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PubMed2000

Expression of promyelocytic leukaemia protein in thyroid neoplasms.

AIMS: Promyelocytic leukaemia protein (PML) is an oncoprotein involved in the pathogenesis of acute promyelocytic leukaemia and is localized in distinct PML nuclear bodies. Our previous observation of overexpression of the PML in hormone-sensitive normal tissues and malignant solid tumours, including the thyroid, led to this analysis of the PML expression in various thyroid neoplasms to characterize the importance of the PML in thyroid carcinogenesis. METHODS AND RESULTS: Immunohistochemistry was performed on paraffin-embedded tissue samples from 106 thyroid neoplasms after antigen retrieval by microwave. Immunoblotting was done with fresh frozen tissues in a few tumours. The PML was strongly expressed in all papillary carcinomas in diffuse or ball-shaped patterns. In the follicular neoplasms, the PML expression was variable, but there was no significant difference between adenomas and carcinomas. In the medullary carcinomas, the PML expression was either not detectable or was lower than in non-neoplastic thyroids. Quantitatively different expression of the PML in various thyroid neoplasms was confirmed by immunoblotting. CONCLUSION: A significant difference of the PML expression according to the type of thyroid neoplasms suggests that the PML is important in papillary thyroid carcinomas, and furthermore, that PML expression may be used in differential diagnosis of thyroid neoplasms.

Adenocarcinoma↗

PubMed2000

Membranous expression of glucose transporter-1 protein (GLUT-1) in embryonal neoplasms of the central nervous system.

The human erythrocyte GLUT-1 is a transmembrane protein which facilitates transport of glucose in the cell in an energy-independent fashion. Neuroectodermal stem cells show strong membrane immunoreactivitry with this marker at early developmental stages in rodents. Membranous expression by undifferentiated neuroectodermal cells gradually decreases while GLUT-1 becomes confined to the endothelial cells, when these acquire blood-brain barrier function. We thus sought to determine whether GLUT-1 expression was limited to embryonal neoplasms of the central nervous system (CNS) which are presumably derived from developmentally arrested neuroectodermal stem cells. Archival material of 40 primary CNS neoplasms were examined for immunoreactivity with anti-GLUT-1. This included both non-embryonal neoplasms (18 astrocytic tumours, one ependymoma and three oligodendroglioma) and embryonal neoplasms (12 cerebellar medulloblastomas, four supratentorial PNETs and two atypical teratoid/rhabdoid tumours (AT/RhT)). In addition, cell lines and nude mice xenografts derived from both undifferentiated and differentiated tumours were assessed for GLUT-1 immunoreactivity by both immunohistochemistry and Western blotting. All embryonal tumours, MBs and PNET xenografts consistently showed GLUT-1 membrane staining. Non-embryonal neoplasms were negative except for vascular staining. Membrane protein fraction of embryonal tumours cell lines immunoreacted by immunoblot with GLUT-1, whereas the glioblastoma cell line was negative. Expression of GLUT-1 supports the stem cell nature of the cells of origin of MBs, supratentorial PNET and AT/RhTs. As a result, GLUT-1 is a useful marker to define the embryonal nature of CNS neoplasms.

Animals↗

PubMed2002

Functioning adrenocortical neoplasms in children.

