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PubMed1989

[Manifestations and therapy of malignant fibrous histiocytomas of the head and neck].

From 1982 through 1987, ten patients with malignant fibrous histiocytomas (MFH) in the head and neck area were treated at the ORL Department of the Central Hospital of Bremen. The primary tumor was situated in the region of the paranasal sinuses in six cases and in the parotid gland, the thyroid gland, the inferior maxilla, and the petrosal bone in one case, each. Nine patients were submitted to primary surgery. A postoperative irradiation was performed in four cases, and in four further cases this was done only when a recurrent tumor had been demonstrated. Three patients received a combined chemotherapeutical treatment. Eight patients died, the median survival time was 15 months. Besides local recurrences which occurred frequently, remote metastases are the decisive factor for the further evolution of the disease. The lung was the most common site of metastatic spread. Only two patients with MFH of the paranasal sinuses are living now without recurrence after an observation time of 24 and 36 months, respectively.

Combined Modality Therapy↗
PubMed1983

[Benign disorders of soft tissue on the roentgen computer tomogram].

Diagnostic procedures of soft tissue lesions have considerably improved by the high density resolution of computed tomography. Indications for investigations by CT are described in detail and illustrated by examples. Enhancement by contrast medium enables further differentiation of the tumors. In most cases for cancer control the scar tissue can be differentiated from relapse. Comparison of both sides reveals isodense tumors. Limits of the CT method will be met in looking for discreet changes in the joints.

Abdominal Muscles↗
PubMed1982

Periductal elastic tissue of breast cancer. Quantitative histologic study.

Using techniques of stereology, we estimated the relative volume of periductal elastic tissue in 60 infiltrating ductal carcinomas of the breast. Volume density of periductal elastic tissue in the neoplasm correlated with our own subjective histologic estimates of the amount of elastic tissue. Periductal elastic tissue had a significantly higher volume density in the neoplasm than in nonneoplastic breast, but the two estimates did not correlate with each other. Similarly, the volume density of elastic tissue in the neoplasm did not correlate with that of neoplastic cells or of stromal collagen in the neoplasm, degree of lymphocytic infiltration, lymph node metastasis, mortality, menstrual status, age, parity, or presence or levels of estrogen receptor protein in the neoplasm. On the other hand, parity correlated with the volume density of periductal elastic tissue in the nonneoplastic parenchyma of the breast. Our findings indicate that there are at least two separate elastogenic effects in infiltrating ductal carcinoma of the breast: that exerted by parity on nonneoplastic tissue and that exerted by cancer itself on the neoplasm.

Adult↗
PubMed1995

[Biological glue does not reduce lymphorrhoea after lymph node excision. Randomized prospective study on 40 patients].

The aim of this prospective and randomized study, was to demonstrate the benefit by using fibrin glue after axillary lymph node dissection. From January 1990 to January 1991, forty females were randomized before surgery for breast cancer: 20 patients of the group A underwent additional application of fibrin glue (5 ml containing 500 IU of thrombin) by spray only in the area of axillary dissection, while the 20 patients of group B acted as the control group. The two groups were compared for age, number of nodes removed and involved, drainage volume and duration and complications. Student's t test, Mann and Whitney non parametric test and chi 2 were used when appropriate for statistical analysis. The two groups were well balanced for age, number of nodes removed and involved, staging and histologic findings. The average volume of lymphorrhoea in the lymph node dissection area was greater after use of fibrin glue (410.4 ml) than in controls (275.5 ml, p = 0.016). No difference was noted between the two groups for the volume of drainage of the mastectomy or lumpectomy site or, for the total volume of drainage. Drainage durations as well as hospital stay were similar. Six complications occurred in group A, and one in group B (p = 0.037).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Malignant granular cell tumors: report of a case and review of the literature.

