The evolution of photodynamic therapy techniques in the treatment of intraocular tumors.
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Eye Neoplasms↗
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Results for “tumor evolution”
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Chondrosarcoma of the trachea. Report of a case.
A tracheal chondrosarcoma was diagnosed in a 74-year-old man during his workup for a bacterial pneumonia. The clinicopathological features and the evolution of these uncommon tumors are discussed in the present report.
Adult↗
Anti-invasive/anti-metastasis strategies: new roads, new tools and new hopes.
Unfortunately, the anticancer drugs that are used nowadays in the clinic have only limited success. To provide a significant clinical advancement, new concepts have to be introduced to aid the design of new tools for therapy. Cancer is not only restricted to neoplastic cells, but rather it involves an ensemble of protagonists. In addition, the evolution of cancer is extremely complex, since multiple cellular activities are involved. Some key steps in the evolution to a metastatic tumor have been shown to be no useful targets. Targeting the stroma cells, however, could bring a new efficiency in anticancer treatment. Targeting the disorganized tissue architecture at the primary site and the restoration of the cell death program in cancer cells appears to create new possibilities in drug design. Also the cytoskeleton, which represents a dynamic set due to its plasticity and multiplicity, seems to be a promising target in anticancer therapy. Moreover, the evolving knowledge of the role of metastasis suppressor genes in regulating cancer cell growth at the secondary site suggests that they could serve as new targets for therapeutic intervention. This review intends to highlight the unraveling of new therapeutic pathways, and to unveil new powerful research tools for combating metastasis.
Animals↗
Pancolonic chromosomal instability precedes dysplasia and cancer in ulcerative colitis.
Patients with long-standing ulcerative colitis (UC) are at increased risk for colon cancer. These cancers are thought to arise from preexisting dysplasia in a field of abnormal cells that often exhibits aneuploidy and p53 abnormalities. Using dual color fluorescence in situ hybridization with centromere probes and locus-specific arm probes for chromosomes 8, 11, 17, and 18, we demonstrate that chromosomal instability (CIN) is present throughout the colon of UC patients with high-grade dysplasia or cancer. In rectal biopsies that were negative for dysplasia, abnormalities in chromosomal arms, especially losses, were most common, whereas centromere gains were most common in dysplasia and cancer. The frequency and type of abnormalities varied between the chromosomes examined; chromosome 8 was the least affected, and 17p loss was found to be an early and frequent event. Chromosomal arm instability showed 100% sensitivity and specificity for distinguishing control biopsies from histologically negative rectal biopsies from these UC patients, raising the possibility that a screen for CIN might detect the subset of UC patients who are at greatest risk for development of dysplasia and cancer. These results suggest that dysplasia and cancer in UC arise from a process of CIN that affects the entire colon; this may provide the mutator phenotype that predisposes to loss of tumor suppressor genes and evolution of cancer.
Centromere↗
[Epidemiological features of epilepsy in adults requiring hospital admission].
INTRODUCTION AND OBJECTIVES: There are few epidemiological studies specifically directed towards finding the features of the adult epileptic population requiring hospital admission. We proposed to analyze these features in a consecutive series of patients admitted to our department with epilepsy and find the prevalence of diagnoses classified as syndromes and epileptic seizures according to the classification of ILAE and their distribution according to age. PATIENTS AND METHODS: We made a retrospective classification of the characteristics of the patients admitted to our department with the diagnosis of epilepsy during 1999. We divided the sample into three age groups: 18 30, 31 60 and >60 years. We calculated the absolute prevalence of the different types of crises and epileptic syndromes, the specific relative prevalence according to age groups and diagnostic category expressed with confidence intervals of 95%. The degree of statistical significance was obtained using the chi squared test of Mantel Haenszel. RESULTS: The sample group contained 96 patients (51% men and 49% women). There were 65.62% partial seizures, 21.87% generalized seizures and 12.5% pseudoseizures. The syndromes found included 60.7% of epilepsies related to site, 5.95% generalized epilepsies, 7% unclassified syndromes and 26.19% special syndromes. Of the symptomatic epilepsies, the commonest etiology was vascular, followed by toxic, tumoral and degenerative. The evolution of the relative prevalence according to age corresponded to three different patterns: ascending (partial crises and special syndromes), descending (pseudocrises and generalized epilepsy) and stable with peaks in middle age (generalized seizures, partial with generalization, unclassified syndromes, symptomatic and cryptogenic partial epileptic syndromes). CONCLUSIONS: The distribution according to seizures is similar to that reported in population studies. Special syndromes are much commoner than that reported in population studies, especially in epilepsies conditioned by the environment. The diagnosis of pseudoseizures are significantly commoner in the group of young adults. Partial seizures and special syndromes tended to be more frequent in older patients, whilst pseudocrises and generalized epilepsies were commoner in younger adults. The remaining seizures and syndromes predominated in the 18 30 year age group.
