptibility of adrenal tissue to circulating renal cancer cells. The case illustrates that surgery of solitary metastases from renal cell carcinoma may be beneficial to the patient. The case further highlights the caution that is required diagnostically in the interpretation of incidentally found adrenal masses when other malignancies are present.
Two unusual primary carcinomas of the lung are described. One occurred in a 31-year-old man and was composed of large, undifferentiated, ovoid to polygonal cells. The other occurred in a 72-year-old man, was composed of spindle-shaped cells, and was initially diagnosed as a localized fibrous mesothelioma. The neoplastic cells of these tumors expressed only vimentin intermediate filaments and showed no other immunohistochemical features of epithelial neoplasms, although they exhibited a metastatic pattern characteristic of lung carcinomas. These two malignant neoplasms further expand the spectrum of unusual lung neoplasms, and suggest that there are pulmonary carcinomas that contain only vimentin intermediate filaments.
PURPOSE: To investigate the orbital invasion and metastatic pattern in retinoblastoma, and to analyze the correlation with other pathologic and prognostic factors. METHODS: Pathologic and admission records of 45 patients with a pathologically confirmed diagnosis of retinoblastoma during the past 20 years were reviewed. Clinical risk factors and pathologic findings were analyzed for association with tumor invasion/metastasis using chi-square, Fisher's exact, and Student's t tests. RESULTS: Clinical risk factors such as exophthalmos, cataract, and pseudohypopyon were significantly correlated with tumor invasion/metastasis. The pathologic finding of choroid involvement was highly predictive of tumor invasion/metastasis. Delayed enucleation (>3 months) also was significantly correlated with tumor invasion/metastasis. CONCLUSION: Tumor invasion/metastasis is strongly associated with various ocular, pathologic, and treatment outcome factors. Identification of these risk factors may help plan treatment regimens.
A renal T-cell lymphoma with exclusive cerebral metastasis was diagnosed in a 5-year-old Staffordshire bull terrier bitch euthanased for aggression. This is the first recorded case of primary renal lymphoma in a dog. Immune suppression, due to chronic canine monocytic ehrlichiosis, may account for the unusual primary site and metastatic pattern of the tumour.
Advances in the management of ovarian cancer by use of aggressive surgery and effective platinum-based chemotherapy have prolonged survival; this may have resulted in an alteration of the metastatic pattern of the disease and spread to unusual sites (e.g, CNS) has become more common. Also, with the availability of more sensitive imaging techniques, these tumors are being diagnosed with increasing frequency. Intramedullary spinal cord metastasis is rare. We report one such case treated successfully with chemotherapy and radiotherapy with long-term survival.
Neuroendocrine differentiation in the neoplastic prostate varies from foci of adenocarcinoma showing immunoreactivity to the pure small cell carcinoma, which correlates with poor prognosis. Widely metastatic disease in unusual sites is reported for small cell carcinoma, and rarely is the serum prostate-specific antigen level elevated. We report a case of recurrent prostate adenocarcinoma presenting as bowel obstruction due to widespread metastatic disease in the omentum and peritoneum. The histopathology of the omental metastasis was that of a large cell neuroendocrine carcinoma, without evidence of an adenocarcinoma. The absence of a clinically evident second primary tumor, the concomitant elevated serum prostate-specific antigen level, and the positive tissue immunoreactivities to prostatic markers all supported the prostatic origin of the omental tumor. Review of the importance of prostatic neuroendocrine differentiation and its unusual metastatic patterns is presented.
We describe a case of urachal adenocarcinoma arising in a 30-year-old woman. The patient underwent partial cystectomy. Three years later, she presented with an isolated metastasis to a thoracic vertebra, which was treated by vertebral corporectomy. Histologic findings are described, and the clinical findings, management, and metastatic patterns of this rare tumor, as well as the differential diagnosis on a biopsy specimen, are discussed.
p53 mutations have been reported to correlate with prognosis and response to therapy in patients with different tumor types. However, although p53 status is related to the primary tumor aggressiveness, an association between its expression and specific metastatic pattern has not yet been investigated. We immunohistochemically analyzed p53 (Pab1801) and ki67 (mib1) primary tumor expression in a series of advanced breast cancer patients presenting a selected pattern of distant metastases at the time of first diagnosis. Forty-eight percent of the overall series was classified as p53 positive while 22% as mib1 positive tumors. The overall agreement between p53 and mib1 expression was statistically significant (p = 0.03). While mib1 primary tumor expression did not show any association with the type of metastasis, p53 positivity was significantly higher in patients with soft tissue metastasis than in patients with bone or viscera metastasis (p = 0.002). No association with the probability of clinical response or different overall survival was found for patients with different p53 or mib1 status either in the overall series of patients or in subgroups of cases with different sites of distant metastasis.
PURPOSE: To determine the incidence and metastatic pattern of multifocal renal cell carcinoma in radical nephrectomy specimens and to use these findings to guide the choice of operative procedure. MATERIALS AND METHODS: Pathology reports for 161 patients who underwent radical nephrectomy at Walter Reed Army Medical Center between 1980 and 1995 were reviewed to evaluate tumor size, stage, and incidence of multifocal tumors. RESULTS: Multicentric neoplasms occurred in 16 of 161 (9.9%) radical nephrectomy specimens from the same institution. Thirteen of the 16 multifocal tumors had cross-sectional diameters > or = 3.5 cm. Of the 16 multifocal carcinomas, 11 were noted in stage I tumors. Multifocal neoplasms were not identified with primary tumors of < 2 cm. CONCLUSION: Our data support previous reports that the incidence of multicentric renal malignancy is low and suggest that patients with small, unilateral masses (< 2 cm) can undergo kidney-sparing surgery with little risk of local recurrence.
Of the 89 patients with disseminated carcinoma of the breast treated with combination or sequential cyclophosphamide, fluorouracil and vincristine, 63 had received evaluable course of endocrine therapy and chemotherapy. The response to endocrine therapy, regardless of its nature or duration, failed to predict response to subsequent chemotherapy. Selection of the patients on the basis of pretreatment disease free interval, menopausal status or metastatic pattern showed the groups of patients to be homogeneous in distribution. In addition, evaluation for a disease free interval greater or less than two years, menopausal status and visceral or nonvisceral metastasis did not allow identification of groups predicting responsiveness to combination chemotherapy.
Cancer complicating pregnancy is a rare coexistence. The incidence is approximately 1 in 1,000 pregnancies. The most common cancers are those more frequently seen during the reproductive age of a woman. Breast cancer, cervical cancer, Hodgkin's disease, malignant melanoma, and leukemias are the most frequently diagnosed malignancies during gestation. The diagnostic and therapeutic management of the pregnant patient with cancer is especially difficult because it involves two persons, the mother and the fetus. In this paper we review: A) the therapeutic and diagnostic management of these patients; B) the safety of diagnostic and therapeutic procedures; C) the metastatic pattern of the maternal tumors to the placenta and fetus, and D) the potential recommendations for therapeutic abortion.