OBJECTIVE: To describe the clinical features, treatment and outcome of functioning adrenocortical tumours in children, and to assess the value of tumour size as a marker for malignant potential. PATIENTS AND METHODS: Twenty-one children (mean age at presentation 4.9 years, range 0.6-11; 12 girls and nine boys) who presented with a functioning adrenal mass over a 29-year period (1972-2000) were assessed. Clinicopathological features and outcome information were obtained from a structured review of the case-notes. Before 1980 the diagnosis and staging was mainly obtained by intravenous pyelography and plain X-ray. Since 1980, ultrasonography, computed tomography and more recently magnetic resonance imaging were the methods of choice. RESULTS: The mean (range) duration of symptoms before diagnosis was 31 (2-108) months. The symptoms and signs at presentation comprised virilization (18 children), Cushingoid features (three), precocious puberty (three) and hypertension (four). Three children had malignant neoplasms, one presented with metastasis and of the other two, one died from the disease within 6 months, despite adjuvant chemotherapy and radiotherapy. The third girl is disease-free 11 years after complete excision of the neoplasm. Eighteen children had a benign neoplasm and all are alive and free of recurrence. In most of the children surgical extirpation was relatively simple, blood loss minimal, recovery uneventful and the hospital stay short (mean 5 days). The virilizing effects of all the neoplasms gradually resolved after surgery within a median (range) of 27 (6-108) months. CONCLUSIONS: Functioning adrenocortical neoplasms in children are rare, with a peak incidence in the first decade, are predominantly unilateral and more common in girls. Most are benign, but both benign and malignant lesions can present with virilizing and Cushingoid features. The malignant neoplasms have an extremely poor prognosis, especially if excision is incomplete, despite adjuvant chemotherapy and radiotherapy. Although there is an association between tumour size and malignancy, this cannot be used as a reliable individual discriminator.

Adrenal Cortex Neoplasms↗

PubMed2001

Trichoblastic carcinoma: a report of two cases of a deeply infiltrative trichoblastic neoplasm.

BACKGROUND: Trichoblastoma is a benign neoplasm with primitive hair follicle differentiation. The tumor is characterized by nests and cords of epithelial cells in an organized relationship with stroma. Some of the epithelial cells resemble follicular germ and other cells show follicular sheath differentiation. The neoplasm is symmetrical and well circumscribed. In addition, cytologic examination shows no atypia. Concept of its malignant counterpart is poorly understood. OBJECTIVE: We report two trichoblastic neoplasms that show histologic features of malignancy. METHODS: Skin biopsies from the lip region of a 53-year-old female and a 74-year-old male who had presented with the neoplasms in that location for several years were reviewed. Excised specimens measured 2 x 1 x 1 cm and 1.6 x 0.7 x 0.8 cm respectively. RESULTS: The histologic sections revealed locally aggressive neoplasms showing prominent differentiation towards hair germ and follicular sheath with formation of papillary mesenchymal bodies, follicular bulb-like structures, small keratin cysts and rare malformed hair shaft. The neoplasm showed asymmetry of architecture and massive subcutaneous and muscular infiltration. CONCLUSION: With demonstration of these two cases and references of few other reported cases we raise the possibility of existence of trichoblastic carcinoma that is distinct from basal cell carcinoma.

Aged↗

PubMed1992

New developments in the pathologic diagnosis of adrenal cortical neoplasms. A review.

In the past decade, our knowledge of neoplasms arising in the adrenal cortex has been expanded greatly. Histologic criteria for distinguishing benign from malignant adrenal cortical neoplasms have been developed. In this review, three systems useful in making this distinction are reviewed and compared. Pathologic indicators of prognosis for adrenal cortical carcinomas have been proposed and these include mitotic rate, stage, surgical resectability, nuclear grade, and tumor size. Of these, mitotic rate appears to be the best indicator. Adrenal cortical carcinomas with a high mitotic rate behave most aggressively. The role of immunohistochemical and DNA content analysis in the diagnosis of adrenal cortical neoplasms is limited. Neoplastic adrenal cortical cells contain a low density of keratins that is often destroyed by routine fixation and paraffin embedding. Thus, the absence of keratins in adrenal cortical neoplasms, particularly carcinomas, in routinely processed tissue should not dissuade the pathologist from making the diagnosis of an epithelial neoplasm. DNA content analysis has revealed an imperfect correlation between DNA ploidy and histologic diagnosis. Some adrenal cortical adenomas contain aneuploid stem cell lines, whereas some adrenal cortical carcinomas have diploid DNA content. Molecular genetic analyses suggest that one or more tumor suppressor genes may be involved in the pathogenesis of adrenal cortical neoplasms.

Adrenal Cortex Neoplasms↗

PubMed2002

Gamma delta T-cell neoplasms: a clinicopathological study of 11 cases.