Adult↗
[Radio-chemotherapy combinations in non operable localized non small cell lung carcinoma: updates and perspectives].
Optimal treatment of non operable localized non small cell lung carcinoma (NSCLC) continues to evolve. Increasing overall survival must evolute through improving local tumoral control and eradication of probable occult metastasis. Historically, median survival varies between 7 and 10 months with a standard conventional fractionated radiotherapy (RT). Induction chemotherapy (CT) followed by RT has demonstrated its superiority over RT alone, modality which is widely utilised. Other studies revealed best results with decreasing metastatic relapses. Three independent meta-analysis confirmed benefit obtained with cisplatin based CT followed by RT that allowed to consider this association as a gold standard. Other authors demonstrated an improvement of local control and survival with concomitant RT-CT or hyperfractionated accelerated RT. Results of all of these new therapeutic modalities still poor. Implication of new CT drugs has conducted for an emergence of new studies finding to demonstrate more encouraging results. Randomized trials are conducted in this way.
Antineoplastic Agents↗
[Solid-cystic pseudopapillary tumor of the pancreas: acute post-traumatic presentation. Case report and review of the literature].
OBJECTIVE: To report an infrequent case of pancreatic pseudopapillary solid-cyst tumor, known as Frantz tumor, discovered after blunt abdominal trauma, and to carry out a review of the literature. BACKGROUND: Frantz's tumor is a very uncommon low-grade malignant papillary-cystic neoplasm of the pancreas that is relatively frequent in young black women and was first described by Frantz in 1959. CASE REPORT: We present the case of a 15-years-old female patient who, 24 h after blunt abdominal trauma, came to the emergency room with intense abdominal and atypical pain and a palpable mass in the left upper quadrant. It was initially diagnosed as a post-traumatic pancreatic pseudocyst. The patient underwent distal pancreatectomy with spleen preservation; the histopathologic report was a pseudopapillary solid and cystic tumor of the pancreas without malignant cells. Clinical evolution has been satisfactory without recurrence of the tumor at 14 months of follow-up. CONCLUSIONS: Frantz's tumor has benign biologic behavior and treatment of choice consists of surgical resection. Outcome after surgical resection is excellent with 90% survival in the long term. Tumoral recurrence has been described in approximately 10% of patients.
Abdomen, Acute↗
[Pancreatectomy for adenocarcinoma: prognostic factors, recommendations for pathological reports].
The ductal adenocarcinoma of the pancreas is a tumor with very poor prognosis, often diagnosed at an advanced stage of evolution. The surgical resection of the tumor is performed in only 15% of the patients but only 10% of them are alive 5 years later. The bad prognostic factors individualized on surgical specimens are the tumor size (>2 cm), lymph node metastases, the poor differentiation of the tumor on microscopic examination, the infiltration of the portal vein and mesenteric vessels by the tumor, the infiltration of the surgical margins, especially the retroperitoneal margin of the tumor. We propose a pre-established form including these items for pathological reports of pancreatectomy for adenocarcinomas.
Adenocarcinoma↗
[Juxtabulbar neurinoma of the spinal accessory nerve].
