Other abdominal and pelvic masses in children.
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Metastatic disease is a well-known complicating factor in the treatment of renal cell cancer. Whereas radical nephrectomy usually is curative in cases of localized disease, no adequate treatment has been established for metastatic renal tumors. Identification of specific chromosome changes or genes responsible for metastatic behavior may lead to new strategies of treatment in the future. In light of this, we cytogenetically analyzed a metastasis of a chromophobe renal cell carcinoma arising in a 73-year-old male and compared the results with genetic data on primary chromophobe renal tumors. The chromosomal pattern of the present case showed, next to the extensive chromosome losses specific for the chromophobe subtype, structural rearrangements involving chromosomes 1, 5, 12, 15, and 18. Determining whether or not (some of) the observed structural changes are important for the metastatic behavior of chromophobe renal cell tumors will have to await further genetic studies on metastases of renal cancer.
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Liver metastasis formation from intrasplenically growing Lewis lung tumor was studied with transmission and scanning electron microscopy. Tumor cells arrested in the sinusoids formed desmosome-like junctions with endothelial cells and crossed the endothelial lining at intercellular gaps and by transcellular diapedesis. The metastatic foci had no newly formed vessels, and the stroma was provided by non-parenchymatous liver cells. Morphology suggested different outcome for tumor cell-host cell interactions at different stages of tumor growth. The host cell activity to destroy tumor cells was present only at the early stage but disappeared later, when the tumor cells were ready to phagocyte normal cells. The reason for this could be the immunosuppressive effect of the primary tumor. Results emphasize the importance to study metastasis formation in primary tumor-bearing hosts.
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We examined the anti-tumor effect of a novel benzoic acid derivative, TAC-101 (4-[3,5-bis(trimethylsilyl) benzamide] benzoic acid) on models with liver metastasis. Oral administration of TAC-101 significantly inhibited spontaneous liver metastasis of AZ-521 (human gastric cancer ) by orthotopic implantation to athymic nude mice. It also inhibited both the liver metastasis of AZ-521 induced by intrasplenic injection and the secondary lung metastasis from the liver. In addition, TAC-101 inhibited the proliferation of Co-3 (human colon adenocarcinoma) that formed a single nodule in the liver of athymic nude mice by intrahepatic implantation. The growth inhibitory effect of TAC-101 on AZ-521 experimental liver metastasis was observed when treatment was started on day 7, 14, or 21 which may correspond to the progressive stage of liver metastasis in clinical settings. Multiple administration of TAC-101 (8 mg/kg/day) significantly prolonged survival time of the animals with liver metastasis by intrasplenic injection of AZ-521 (T/C = 230%) and A549 (human lung adenocarcinoma; T/C = 186%). These effects of TAC-101 were stronger than those of 5-FU, CDDP or ATRA. Furthermore, TAC-101 inhibited the binding of AP-1 to DNA on electrophoretic mobility shift assay using nuclear extract of AZ-521 cells, although ATRA did not inhibit. These findings suggested that TAC-101 may be a candidate for a new class of anti-cancer agents for liver metastasis.
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Laparoscopy with spleen and multiple liver biopsies was performed in 94 patients with Hodgkin's disease in stages III B and IV B. In four of them involvement of the liver was demonstrated in this way. Exploratory laparotomy was subsequently performed in 35 patients, liver involvement being revealed in only one patient in whom it had not been previously demonstrated by laparoscopy and (or) biopsy. While laparoscopy proved to be of similar value to exploratory laparotomy in assessing liver involvement, it was no substitute for operation. It was valuable in determining the stage of the disease and following its course.
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Investigation of the upper abdomen by ultrasound was conducted in 97 patients with various neoplasms. 21 patients only showed a normal pattern of the liver. Parenchymatous changes of the liver were observed in 32 patients, deformation in 6 patients and parenchymatous changes together with deformation in 38 patients. 13 patients were diagnosed to have metastatic lesions of the liver, 7 patients were not known to have such lesions previously. Involvement of both kidneys was seen in one patient with Hodgkin's disease. One patient had polycystic kidneys, diagnosed for the first time by echographic examination.
