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PubMedDate not supplied

Thymidine phosphorylase activity in liver tissue and its correlation with multifocal occurrence of hepatocellular carcinomas.

BACKGROUND: In hepatocellular carcinoma (HCC), new tumors develop in the residual liver within a few years after hepatectomy. However, the biological risk factors of multifocal occurrence of cancers remains unclear. In this study, the thymidine phosphorylase (TP) activity, which is known as an angiogenic factor, of cancerous and non-cancerous liver tissues in HCC was analyzed to determine its suitability as a biological marker of the multifocal occurrence of HCCs. MATERIALS AND METHODS: Fresh tissues (tumor: HCC and adjacent liver tissue: N-HCC) from 63 patients with HCC and normal liver tissues (NL) from 6 patients without HCC were obtained. The TP activities of the tissues were analyzed by an enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean TP activity of 63 HCCs (136 U/mg protein) was higher than that of 63 N-HCCs (81 U/mg protein) and that of 6 NLs (47 U/mg protein, p < 0.001). Multifocal occurrence of HCCs were detected in 17 patients. In these 17 patients, the mean TP activity of HCCs (145 U/mg protein) was not different from that of HCCs from the remaining 46 patients (133 U/mg protein, p = 0.272), however the mean TP activity of N-HCCs (110 U/mg protein) was significantly higher than that of N-HCCs from the remaining 46 patients (71 U/mg protein, p = 0.038). Moreover, only a high TP activity of N-HCCs was detected as a significant risk factor of multifocal occurrence of HCCs. CONCLUSION: Patients who have tumors with high TP activity in the non-cancerous livers may have a risk of multifocal occurrence of HCCs in the residual liver.

Adult↗
PubMedDate not supplied

Adenomas and carcinomas may be histologically detected in apparently normal colonic mucosa. A study of carcinogen-treated rats.

Clinical reports indicate that colonic neoplasias may be overlooked at colonoscopy. We investigated, in an experimental model, whether both gross and high power microscopical examinations could detect all induced colonic neoplasias. Forty-nine Sprague-Dawley rats received 1,2-dimethylhydrazine for 27 weeks. The colons were scrutinized grossly and at high-power microscopy complemented with chromoscopy. Biopsies were obtained from all mucosal alterations seen at gross and at high power microscopy. The gross examination of the colonic specimens in the 49 animals revealed 196 polyps or suspected polyps. Histology showed that 85.2% (167 out of 196) were adenomas or adenocarcinomas. The remnant polyp-free colons were subsequently examined by high-power stereo microscopy (46 magnifications). Fifty-five new lesions were detected and removed. Histology showed 48.9% (n = 24) additional neoplastic lesions in the 49 colon specimens. The remnant polyp-free colons were subsequently processed for histology. The sections showed 57 additional neoplastic lesions in the 49 colon specimens: 93.0% (n = 53) were adenomas (n = 35) and crypt dysplasias (n = 18), while the remaining 7.0% (n = 4) were invasive carcinomas. Experimentally-induced colonic neoplasias may be overlooked even after a careful scrutiny of the colonic mucosa using high-power optical devices.

1,2-Dimethylhydrazine↗
PubMed2002

Exclusion of breast cancer as an integral tumor of hereditary nonpolyposis colorectal cancer.

Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant genetic predisposition syndrome that accounts for 2-7% of all colorectal cancers. Diagnosis of HNPCC is based on family history (defined by Amsterdam or Bethesda Criteria), which often includes a history of multiple synchronous or metachronous cancers. The majority of HNPCC results from germ-line mutations in the DNA mismatch repair (MMR) genes hMSH2 and hMLH1 with rare alterations in hMSH6 and hPMS2 in atypical families. Both HNPCC and sporadic MMR-deficient tumors invariably display high microsatellite instability (MSI-H). Two types of HNPCC families can be distinguished: type I (Lynch I) with tumors exclusively located in the colon; and type II (Lynch II) with tumors found in the endometrium, stomach, ovary, and upper urinary tract in addition to the colon. A proposed association of breast cancer with type II HNPCC is controversial. To address this important clinical question, we examined MSI in a series of 27 female patients who presented with synchronous or metachronous breast plus colorectal cancer. Although MSI-H was found in 5 of 27 (18.5%) of the colon cancers, in all cases the matched breast cancer was microsatellite stable. We also examined the breast tumors from three women who were carriers of MMR gene mutations from HNPCC families. None of these three breast tumors displayed MSI nor was the expression of MMR proteins altered in these tumors. We conclude that breast cancer largely arises sporadically in HNPCC patients and is rarely associated with the HNPCC syndrome.

Breast Neoplasms↗
PubMedDate not supplied

[Gastrointestinal stromal tumors: a case with mixed muscular-neuronal origin].

GIST have still today controversial aspects of their histogenesis that are reflected on the classification and prognosis. It's showed a particular case with mixed muscular-neuronal histogenesis that supposes totipotent cell origin of these neoplasms. Diagnosis, classification and prognosis are very difficult to evaluate; surgery at the moment is the only useful treatment modality.

Aged↗
PubMedDate not supplied

Malignancy in choledochal cysts.

BACKGROUND/AIMS: Malignancy in choledochal cysts is a rare condition. This study presents our experience with this condition, with emphasis on the clinical presentation, management and outcome. METHODOLOGY: Subjects included 80 adults with choledochal cysts treated from January 1979 to December 1995. Of these patients, eight were found to have malignancy in the cyst and formed the basis of this study. RESULTS: Four patients had synchronous and four had metachronous carcinoma lesions arising in the choledochal cyst. The clinical presentations were: biliary tract infection in 5 patients, gastric outlet obstruction in two and right upper quadrant pain and body weight loss in one. Operations for bile duct malignancy included total excision in two patients, choledochotomy with T-tube drainage in two patients, gastrojejunostomy in two patients, percutaneous transhepatic biliary drainage and gastrojejunostomy in one patient and metastatic lymph node biopsy only in one. One patient died due to septic shock within 30 days of operation (operative mortality). Postoperative survival time ranged from 4 to 9 months with a mean of 6.2 months. One of these patients was still alive at the time of writing (7 months). CONCLUSIONS: The frequency of malignancy in the choledochal cysts was 10% in our series. Malignancy in the choledochal cyst should be highly suspected in patients with cholangitis symptoms, body weight loss and anemia. Prognosis in this disease entity is poor.

Adenocarcinoma↗
PubMedDate not supplied

The separate-lesion type combined hepatocellular carcinoma and cholangiocarcinoma.

The separate-lesion type of combined hepatocellular carcinoma and cholangiocarcinoma is particularly rare. We treated two such patients with hepatic resection after performing dynamic computed tomography. In case 1, a 64-year-old Japanese man with chronic hepatitis C underwent right hepatic lobectomy for two hepatic tumors; both tumors originally were thought to be hepatocellular carcinomas because both were hypervascular. However, histologic examination revealed that one tumor was hepatocellular carcinoma and another tumor was tubular adenocarcinoma. In case 2, a 73-year-old man, a second lesion was detected 8 months after transcatheter arterial embolization for hepatocellular carcinoma associated with chronic hepatitis C. The newer lesion in case 2 showed delayed enhancement by dynamic computed tomography. We diagnosed the lesion as cholangiocarcinoma and performed right hepatic lobectomy and dissection of lymph nodes in the hepatoduodenal ligament. Histologic examination confirmed that the new lesion was tubular adenocarcinoma. Case 1 and 2 respectively represent synchronous and metachronous occurrence of the separate-lesion variety of combined hepatic cancer.

Aged↗
PubMed2002

[A case of multiple malignancies].