A 27-year-old woman presented with right spinal accessory juxtabulbar schwannoma, associated with hydrocephalus. The only specific clinical symptom was long-standing weakness of the right trapezius. C.T. scan evoked a cerebellar tumor, whilst the jugular foramen appeared normal. Vertebral angiography was not decisive. M.R.I. suggested an extra-axial tumor. Post-operative evolution was entirely favourable. Schwannomas of the 9th, 10th and 11th cranial nerves are generally located at the level of the jugular foramen but can also be observed along the extracranial path of these nerves. An intracranial paramedial, or so-called "intracisternal" localization is rare and is best diagnosed by magnetic resonance imaging.
Accessory Nerve↗
Adenoid cystic carcinoma with hyperostosis after stereotactic radiosurgery.
Adenoid cystic carcinoma (ACC) of the head and neck is a relatively rare tumor characterized by slow evolution, recurrences, and protracted clinical course. We performed stereotactic radiosurgery in order to palliate symptoms for intraorbital recurrence of ACC that had been treated with total resection of the left parotid gland, radical neck dissection, and conventionally fractionated radiotherapy. We experienced interesting hyperostosis in the area irradiated by the stereotactic radiosurgery.
Carcinoma, Adenoid Cystic↗
[Tuboovaric actinomycosis. A report of a case].
OBJECTIVE: Tuboovaric actinomycosis case report. PRESENTATION PATIENT: eighteen-year-old woman using intrauterine devise for the past two years and with a four months old appendicectomy. Initially, a two month old pelvic tumor with acute abdominal pain and fever was identified. A laparotomy was performed with total pelvic tumor section. A week later, postoperatory colonskin fistula appeared requiring surgery. The histopathology report showed tuboovaric actinomycosis. Therefore, sodic penicillin was used to treat the patient until health was recovered. CONCLUSION: Actinomycosis is characterized by late diagnosis and must be suspected in patients with pelvic tumor exeresis with nonsatisfactory evolution, where intestinal surgery and IUD use are risk factors.
Abdominal Abscess↗
[Metastases in both internal auditive meatus of nasosinusal melanoma].
Primary malignant melanoma of the nasal and paranasal sinusses is rare and represent 3% of malignant nasosinusal tumors. The prognosis of this tumor is poor. The evolution is unpredictable; there is very commonly a series of local recurrences which may be well controlled, followed by remote metastases remaining long quiescent. There are no statistical difference in local control or survival between patients receiving surgery alone and those receiving surgery and radiotherapy. Chemotherapy is used for metastatic forms. We present a case of a patient with a primary malignant melanoma of the nasal mucosa. Tree years after diagnosis we found intracranial metastases in left and right auditive internal meatus.
Brain Neoplasms↗
Microdissection-based allelotyping: a novel technique to determine the temporal sequence and biological aggressiveness of colorectal cancer.
Pathologic staging in colorectal adenocarcinoma (CA) is based on the concept that the timing of metastatic tumor spread is directly related to the depth of the primary tumor invasion. To evaluate the temporal sequence of CA metastasis, we performed microdissection mutational profiling at multiple microscopic sites of primary and metastatic CA specimens. Twenty-one cases of CA were selected from fixed-tissue archives. Primary tumors were microdissected at the deepest point of invasion. Comparative mutational profiling for different genomic loci [1p36(CCM = cutaneous malignant melanoma], 3p26(OGGI = 8 oxoguanine DNA glycosylase), 5q23 (APC, MCC = mutated in colorectal cancer), 9p21(p16/CDKN2A = cyclin-dependent kinase 2A), 10q23(PTEN = phosphatase and tensin homolog [mutated in multiple advanced cancers 11), 12p12(K-ras-2 point mutation), 17p13(TP53), 18q25(DCC= deleted in colorectal cancer) was carried out on each microdissected tissue target using microsatellite loss of heterozygosity determination or DNA sequencing. All primary and metastatic sites of CA manifested acquired mutational change in 18 to 91 per cent of the genomic markers. In 15/21 (71%) cases, metastatic sites lacked a specific allelic loss seen in the corresponding primary tumor, indicating that the metastasis occurred before maximal depth of primary invasion. This was further supported by discordant mutational profiles between primary and secondary tumors, requiring divergent clonal evolution. This is the first report describing the temporal sequence and significance of sequential mutational acquisition in clinical tissue specimens with potential implications for a new molecular pathology approach to classify human cancer.