BACKGROUND: The majority of T-cell neoplasms express T-cell antigen receptor (TCR) alpha beta on their cell surface, and a few cases show the TCR gamma delta phenotype. Recently, a variety of gamma delta T-cell neoplasm was recognized; however, its clinicopathological features have not been extensively analyzed. Here we report the results of a clinicopathological study of 11 cases of gamma delta T-cell neoplasm. PATIENTS AND METHODS: During the 11-year period from 1989 to 1999, 104 patients with T-cell neoplasms were examined by flow cytometric analysis and/or immunohistochemical analysis. Tumor cells from all 104 patients expressed one or more of the T-cell antigens-CD2, CD3, CD5 and CD7. Forty-nine of the 104 cases of T-cell neoplasms were examined immunophenotypically for TCR alpha beta/gamma delta subsets. RESULTS: Expression of TCR gamma delta on tumor cells was found in five (33%) of 15 patients with precursor T-cell lymphoblastic leukemia/lymphoma, one (25%) of four with T-cell granular lymphocytic leukemia and five (26%) of 19 with peripheral T-cell lymphoma (PTCL), whereas no expression was found in 11 patients with adult T-cell leukemia-lymphoma. Primary sites of the five patients with gamma delta PTCL were as follows: lymph node, three; skin, one and liver, tonsil and skin, one. The courses of the three patients with gamma delta PTCL of nodal onset were very short (3, 5 and 9 months, respectively), and they were all resistant to combination chemotherapies. CONCLUSIONS: Although gamma delta T-cell neoplasm constitutes a heterogeneous population, it is important to examine the expression of TCR with the view to identifying possible poor prognostic subgroups, such as primary nodal gamma delta T-cell lymphoma.

Adolescent↗

PubMed1994

Oncogene expression in hepatic and biliary neoplasms of the fish Rivulus ocellatus marmoratus: correlation with histologic changes.

One day old mangrove rivulus (Rivulus ocellatus marmoratus) were exposed to 9 mg/l diethylnitrosamine (DEN) for 6 weeks, kept in water without DEN for an additional 18-20 months, then necropsied. Oncogene expression was detected by immunohistochemical staining of freeze-dried cryofixed livers. Positive controls for immunohistochemistry included tumors grown by injecting athymic nude mice with cell lines having known oncogene expression. Livers from 15 DEN-exposed fish contained 178 altered foci and neoplasms; 48% of these lesions over-expressed Ras, Myc, Fos, p53 or epidermal growth factor receptor (EGFR). Raf overexpression was not detected. Myc overexpression was positively correlated (P < 0.05) with smaller hepatocyte size in both hepatocellular neoplasms and in altered foci. Increased EGFR expression occurred primarily in inflamed lesions. Increased Ras expression in hepatocellular neoplasms was correlated with anaplasia, gamma-glutamyltranspeptidase activity and lesions that contained mixed acinar and trabecular profiles. Accumulation of p53 occurred more often in neoplasms than in altered foci and correlated with unusual cytoplasmic vacuoles. In hepatocellular neoplasms, Fos overexpression was correlated with increased cell diameter, nuclear pleomorphism, and enlarged nucleoli. Only 1/14 biliary neoplasms overexpressed an oncoprotein (Myc). None of the changes in oncoprotein expression were correlated with cell proliferation (bromodeoxyuridine staining). Although several of the correlations found in mangrove rivulus also occur in mammals, the general relevance of some of our findings can be determined only after they are confirmed in other species.

Amino Acid Sequence↗

PubMed2005

Endoscopic sinus surgery for benign and malignant nasal and sinus neoplasm.