A case of fourfold cancer: of the vulva and larynx diagnosed synchronously and the breast and lung diagnosed metachronously is presented.

Aged↗
PubMed2002

Synchronous and metachronous extrapelvic metastases of cancer of the cervix: a study of prognosis and palliation.

Thirty-eight women with cancer of the cervix and extrapelvic metastases (EPM) were retrospectively reviewed with respect to prognosis and responses to palliative radiotherapy. Seventeen patients had synchronous EPM and 21 individuals displayed metachronous metastatic disease outside of the pelvic cavity. A meaningful difference was not revealed (p = 0.11) in the comparison of the two groups' 2-year survival rates. However, this small retrospective review highlighted the efficacy of radiotherapy administered for palliation to this cohort of patients.

Adult↗
PubMed1976

Synergism between neutron radiation and diethylstilbestrol in the production of mammary adenocarcinomas in the rat.

When young female A X C rats were given 9.6 rads of 0.43-MeV neutrons, 32 of 33 survived a 50-week follow-up period, 2 rats developed a total of 3 mammary adenocarcinomas, and 3 rats developed a total of 4 mammary fibroadenomas. For 25 rats implanted with a 20-mg pellet containing 5 mg diethylstilbestrol and 15 mg cholesterol, average survival was 284 days; 22 rats developed a total of 182 mammary adenocarcinomas, and 21 rats developed a pituitary tumor. When diethylstilbestrol was given 2 days before neutron radiation to 35 rats, the average survival was 239 days; 32 rats developed a total of 842 mammary adenocarcinomas, 1 rat developed a single mammary fibroadenoma, and 34 rats developed a pituitary tumor. All of the 31 control rats survived the 50-week study period, and none developed tumors. Twenty-one of the rats that received both diethylstilbestrol and neutron radiation and 1 rat that received only diethylstilbestrol exhibited a multiple mammary adenocarcinoma response with a range of 18 to 72 mammary adenocarcinomas per rat. These results were interpreted to mean that a synergistic interaction between diethylstilbestrol and neutron radiation on mammary adenocarcinoma formation occurs in terms of an earlier onset and a larger number of mammary adenocarcinomas. These results confirm and complement a previously reported synergistic interaction between diethylstilbestrol and X-radiation on mammary adenocarcinoma formation in A X C female rats.

Adenocarcinoma↗
PubMedDate not supplied

The multiple tumor syndrome. Personal experience.

The multiple tumor syndrome is an unusual pathologic condition, which consists in association of multiple malignancies in the same patient. Seven cases are discussed: two women, five men, aged 32-70 years. The period between the two neoplasias was 2-23 years (in 6 cases). In one case the two malignancies appeared concomitantly. The hematological malignancies were: multiple myeloma: 2 cases; chronic granulocytic leukemia: 2 cases; chronic lymphatic leukemia: 3 cases. In four cases, the solid tumor followed the hematological malignancy at variable periods (2 and 4 years). In other two cases, the solid tumors preceded the hematological malignancy with 2 years, 23 years respectively. The solid tumors were genital cancers, malignant melanoma, spino-cellular carcinoma, thyroid cancer, hemangiosarcoma. In a single case the second tumor was a hematological malignancy too (NHL-diffuse lymphocytic lymphoma). Possible implications of previous therapy and environmental factors are discussed.

Adult↗
PubMed2002

Parametric mixture model for analysing relative survival of patients with multiple cancers.

BACKGROUND: This study aimed to provide a parametric mixture model for analysing relative survival and cure rates of patients with multiple cancers. METHODS: A new model was introduced by extending a parametric mixture model on relative survival of patients with a single cancer. The model was applied to empirical data on lung cancer as a first and second tumour after a first localised colorectal cancer. RESULTS: Survival and cure from subsequent cancer are estimatable with the parametric mixture model on relative survival of patients with multiple cancers. Survival from lung cancer does not differ between the first and second tumour, but there is suggestive evidence that survival from second lung cancer is higher than that from the first lung cancer. DISCUSSION: Relative survival analysis of patients with multiple cancers can be extended to incorporate cure rates and excess hazards related to the individual cancers. Prognostic factors can be included in the model.

