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At least 19 recordsLinked to original sources
PubMed1979

Unknown primary adenocarcinoma: incidence of overinvestigation and natural history.

Out of 1300 patients referred to a medical oncology unit, there were 87 with metastatic cancer in whom a primary tumour site was not evident from the history and after physical examination and chest radiography had been carried out. An analysis of the investigations performed in these patients and their results showed that in only eight of the 87 patients did non-surgical investigations at presentation determine the primary site. In two patients it was identified by diagnostic laparotomy, and in a further 13 clinical follow-up led to recognition of the primary tumour site before death. Few investigations should be performed in patients in whom the primary site is known since they have a low yield, and in our population identifying the primary tumour did not improve the outcome or alter management. Treatable tumours should be excluded, and this may be done in most cases by simple blood tests, particularly those measuring acid phosphatase activity and other tumour markers.

Adenocarcinoma↗
PubMed2026

Genetic mutations in metastatic adenocarcinoma of unknown primary.

INTRODUCTION: Although several genomic alterations have been reported in adenocarcinoma of unknown primary (ACUP), molecularly targeted therapies are not yet clinically established, and comprehensive genomic profiling (CGP) is rarely used in daily practice. AIM: We aimed to clarify the molecular landscape and prognostic impact of key mutations in recurrent or metastatic ACUP. MATERIALS AND METHODS: Data from 480 consecutive ACUP patients registered in Japan's National Cancer Center (C-CAT) between June 2019 and August 2025 were analyzed. Somatic mutations were identified using the FoundationOne CDx platform. Overall survival (OS) was assessed by Kaplan-Meier analysis, log-rank tests, and multivariate Cox proportional hazards modeling. RESULTS: The most frequent alterations were TP53 (59.4%), KRAS (31.5%), CDKN2A (26.3%), KMT2D (22.3%), LTK (17.9%), NOTCH3 (16.9%), STK11 (16.3%), CDKN2B (15.8%), ERBB2 (15.4%), and GNAS (15.2%). Patients harbored an average of 17.3 9.9 mutations. Mutations in GNAS (p = 0.046) and PIK3CA (p = 0.025) were associated with better OS, whereas ARID1A (p = 0.049) and NOTCH1 (p = 0.038) predicted worse OS. In Cox analysis, hazard ratios (HR [95% CI]) were 0.57 (0.36-0.92, p = 0.020) for GNAS, 0.57 (0.33-0.96, p = 0.033) for PIK3CA, 1.98 (1.27-3.09, p = 0.0024) for ARID1A, and 1.84 (1.17-2.91, p = 0.0090) for NOTCH1. CONCLUSIONS: GNAS and PIK3CA mutations were linked to favorable outcomes, while ARID1A and NOTCH1 alterations indicated poor prognosis in ACUP. These results highlight the prognostic significance of specific genomic alterations and support integrating CGP into the clinical management of ACUP.

Humans↗
PubMed1979

Adenocarcinoma of unknown primary site: a clinico-pathological study.

An analysis of the clinico-pathological findings in 49 patients with adenocarcinoma of unknown primary origin indicates a short survival time. No factors were identified that influenced survival. Thromboembolic episodes and second primary tumors commonly complicate the clinical course. Metastases in widespread organs are common autopsy findings. Immunological mechanisms may explain these findings.

Abdominal Neoplasms↗
PubMed1979

Phase I clinical and pharmacological study of 4'-(9-acridinylamino)-methanesulfon-m-anisidide using an intermittent biweekly schedule.

4'-(9-Acridinylamino)methanesulfon-m-anisidide (m-AMSA, NSC 249992), an acridine derivative, was given to 28 patients with solid tumors and one patient with Hodgkin's disease in a Phase I clinical trial. The dose schedule used was a single dose given every 14 days for three doses. The amount given ranged from 10 to 120 mg/sq m/dose. Dose-limiting toxicity was moderate to severe leukopenia which occurred at and above 70 mg/sq m. Thrombocytopenia was infrequent and did not require transfusion. Nonhematological side effects were mild and included nausea, vomiting, local irritation, and fever. Antineoplastic activity was noted in liposarcoma, adenocarcinoma of unknown primary origin, and squamous carcinoma of unknown primary origin (one patient each). Pharmacokinetics studies were done in 19 patients. Total m-AMSA and free m-AMSA concentrations showed a biphasic distribution with an initial rapid phase of t1/2 = 10 to 15 min for both, and a second slow phase of t1/2 = 8 to 9 hr for total m-AMSA and 3 hr for free m-AMSA. Phase II studies with m-AMSA, in hematological cancers are warranted, since its most consistent effect is on leukocytes. The recommended dosages for solid-tumor Phase II studies are 70 mg/sq m for good-risk patients and 50 mg/sq m for poor-risk patients, given as a single dose every other week, or 120 mg/sq m for poor-risk patients for the single-dose every-3-week schedule.