PURPOSE OF REVIEW: Endoscopic sinus surgery has become widely accepted as the standard of treatment for chronic inflammatory diseases of the paranasal sinuses unresponsive to medical treatment. With increased skill with endoscopic surgical technique, advanced technologies such as intraoperative imaging systems, and a better understanding of the complex anatomy of the paranasal sinuses and surrounding vital structures, many otolaryngologists have increasingly applied their expertise in endoscopic sinus surgery to the resection of nasal and sinus neoplasms. The following represents a review of the recent literature on the latest trends regarding endoscopic resection of nasal and paranasal sinus neoplasms. RECENT FINDINGS: There has been an increasing popularity in the removal of nasal and paranasal sinus neoplasms through an endoscopic approach. In the recent literature, emphasis has been on the endoscopic surgery of benign tumors, especially inverted papilloma and nasopharyngeal angiofibroma. Other benign neoplasms have also been reported, but only in small case reports. There have been a few recent reports supporting endoscopic removal of malignant neoplasms as well. However, the follow-up is too short and study groups too small to make definitive conclusions. SUMMARY: In the hand of experienced and skilled surgeons, complete endoscopic removal is attainable in most cases. Especially for the more common benign neoplasms, such as inverted papilloma and early stage angiofibroma. En bloc resection is not necessary to achieve oncologic cure. However, several factors have to be considered before selection of this surgical approach. Large tumor size, intracranial or orbital extension, and extensive frontal or infratemporal fossa involvement are relative, but not absolute limitations.

Angiofibroma↗

PubMed1996

Neoplasms with sweat gland differentiation express various glycoproteins of the carcinoembryonic antigen (CEA) family.

Carcinoembryonic antigen (CEA) is a well-established marker for sweat gland differentiation in adnexal neoplasms. In contrast to previous assumptions, CEA does not represent a single oncofetal antigen but comprises a family of homologous glycoproteins, i.e. the classical CEA-180, biliary glycoprotein (BGP), and non-specific crossreacting antigens (NCA). The aim of the study was to evaluate the distribution of the respective glycoproteins of the CEA family in sweat gland neoplasms, as compared to normal sweat glands. A panel of mono-specific antibodies was applied to a total of 83 samples of hyperplastic and cystic alterations of sweat glands, sweat gland neoplasms, and cutaneous metastases of different origin. Within a single group of neoplasms the immunohistochemical profile was rather consistent. Staining for both CEA-180 and NCA-90 indicated ductal differentiation of both eccrine and apocrine glands. Co-expression of CEA-180, NCA-90, and BGP was consistent with differentiation towards the secretory part of eccrine glands or the transitional portion of proximal ducts. Neoplasms with signs of apocrine secretion showed a preferential immunoreactivity for NCA-90 and BGP. In conclusion, a specification of the members of the CEA family may be of some value in the differential diagnosis of adnexal neoplasms, but not in the discrimination of sweat gland carcinoma from metastatic carcinoma.

Adnexal Diseases↗

PubMed2006

[Analysis of the characteristics of patients with bladder cancer diagnosed of multiple neoplasms in the health district of León (Spain)].

OBJECTIVE: We analyzed the characteristics of the patients with bladder neoplasms who developed a multiple malignant primary neoplasm (MMPN) in the health district of León, the impact on survival and the prognostic variables. MATERIAL AND METHODS: We have used the data from the Tumor Registry of the Hospital of León and selected all those patients who were diagnosed of a bladder tumor between 1993 and 2002. They were classified into two groups: the first with 71 patients with MMPN and a second group with 159 patients with single bladder tumors diagnosed between 1996 and 1997. RESULTS: Incidence of MMPN was of 7.1 percent. More than half of the patients had familial oncologic background. The second most frequently diagnosed neoplasms were urologic, followed by gastrointestinal and respiratory. Survival of patients with MMPN was 21 percent lower than single neoplasms. Variables with prognosis significance were the stage of the second neoplasm, diagnosis of a second urologic neoplasm and surgery treatment for the second tumor. CONCLUSIONS: MMPN in patients with bladder tumors are frequent in our geographic area. The high frequency of familial oncologic antecedents in these patients suggest a genetic background. Prognosis of MMPN patients is worse than single tumors patients, but no differences were observed regarding prognosis in patients with synchronous or metachronous MMPN.

Aged↗

PubMed1992

Spontaneous brain and spinal cord/nerve neoplasms in aged Sprague-Dawley rats.