BACKGROUND: Granular cell tumors are uncommon soft tissue tumors and are more commonly benign. Malignant granular cell tumors are extremely rare, may be confused with other soft tissue sarcomas, and can be diagnosed only when metastatic disease that has the same histologic features as the primary tumor has been identified. Metastases are more commonly seen in lymph nodes and lungs; however, often the metastatic disease is not identified at the time of initial diagnosis and presents anywhere from 3 to 37 months after initial treatment. Certain findings, such as histologic appearance and size, may suggest that a granular cell tumor has uncertain malignant potential. METHODS: We evaluated a patient with a granular cell tumor of uncertain malignant potential of the left chest wall and no evidence of metastatic disease on physical examination with a preoperative work-up to identify sites of occult disease. RESULTS: The patient was found to have suspicious ipsilateral axillary adenopathy on magnetic resonance imaging and computed tomography scan. No other regional or distant disease was identified. The patient underwent an en bloc wide excision and axillary lymph node dissection. Metastatic disease was identified in nine of 23 lymph nodes. CONCLUSIONS: Patients who are diagnosed with a granular cell tumor of uncertain malignant potential may benefit from preoperative radiologic evaluation because occult metastatic disease may be identified, alter the surgical approach, and possibly affect the long-term outcome.

Diagnosis, Differential↗
PubMed1977

Cytokinetic definition of acute and chronic breast cancer.

The purpose of this paper is to report the extant observations at the Ellis Fischel State Cancer Hospital-Cancer Research Center and in the literature on the gross rates of growth of human mammary cancer as measured for primary cancers in the breast by mammography and for metastatic cancer in the skin and lymph nodes by direct measurements. From these measurements, the gross or net rates of growth for the cancers have been calculated and reported as actual doubling times. Cytokinetic variables contribute to the observed growth, and the data are used to estimate the potential acuteness or chronicity of breast cancer.

Acute Disease↗
PubMed1993

Morpho-physiological function and role of omental milky spots as omentum-associated lymphoid tissue (OALT) in the peritoneal cavity.

The morpho-physiological function and role of milky spots in the greater omentum are reviewed. These milky spots are composed of cellular aggregations of mesenchymal cells, mainly macrophages and lymphocytes, surrounding capillary convolutions termed omental glomeruli. Initial lymphatics of the omentum begin at the milky spots and drain into lymph collectors. The lymphatic capillaries in the omental milky spots take part in the absorption of various substances from the peritoneal cavity. Omental milky spots probably act as the first line of defense in the peritoneal cavity and therefore are immunologically important. In human infants, most of the cells in these milky spots are macrophages (49%); less common are B lymphocytes (29%) and T lymphocytes (12%). Whereas macrophages form clusters near the peritoneal surface of the milky spots and are oriented toward the peritoneal cavity for migration, clusters of B and T lymphocytes are typically found in periarteriolar locations within the milky spots. This cell zonation facilitates phagocytosis and processing of circulating antigens and foreign bodies which emanate from the peritoneal cavity. During inflammation, the number and size of omental milky spots dramatically increase, and some develop germinal centers within the lymphatic follicles and produce antibodies. During intraperitoneal immunotherapy, the omental milky spots and their cellular elements may be activated by intraperitoneal administration of biological response modifiers, and thereby represent an important immunoregulatory system for the peritoneal cavity. Omental milky spots are also closely linked to the dissemination of cancer cells. Thus, intraperitoneally inoculated experimental tumor cells selectively invade the milky spots and proliferate there to form tumor nodules. This occurrence is relevant to clinical practice where nodular metastases to the omentum are common. Omental milky spots are analogous to regional lymph nodes and as such are the omentum-associated lymphoid tissues and participate in intraperitoneal immune reactions.

Animals↗
PubMed1997

Surgical chemotherapy in the management of melanoblastoma of the lower extremities.