Acridines↗
PubMed1977

Colonic neoplasms: tissue estrogen receptor and carcinoembryonic antigen.

Estrogen receptor protein was found in 24% of colonic neoplasms. Presence of estrogen receptor activity was independent of age or sex of the patient, state of differentiation or spread of the tumor, and concentration of carcinoembryonic antigen in the tumor. Estrogen receptor activity in colon tumors probably reflects novel protein synthesis resulting from dedifferentiation. Measurement of tumor estrogen receptor protein and carcinoembryonic antigen may have discriminatory value in the patient with metastatic adenocarcinoma and an unknown primary neoplasm.

Adenocarcinoma↗
PubMed1978

Adenoacanthoma of the pancreas: report of four cases and literature review.

Cases of 20 patients with adenoacenthoma of the pancreas with clinicopathologic data, including the four added, are reviewed. The clinical manifestations, sites of metastases, survival and gross pathology appear to be similar to the usual adenocarcinoma of the pancreas. Adenoacanthoma of the pancreas most probably represents squamous metaplasia of an adenocarcinoma or arises from an undifferentiated cell in the pancreatic duct system. The metastases are typically an admixture of both elements but in four cases, pure squamous or adenocarcinoma metastases were encountered. It is suggested that the pancreas should be included as a possible source in those patients with an unknown primary who have a metastasis consisting of either an admixture of squamous and glandular elements or a pure squamous type and in those instances in which a pure squamous and a pure adenocarcinoma are encountered in different metastases.

Adenocarcinoma↗
PubMed1978

Osteoblastic bone metastases secondary to adenocarcinoma of the pancreas.

The incidence of bone metastases secondary to adenocarcinoma of the exocrine pancreas is unknown since radiological studies of the bones during life, routine bone scintigrams or extensive examination of the skeleton at autopsy is rarely undertaken in the absence of specific clinical indications. Symptom-producing bone metastases are relatively uncommon; a review of the literature suggests that the vast majority are osteolytic in nature with only a few isolated case reports of purely blastic deposits. In the authors' experience osteoblastic bone metastases are commoner than is generally recognised. Of 12 patients with symptom-producing bone deposits secondary to adenocarcinoma of the pancreas, five (41.6%) were purely blastic in nature. The clinical, radiological and pathological findings in these five cases are reported in order to emphasise that the pancreas is a potential source of purely blastic bone metastases and should be considered as a possible primary site in patients who present initially with osteoblastic bone deposits of unknown origin.

Adenocarcinoma↗
PubMed1978

[Adenocarcinomas of unknown origin. Study of 17 autopsies (author's transl)].

This article reports on the autopsy results of 17 patients with adenocarcinomas from occult primary tumours: 10 are of bronchial origin, 3 of renal origin, 1 of hepatic origin, 1 of ovarian origin, and 1 of pancreatic or bronchial origin. In one case no primary tumour was found. Factors which can lead the clinicians toward further investigations are the location or nature of the first clinical signs (neurological and respiratory for bronchial cancers, subdiaphragmatic for primary abdominal tumours) and smoking habit (bronchial carcinoma in smokers).

Adenocarcinoma↗
PubMed1977

Estrogen receptor assay in the differential diagnosis of adenocarcinomas.

Estrogen receptor determination by the sucrose gradient method was applied to 295 tumor tissues of various origins. Estrogen receptor of the 8 S type was found only in adenocarcinoma of the breast, uterus, and ovary. Of 19 patients with metastatic carcinoma of unknown origin, four benefited from estrogen receptor study (ie, appropriate therapy could be initiated) and one was helped retrospectively on the clinical diagnosis. Estrogen receptor assays may also be useful in determining whether bilateral breast involvement represents two primary lesions or metastasis. Estrogen receptor studies should be included in evaluating cancers of unknown origin in female patients.

Adenocarcinoma↗
PubMed1976

Control of local and regional subclinical disease by radiation therapy.

An irradiation dose of 5000 rads in 5 weeks appears to be highly efficient for eradication of subclinical disease in the oropharynx or nasopharnyx. Irradiation alone in the range of 4500 to 5000 rads, five treatments per week, 4 1/2 to 5 weeks, appears to be greater than 90% efficient for eradicating subclinical disease for both squamous-cell carcinoma and adenocarcinoma in regional lymph nodes. The site of origin of the primary squamous-cell carcinoma or adenocarcinoma seems to be independent of the response in the regional lymph nodes. It is unknown whether concomitant elective chemotherapy will modify the dose for control required for subclinical disease in squamous-cell carcinoma or adenocarcinoma.

Adenocarcinoma↗
PubMed1979

Adenocarcinoma of unknown origin. A rational approach to a diagnostic puzzle.