Adult↗
PubMed2003

[Diagnostic and therapeutic approach to bilateral germinal tumor. Presentation of a case and review of the literature].

The germinal bilateral tumor represents from 1 to 4% of the testicle tumors, and it usually turns to be one of the most difficult ones when talking about diagnosis and treatment. We are attaching a 30 years old patient case, with a diagnosis consisting in a seminoma with yolk sac tumor area from the left testicle, that was treated with orquiectomy. Eleven months later, the patient presented a second neoplasm in the contralateral testicle, whose histology was a classical seminoma with carcinoma "in situ" peritumoral, being also treated with orquiectomy. Medical literature is revised with emphasis in the involved risk factors and the techniques used to treat these testis tumor groups: carcinoma "in situ" detection appears to be the strongest predicting factor. Testicular contralateral biopsy is proposed in some select cases. Even though radical orquiectomy is still the treatment to choose, local radiotherapy and conservative surgery are also an option in patients with bilateral tumor.

Adult↗
PubMed2003

[Ipsilateral metanephric adenoma and clear-cell carcinoma. Personal experience and review of the literature].

OBJECTIVES: To perform an update in such an infrequent pathology and to report our own experience. METHODS: We report two new cases and review the national and international literature. RESULTS: We report two cases of ipsilateral metanephric adenoma and clear cell carcinoma. The first case, metachronous, was detected after 15 months of follow-up in a patient who underwent partial nephrectomy due to clear cell carcinoma. The second one, synchronic, was incidentally discovered in the surgical specimen. CONCLUSIONS: Metanephric adenoma is as infrequent neoplasia; its diagnosis is histological, being difficult to suspect by complementary diagnostic tests, so that most cases undergo surgical treatment in spite of its benign character.

Adenocarcinoma, Clear Cell↗
PubMed1992

[A surprising double tumor of the liver 60 years following thoratrast diagnosis].

A 66-year-old man with thorotrastosis of the reticuloendothelial system is described. Post mortem two tumours were found in an enlarged liver: a cholangiocarcinoma and an angiosarcoma. Coincidentally, a hilar neurofibroma was found. The former two tumours most probably developed because of a lifelong endogenous alpha-irradiation by thorium disintegration. The exceptional latency period of 60 years' duration is emphasized.

Adenoma, Bile Duct↗
PubMed1992

Hereditary and environmental factors associated with risk and progression of head and neck cancer.

The familial occurrence of head and neck cancers supports the role of heredity in this disease group. The roles of environmental and genetic factors are difficult to separate. There are several well-characterized entities, however, that are associated with risk and prognosis of head and neck cancer, including Lynch-II syndrome, Bloom syndrome, Fanconi's anemia, xeroderma pigmentosum, ataxia telangiectasia, and Li-Fraumeni syndrome. Mutagen-induced chromosomal damage is associated with an increased risk of multiple primary neoplasms and upper aerodigestive tract cancers. A possible reduction of genotoxicity, mediated by micronutrients, was demonstrated in vitro. Sister chromatid exchanges and micronuclei are useful exposure and disease markers. Metabolic changes (acetylation, DBQ phenotype, and the AH locus polymorphism) have been found to be associated with cancer of the upper aerodigestive tract. Most associations between histocompatibility antigens and solid tumors are relatively weak, probably because of the masking effects of environmental factors. Infections by HPV, EBV, and HSV have a causative or predisposing role in several types of head and neck cancer. Amplification and rearrangement of oncogenes may also play a role in carcinogenesis, and oncogene amplification may be associated with aggressive tumor behavior and unfavorable clinical prognosis. Ploidy of tumors seems to be an important determinant of survival and response to therapy.

Environment↗