Primary malignant neoplasms of the brain and spinal cord occurred in 20/718 male (2.8%) and in 13/717 female (1.8%) Crl:CD Br strain Sprague-Dawley rats. Of 33 neoplasms, 30 were found in brain while 3 were in the spinal cord. In males and females, the most common brain neoplasm was astrocytoma (13 males, 9 females). Other neoplasms, granular cell tumor (1 male), mixed glioma (2 males, 1 female), reticulosis (1 male, 2 females), and oligodendroglioma (2 males), were especially uncommon. Spinal cord neoplasms included 2 schwannomas (1 male, 1 female) and an astrocytoma (1 male). The overall brain neoplasm incidence was similar for males (2.8%) compared to data compiled for this strain, and there was a 2-fold increase for females (1.8% vs 0.9%) compared to available incidence data.

Aging↗

PubMed1993

Histopathologic features and post-surgical sequelae of 57 cutaneous neoplasms in ferrets (Mustela putorius furo L.).

The study of the signalment, histomorphologic features, and post-surgical clinical progress of 57 cutaneous neoplasms in 55 domestic ferrets (Mustela putorius furo L.) was based on diagnostic pathologic accessions (1987-1992) from 142 ferrets. Mean age of the group was 4.3 years; 31/54 (57%) were female and 23/54 (43%) were male. Thirty-three (58%) of the cutaneous neoplasms were basal cell tumors. The mean age of ferrets with basal cell tumor was 5.2 years, and 23/33 (70%) were female. Histologically, the basal cell tumors were composed of well-differentiated basaloid epithelial cells with various degrees of squamous and sebaceous differentiation, similar to those seen in basal cell neoplasms of dogs. Nine of the 57 (16%) cutaneous neoplasms were mastocytomas. The mean age of ferrets with mastocytoma was 4.1 years; four were male, four were female, and the sex of one was unrecorded. Histologically, the mastocytomas were composed of well-differentiated mast cells with few eosinophils, similar to cutaneous mastocytomas of domestic cats. The mast cells had a small number of metachromatic cytoplasmic granules, and in six of eight neoplasms the granules had an affinity for conjugated avidin-peroxidase. Six of the cutaneous neoplasms (11%) were fibromas. The mean age of ferrets with fibroma was 2.7 years; 5 (83%) were male. Two cutaneous hemangiomas (4%) were in females, which were 4 and 5 years of age. There was one each hemangiosarcoma, cutaneous polyp, anal gland adenocarcinoma, lymphosarcoma of the prepuce and inguinal lymph node, and adenocarcinoma of the prepuce.

Animals↗

PubMed2025

Thyroid disease and breast cancer, benign breast neoplasm: a two-sample Mendelian randomization study.

BACKGROUND: Breast cancer (BC) is a prevalent and significant health issue and a major contributor to global cancer incidence, accounting for 31% of all reported cases in women. Benign breast neoplasm, as a benign tumor with a high incidence in women, may play an important role in the development of BC. Previous studies have shown that thyroid dysfunction and thyroid cancer (TC) can lead to the occurrence of many cancers. Therefore, we conduct Mendelian randomization (MR) analysis to explore the causality of thyroid dysfunctions, TC, and breast neoplasm. METHODS: The data of the analysis from the genome-wide association study (GWAS) dataset. The exposure includes FT4, TSH, hypothyroidism, hyperthyroidism, and TC. Meanwhile, the outcome consists of BC, HER2-enriched BC, HER2-negative BC, and benign breast neoplasm. We used five methods (inverse variance weighted (IVW) random effects model, IVW fixed effects model, MR-Egger method, median weighted method, and the weighted mode method). We used the MR-PRESSO test and MR-Egger intercept test to detect horizontal pleiotropy and Cochran's Q test to detect heterogeneity. RESULTS: The IVW method showed a positive relationship between high FT4 levels and BC (OR = 1.210 p = 0.008) and an inverse association between TSH levels (OR IVW = 0.908 p = 0.007), hypothyroidism (OR IVW = 0.959, p = 0.014) and BC. For HER2-positive BC, an elevated FT4 level was associated with an increased risk (OR IVW = 1.314, p = 0.001). Genetically predicted high TSH levels (OR IVW = 0.899, p = 0.02) and hypothyroidism (OR IVW = 0.944, p = 0.003) were associated with a decreased risk of HER2-positive BC. Meanwhile, individuals with TC (OR = 1.003, p = 0.048), and hyperthyroidism (OR IVW = 1.127, p = 0.006) were associated with an increasing risk of development of benign breast neoplasm. Hyperthyroidism was associated with an elevated risk of benign breast neoplasm. CONCLUSIONS: The present MR study explains the association between thyroid diseases and BC (mainly in HER2-positive BC). Furthermore, it demonstrates that hyperthyroidism, low levels of TSH, and TC may contribute to the development of benign breast neoplasm.