The therapy of advanced melanoblastomas of the lower extremities is limited. Surgery alone is insufficient due to the extent of the tumor, the radicality of mutilating surgery is questionable because of the existing or suspected subclinical metastasis. To avoid amputation, regional chemoperfusion and simultaneous hemofiltration may be the choice of treatment. Between 1993 and 1995 the authors performed surgical chemotherapy on 21 occasions in 14 patients with advanced melanoblastoma of the lower limb. Partial remission of 4 to 11 months developed in 10 patients, 3 patients achieved subjective improvement for 3 to 6 months, 1 patient had disease progression. Simultaneous application of surgical regional chemotherapy and hemofiltration offers an alternative approach in the management of patients suffering from advanced melanoblastoma.

Antibiotics, Antineoplastic↗
PubMed1997

Immunochemotherapy with recombinant interferon-alpha 2b plus dacarbazine in the treatment of advanced malignant melanoma.

In order to estimate the therapeutic activity and tolerability of immunochemotherapy with recombinant interferon-alpha 2b (rIFN-alpha 2b) plus dacarbazine (DTIC), a study was carried out in 61 patients with cytologically and/or histologically confirmed metastatic malignant melanoma. The treatment regimen was as follows: rIFN-alpha 2b 2 x 10(6) IU intramuscularly on days 1 to 4, and DTIC 800 mg/m2 intravenously on day 5, repeated at 3-week intervals until the progression of the disease or, in the case of a complete response, for up to 6 months. The overall response rate was 28%-12% complete response (CR) and 16% partial response (PR). The median response duration was 10.9 months (CR 11.5 months, PR 9.3 months; P > 0.05). Responses occurred in soft tissue and lung metastases only. The median times to treatment failure for responding and non-responding patients were 10.9 and 3 months, respectively (P < 0.0001), and the median survival durations were 16.5 and 5.8 months, respectively (P < 0.0001). The stratification of the patients into a low-risk group (World Health Organization performance status [WHO PS] < or = 1 and soft tissue or lung metastases) and a high-risk group (WHO PS = 2 or disease localization other than skin, lymph nodes or lung) showed a significant advantage for the first group with respect to the response rate, median time to treatment failure and survival duration. A flu-like syndrome was recorded in 72% of patients, nausea and vomiting in 34%, haematological toxicity in 26%, hepatic toxicity in 5%, and neurotoxicity in 5%. In view of the results obtained in our study and those reported in the literature, IFN plus DTIC immunochemotherapy represents a reasonable treatment option, particularly for patients with soft tissue and lung metastases.

Adult↗
PubMed1993

Prognostic value of p53 protein expression in breast carcinomas.

A group of 196 ductal infiltrating carcinomas of the breast was examined immunohistochemically for p53. The purpose of this study was to show whether frozen and fixed tissues are equally adequate for detection of p53 and which antibodies should be used to have a prognostic value. Detection was superior on frozen to that on formalin-fixed tissues. It was not possible with any method to improve results on fixed tissues. Detection of p53 was different for each antibody: M 1801 detected 41 cases on frozen tissues, M-240 52 cases, M-421 28 cases. Using all the antisera, and the rabbit antiserum CM1, it was possible to detect 71 cases (36%). The percentage was the same in infiltrating lobular carcinomas but higher (94%) in medullary carcinomas. p53 was associated with high grade and ER-tumours. In formalin-fixed tissues, p53 had no prognostic value. In frozen tissues p53 was not an independent factor of prognosis. However, it was important in sorting out cases with bad prognosis in the ER-carcinomas and in the carcinomas without metastases. The prognostic value was different for each monoclonal antiserum. Positivity with M421 associated with negativity for M240, and positivity only for M1801 sorted out cases with a poor prognosis (67% and 50% deaths at 5 years).

Adult↗
PubMed1988

Multicentric reticulohistiocytosis. Report of three cases with the evaluation of tissue proteinase activity.