Adenocarcinoma↗
[A case of bilateral kidney tumor combined with staghorn calculi and skin cancer].
A rare case of bilateral renal tumor with benign clinical evolution, associated with staghorn calculosis and skin cancer, is reported. Delayed operative treatment was due to difficulties in establishing the diagnosis, controversial results of the sonographic and X-ray examination and lack of cooperation by the patients. The right kidney and regional lymph nodes were removed; metastases were verified on histologic examination of the lymph nodes. After the operation the patient received complex radio-, chemo- and hormonal therapy. Basocellular skin cancer which later developed was cured by contact radiotherapy.
Adenocarcinoma↗
Methods of active immunotherapy and viral oncolysis in some forms of cancer.
In some cancers with a high antigenicity (gastric, intestinal, mammary, laryngeal, etc.) the authors associated to the classical treatment an autovaccine prepared by combining the tumoral extract (obtained by trituration, sonication and centrifugation, and stored at -80 degrees C) with some mitogens (phytohemagglutinin) and adjuvants (ovalbumin, tuberculin, lymphocyte promotion factor, etc.) obtaining a greater survival (4-6 years). The association of viruses with an oncolytic action (mumps virus) to the active unspecific immunotherapy in some cancerous structures (peritoneal, pleuropulmonary and synovial malignant mesothelioma, malignant cholangioma of the liver, hepatic metastases of some adenocarcinomas of the colon, gastric cirrhous, clearly differentiated macrocellular carcinomas of the lung, pulmonary mucoid adenocarcinomas, traditional recurrent carcinomas of the urinary bladder), in which all other oncotherapeutic resources have been exhausted, induced slow involution up to disappearance of the tumor and a favourable evolution of the patients without signs-of recurrence after 5-7 years in 73% of cases. To obtain the expected results it is mandatory to comply strictly with certain principles, established by the authors for each of the two original methods, expounded in detail in the text.
Adjuvants, Immunologic↗
[Evaluation of parietal infiltration in carcinoma of the bladder: comparison of MR imaging, CT and histology].
Twenty-two patients with bladder carcinoma were examined by MR imaging and CT to determine the degree of parietal involvement. The results were then compared with the surgical and histological findings. A classification in CT and MR stages was elaborated in order to supply corresponding models to clinical TNM staging. Three groups were thus formed, corresponding to the evolutive phases of the tumor. The first MR group included T1-T2 forms (accuracy: 75%); the second group included T3a forms (accuracy: 75%), and the third T3b-T4 forms (accuracy: 90%). Overall MR accuracy was 81.81%. The first CT group included T1 forms (acc. 71.42%), the second group T2-T3a forms (acc. 60%), and the third group included T3b-T4 forms (acc. 90%). Overall CT accuracy was 77.27%. MR imaging proved thus more accurate than CT in the staging of bladder tumors, especially thanks to its allowing deep muscular involvement to be assessed.
Biopsy↗
[Aspects of healthy and pathologically changed laryngeal epithelium in a model. 2].
Atrophy of laryngeal epithel at aged men can in model according to the literature lead back on prolongation of mitosis cycles. An increasing tendency of cornification and decreasing formation of pegs in range of basilar membrane are also demonstrable. Formation and development of a tumor instance a pathological evolution of tissue in model.
Aging↗
[Sarcomas of the bone and soft tissue: general observations].
The term sarcomas regroups a large variety of malignant tumors originating from the mesenchymal tissues, which represent only 1% of cancers, with a higher relative frequency in children. Whether bone or soft tissue tumors, their preeminent general evolutive characteristics are a high local aggressiveness and a high frequency of hematogenic metastatic diffusion, with a predilection for pulmonary involvement. An improved knowledge of the natural history of sarcomas has led to a better definition of multidisciplinary therapeutical protocols for each particular disease.
Bone Neoplasms↗