Humans↗

PubMed1998

Polymerase chain reaction-based microsatellite polymorphism analysis of follicular and Hürthle cell neoplasms of the thyroid.

Follicular and Hürthle cell carcinomas of the thyroid cannot be differentiated from adenomas by either preoperative fine needle aspiration or intraoperative frozen section examination, and yet there exist potentially significant differences in the recommended surgical management. We examined, by PCR-based microsatellite polymorphism analysis, DNA obtained from 83 thyroid neoplasms [22 follicular adenomas, 29 follicular carcinomas, 20 Hürthle cell adenomas (HA), and 12 Hürthle cell carcinomas (HC)] to determine whether a pattern of allelic alteration exists that could help distinguish benign from malignant lesions. Alterations were found in only 7.5% of informative PCR reactions from follicular neoplasms, whereas they were found in 23.3% of reactions from Hürthle cell neoplasms. Although there were no significant differences between follicular adenoma and follicular carcinoma, HC demonstrated a significantly greater percentage of allelic alteration than HA on chromosomal arms 1q (P < 0.001) and 2p (P < 0.05) by Fisher's exact test. The documentation of an alteration on either 1q or 2p was 100% sensitive and 65% specific in the detection of HC (P < 0.0005, by McNemar's test). In conclusion, PCR-based microsatellite polymorphism analysis may be a useful technique in distinguishing HC from HA. Potentially, the application of this technique to aspirated material may allow this distinction preoperatively and thus facilitate more optimal surgical management. Consistent regions of allelic alteration may also indicate the locations of critical genes, such as tumor suppressor genes or oncogenes, that are important in the progression from adenoma to carcinoma. Finally, this study demonstrates that Hürthle cell neoplasms, now considered variants of follicular neoplasms, differ significantly from follicular neoplasms on a molecular level.

Adenocarcinoma↗

PubMed2002

Urothelial neoplasms of the kidney and ureter. An epidemiologic, pathologic, and clinical review.

Urothelial neoplasms occur with varying frequency at different sites along the urothelial tract. Approximately 5% of urothelial neoplasms occur in the kidneys and ureters, while the majority of these tumors occur in the urinary bladder. Consequently, urothelial disease of the bladder has been evaluated to a greater extent than urothelial tumors elsewhere, and many of the features of bladder urothelial neoplasms have been applied to these tumors at other sites. While the classification of urothelial neoplasms is the same for tumors in the bladder, kidney, and ureter, there are some features of urothelial neoplasms of the kidney and ureter that are unique to these sites. An epidemiologic, pathologic, and clinical review of urothelial neoplasms of the kidney and ureter is presented.

Humans↗

PubMed2004

Clusterin, a marker for anaplastic large cell lymphoma immunohistochemical profile in hematopoietic and nonhematopoietic malignant neoplasms.