Three cases of multicentric reticulohistiocytosis showing typical clinical, histologic, and ultrastructural findings are reported. In one, gastric cancer occurred; in the other two cases, severe polyarthritis was the only detectable internal involvement. The serine proteinases, urokinase and tissue-type plasminogen activator, were evaluated both with the autohistographic technique and spectrophotometric assay in lesional skin and synovia. Urokinase levels appeared grossly increased in the lesional synovia and moderately increased in the lesional skin. We suggest that urokinase, presumably released by the activated proliferating histiocytes, may play a major role in the extracellular matrix degradation leading to erosion of cartilage and adjacent bone in multicentric reticulohistiocytosis.

Adult↗
PubMed1991

Increase in levels of plasminogen activator and type-1 plasminogen activator inhibitor in human breast cancer: possible roles in tumor progression and metastasis.

We measured antigen levels of two kinds of plasminogen activators, tissue type plasminogen activator (t-PA) and urokinase type plasminogen activator (UK), as well as their primary inhibitor, type-1 plasminogen activator inhibitor (PAI-1) in the tissue extracts of benign and malignant breast tumors. Tumor tissues of 36 fibroadenomas and 39 breast cancers were examined. t-PA levels were not different in both groups. Malignant tumors contained the significantly higher levels of UK than benign tumors (p less than 0.001). Furthermore in breast cancer tissues, UK antigen levels of tumors with axillary lymph node involvements were significantly higher than those of tumors without lymph node involvements (p less than 0.05). PAI-1 antigen levels of breast cancer tissues were dramatically higher than those of fibroadenoma (p less than 0.001). PAI-1 levels of node positive carcinomas showed also values significantly higher than node negative ones (p less than 0.01). When we divided cancer tissues into three groups as node negative tumors, tumors with positive axillary nodes fewer than four and tumors with four or more positive nodes, PAI-1 levels increased corresponding to the progression of lymph node involvements (p less than 0.05). Immunohistochemical studies, using mouse monoclonal antibodies to human UK and PAI-1, showed that those immunoreactivities were diffusely distributed in the cytoplasm of human breast cancer cells. Their staining patterns were very similar to each other.

Adenofibroma↗
PubMed2005

Mesorectal spread and micrometastasis of rectal cancer studied with large slice technique and tissue microarray.

BACKGROUND AND OBJECTIVES: Mesorectal tissue seems to be an ideal substrate for the spreading of tumors. The aim was to study the distribution of mesorectal neoplastic foci, examine occurrence of circumferential margin involvement and investigate micrometastasis of the lymph nodes. METHODS: A large slice technique, combined with tissue microarray, was used in the pathologic study of 31 specimens operated on following the principles of total mesorectal excision (TME). RESULTS: Three hundred and forty-nine mesorectal neoplastic foci were examined from 18 specimens. Almost one third of them were in the outer layer of mesorectum. Concerning position of primary tumor, ipsolateral neoplastic foci were significantly more than contralateral neoplstic foci. Twelve specimens were diagnosed to have circumferential margin involved. Nine hundred and ninety-two lymph nodes were harvested with 148 involved by tumor. No significant difference in occurrence of micrometastasis was observed among tumors of different stage. CONCLUSION: Combination of large slice and tissue microarray provided a more detailed method in studying the spread of rectal cancer. Complete excision of the mesorectum with fascia propria circumferentially intact is essential since there is an outer scattering and lateral discrepancy for neoplastic foci distribution. Circumferential margin involvement and micrometastasis observed suggested adoption of preoperative and/or postoperative radiochemotherapy.

Adult↗
PubMed1994

[Soft-tissue rhabdomyosarcoma of the lesser pelvis].

For the 1967-1989 period of time of 225 patients with malignant nonorganic small pelvis tumors in 15 the soft tissues rhabdomyosarcoma of small pelvis cavity was diagnosed (including 7 children and 8 adults). The main tumor symptoms are the pain and the disorders of physiologic excretions. The fourth stage of the disease was diagnosed in 13 of 15 patients. In spite of performance of extensive combined intervention, chemotherapy and irradiation therapy the treatment results are poor: the whole of the patients have died for a period of 3 years (mainly up to 1 year period of time).

Adolescent↗