Staging was undertaken in 118 patients with primary lymph node neoplasms; the sensitivity of computer tomography in the paraaortic region was 80%, that of lymphography 89%. Specificity of computer tomography was 93%, of lymphography 95%. In the iliac region, sensitivity was 81% (CT) and 90% (lymphography), and specificity was 90% (CT) and 97% (Lymphography). The value of computer tomography should, however, be stressed, since it can demonstrate lymph nodes not shown by lymphography, including those in the mediastinum, as well as lesions in the spleen, liver and lungs.
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We present the case of a 66-year-old man with a moderately differentiated adenocarcinoma of the left colon and isolated spleen metastases, complicated with a gastrosplenic fistula. The patient underwent a palliative segmental resection of the primitive colic tumour, as no curative treatment could be offered in view of the spleen involvement. Adjuvant chemotherapy was started. After a few chemotherapy treatments, he developed a gastrosplenic fistula which required the resection of the spleen and the greater gastric curvature together. This fistula was, among other things, responsible for bad breath that immediately disappeared postoperatively. At the end of the chemotherapy course, all carcinologic features had also disappeared.
The ability of monoclonal antibodies against the Thy-1.1 differentiation antigen to inhibit the growth of transplanted syngeneic AKR/J SL2 leukemic cells has been previously demonstrated. In the present study we further examined therapy with monoclonal antibody of the IgG2a isotype, which was the most effective isotype studied. Intravenous infusion of ascites fluid containing the anti-Thy-1.1 monoclonal antibody 19-E12 1-2 h after tumor implantation led to inhibition of the growth of 3 X 10(5) but not 3 X 10(6) syngeneic SL2 leukemic cells. The achievement of the maximal therapeutic effect required the infusion of a dose containing 3.2 mg of antibody, which inhibited the growth of a subcutaneous inoculum of 3 X 10(5) SL2 leukemic cells in 83% of treated mice. Multiple doses of antibody were no more effective than a single dose given shortly after tumor implantation. The infusion of this relatively large 3.2-mg dose of antibody was required to infiltrate the subcutaneous space and saturate surface Thy-1.1 sites on leukemic cells in a subcutaneous tumor nodule. The failure of antibody to inhibit larger numbers of tumor cells was investigated. Growth of a subcutaneous tumor nodule in mice challenged with more than 3 X 10(5) cells resulted from the growth of Thy-1.1-bearing cells in spite of the presence of the infused anti-Thy-1.1 antibody on their surfaces. In contrast, metastatic growth was due to the emergence of variant leukemic cells lacking the Thy-1.1 antigen. Thus, treatment of transplanted T leukemic cells with an IgG2a anti-Thy-1.1 monoclonal antibody was effective in eliminating 3 X 10(5) antigen-bearing leukemic cells from the subcutaneous space and was very effective in preventing metastasis of leukemic cells expressing the target Thy-1.1 antigen. Therapy was limited by the failure of host mechanisms to eliminate larger numbers of subcutaneous leukemic cells coated with the infused antibody and by the emergence of variant leukemic cells lacking the target antigen.
We describe the clinical, histologic, immunophenotypic, and genotypic features of five cases of histologically discordant lymphomas with B-cell and T-cell components. Three patients presented with B-cell lymphoma; T-cell lymphoma subsequently developed. One patient presented with T-cell lymphoma; B-cell lymphoma subsequently developed. One patient presented with synchronous B-cell and T-cell lymphomas. There were three men and two women. The median age at the initial diagnosis of lymphoma was 66 years. The mean interval between the development of the two lymphomas was 83 months. All patients died of disease. The mean survival was 96 months after the initial diagnosis of lymphoma and 14 months after the diagnosis of the histologically discordant lymphoma. Epstein-Barr virus was found in two cases--the B-cell lymphoma in the patient who presented with synchronous lymphomas, and the subsequent T-cell lymphoma in one of the patients who presented with B-cell lymphoma. Based on the results of immunophenotypic and genotypic analyses, these cases likely represent the occurrence of two distinct lymphoid neoplasms rather than histologic progression of the same neoplastic clone. Furthermore, a subset of these cases are Epstein-Barr virus-associated.