Determination of the tissue of origin of disseminated adenocarcinoma is often difficult. Careful clinical evaluation of the patient in light of known characteristics of certain primary tumors, followed by appropriate screening tests, may yield decisive information. If not, a decision for or against more specific tests must be made.

Adenocarcinoma↗
PubMed1979

[Cervical lymph nodes metastasis from an unknown primary: diagnosis, treatment and prognosis. A retrospective study of 127 cases observed from 1959 to 1973 (author's transl)].

Authors present clinical records of 127 patients bearing metastatic cervical lymph nodes of unknown origin and referred to the Cl. Regaud Cancer Center between 1959 and 1973. According the prognosis, it is possible to distinguish patients into three groups. In group I, patients (10%) have a lower neck involvement by an adenocarcinoma. The survival is dramatically bad. Group II includes also 10% of patients who have a fairly better prognosis, they are younger people bearing poorly differenciated squamous metastatic lymphonode(s) in the upper neck. Group III. The remaining eighty per cent of patients are heavy drinkers and smokers. Their upper neck is hurt by lymphatic metastases from a well or moderately differenciated squamous cell carcinoma. They have much about the same prognosis than people bearing a known primary carcinoma of the upper aerodigestive tract. After having excluded the first group of patients who is at high risk of having a widely disseminated illness, we can remark that about one half of relapses occurred in the cervical area. A well planned combination of neck dissection and whole cervical lymphatic areas irradiation may further reduce such recurrences and so may enhance the present results: 23% survival 3 years after completion of treatment.

Adenocarcinoma↗
PubMed1978

Carcinoma of unknown primary: natural history and response to therapy.

Twenty-three consecutive patients with metastatic carcinoma of unknown primary referred to a medical oncology service over the past two years were studied. In the majority of patients, death occurred within one year of diagnosis and a priamry site of disease was identified at postmortem examination. Of patients who had a primary site identified, findings suggestive of involvement of that site were present during the course of their illness. Survival was greatest in patients with adenocarcinoma histology, with lymph node site of presentation and in those treated with both radiation therapy and chemotherapy, although these differences were not statistically significant. Despite the prolonged survival of a few patients, it is clear that failure to extensively evaluate subtle clinical findings and the lack of efficacious therapy for the malignancies commonly encountered seriously limit the survival of the vast majority of these patients. The identification of new tumor markers and the use of adjunctive chemo-immunotherapy to excisional surgery may ultimately improve to outlook for these patients.

Adenocarcinoma↗
PubMed1979

Multiple adenocarcinomas and premalignant changes in "backwash" ileitis.

In a patient with long-staning ulcerative colitis and "backwash" ileitis, multiple carcinomas developed in the colon and ileum. In both locations premalignant mucosal changes of the basal cell proliferation type were seen adjacent to and remote from sites of carcinoma. Although the frequency of such premalignant and malignant changes in "backwash" ileitis is unknown, their concurrence in this case suggests that ulcerative colitis involving the terminal ileum increases the risk of small bowel carcinoma.

Adenocarcinoma↗
PubMed1979

[Computerized tomography in the evaluation (author's transl)].

CT can clearly demonstrate dilation of intra- and extra-hepatic bile ducts due to mechanical obstruction. Note is made that the intrahepatic bile must not necessarily participate in dilation in obstructive jaundice. The cause in 27 cases observed in our institutions was as follows: 16 pancreatic tumors; 1 stone; 2 extrahepatic bile duct obstructions; 4 liver lesions (tumor and cirrhosis) and 4 with cause unknown. Furthermore, CT is helpful in the evaluation of hepatogenic non-obstructive jaundice such as due to primary liver cell carcinoma (hepatoma), metastases to the liver and advanced cirrhosis of the liver. The value of CT in the evaluation of different types of cholestasis is demonstrated by several exemplary cases; and the problems of differential diagnosis are pointed out.

Adenocarcinoma↗
PubMed1979

Metastasis to neck from unknown primary tumor.

The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance.

Adenocarcinoma↗
PubMed1979

Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roentgenographic procedures.

Two hundred sixty-six patients with metastatic nonsquamous carcinoma of unknown origin underwent upper and lower gastrointestinal series, intravenous pyelograms, and chest roentgenograms (CR) for location of a primary cancer site. Of 129 identified cancer sites, only 22 were verified antemortem, whereas necropsy disclosed 25 cases with false-positive examination results. The CR patterns thought typical for lung cancer (eg, single mass lesion and hilar or mediastinal adenopathy) were often shown (43%) to represent metastatic lesions. Because contrast roentgenographic studies are costly, uncomfortable, of low yield, and often misleading, they should be limited to cases with specific organ dysfunction.

Adenocarcinoma↗