We evaluated the immunohistochemical staining profile of clusterin in paraffin sections of 143 neoplasms (non-Hodgkin lymphoma, 83, including 41 anaplastic large cell lymphomas [ALCLs]; Hodgkin lymphoma, 17; primary and metastatic carcinoma, 30; and other neoplasms, 13). In 40 of 41 ALCLs (34 systemic, 7 cutaneous), neoplastic cells revealed clusterin reactivity characterized by a Golgi staining pattern. The proportion of reactive cells varied with more than 25% positive cells in the majority of cases. In 7 non-Hodgkin lymphomas of other types, fine cytoplasmic (3 cases) or strong membranous reactivity (4 cases) was observed for clusterin. In Hodgkin lymphoma, rare Reed-Sternberg cells exhibited focal cytoplasmic or membranous clusterin positivity. In the nonhematopoietic neoplasms, a Golgi staining pattern was apparent in only 2 cases, 1 lobular carcinoma of the breast and 1 poorly differentiated colonic carcinoma; however, cytoplasmic reactivity was noted in 12 of 30 carcinomas and 1 of 5 neuroendocrine neoplasms. A Golgi pattern of reactivity for clusterin seems highly characteristic of ALCL among hematopoietic neoplasms, but also might be observed in rare nonhematopoietic tumors, necessitating the use of a broad immunohistochemical panel for evaluation of poorly differentiated neoplasms of indeterminate derivation.

Adolescent↗

PubMedDate not supplied

[Multiple primary neoplasms in colorectal cancer patients] .

INTRODUCTION: Multiple primary neoplasms are defined as a second malignance having histology and site different from the first. The increase of the life expectation in cancer patients leads to an increase in multiple primary neoplasms incidence. This study analyzes the characteristics of patients with colorectal cancer and another primary neoplasms. PATIENTS AND METHODS: In the period from 1993 to 1998, 145 patients with colorectal cancer were accompanied in the Oncology Division of Gastroenterology of Federal University of São Paulo, São Paulo, SP, Brazil. Five patients (3.4%) had multiple primary neoplasms. The possibility of metastasis were excluded and the second cancer was confirmed by hystological examination. RESULTS: The medium age was of 60.6 years old, four were female and one male. Three had rectum cancer and two colon cancer, one in the right colon and one in the left colon. The other site of cancer was breast, uterus, uterus and vagina, skin and lip. One patient died and the others were in attendance, two for more than three years. Two patients received pelvic radiotherapy before the rectal cancer. In one patient the tumor colorectal cancer appeared before the other cancer, and in four it appeared later on to the diagnosis of the other primary neoplasia. DISCUSSION: The prevalence of multiple primary neoplasms was of 3.4%, being major in female. Uterus' cancer was the more frequent association. Radiotherapy was performed in 40% of patients. We believe that attendance of cancer patients is very important to precocious diagnosis and treatment of multiple primary neoplasms.

Adenocarcinoma↗

PubMed2006

Review of scalp alopecia due to a clinically unapparent or minimally apparent neoplasm (SACUMAN).

Neoplastic cells, both malignant and benign, local occurring and metastatic, can cause alopecia of the scalp. However, the infiltration of neoplastic cells is sometimes not florid; a condition known as "scalp alopecia due to a clinically unapparent or minimally apparent neoplasm" (SACUMAN). Neoplastic cells can nevertheless destroy hair follicles by inducing fibroplasias via inflammatory mediators, attracting inflammatory cells and/or replacing normal cellular populations. The infiltrative nature of such an alopecia can be unapparent or only minimally apparent. The most common neoplasm in which an uncomplicated, minimally or unapparent scalp alopecia occurs and no infiltrate of cancer is suspected is metastatic breast carcinoma. Other causes include squamous and basal cell carcinomas, angiosarcoma, gastric carcinoma, placental site tromphoblastic tumor, and mycosis fungoides. Syringoma-like proliferations can underlie alopecia. It is unclear whether these proliferations are true syringomas or normal findings. In conclusion, neoplasms causing cicatricial alopecia of the scalp are very rare, so generalizations from the limited number of case reports are of uncertain importance. Moreover, it is likely that many cases of neoplasms causing cicatricial alopecia of the scalp are diagnosed as inflammatory alopecia and not neoplasms, thus depriving us of a full accounting and understanding of this entity. Dermatologists must be aware that in rare cases a bland scalp alopecia can represent a new or recurring, local or metastatic neoplasm.

Alopecia↗