Carcinomas Of Other Organs Research Articles

A CLINICAL STUDY OF THE LARGE INTESTINAL CARCINOMA ASSOCIATED WITH MALIGNANT TUMORS OF THE OTHER ORGANS

A recent 10 year-experience with 40 cases of multiple primary carcinoma of the large intestine and other organs was clinically studied. The 40 cases represented 4.8% of 835 cases operated on for colorectal carcinoma in the same period, including 11 synchronous, 27 heterochronous and 2 synchronous/heterochronous multiple carcinoma cases.Among carcinoma in other organs, gastric carcinoma was the most common (53.5%). Multiple carcinoma cases were more common in males and in elders, and appeared to have a family history of cancer in a higher frequency than the 835 operated cases. The clinicopathological findings of colorectal carcinomas in 32 multiple primary malignant cases with resection of colorectal carcinoma were not so characteristic compared to the 658 resectable cases without carcinoma of other organs. The cumulative 5-year survival rate of the 31 cases with resection of both colorectal carcinoma and carcinoma of other organs was significantly lower than that of 658 resectable cases described above. In order to improve the prognosis of multiple carcinomas, we have to make more effort at improving the prognosis of primary malignant tumors of other organs, especially gastric carcinoma, in synchronous cases, and at detecting early the associated colorectal carcinoma in heterochronous cases, if another carcinoma of other organ preceded.

Immunohistochemical Study of a Newly Defined Oncofetal Antigen (HGR-Ag) in Tumors of the Central Nervous System

The oncofetal antigen (HGR-Ag) in brain tumors was newly defined using the monoclonal antibody derived from tissue extracts of an anaplastic astrocytoma. The HGR-Ag was purified through sequential chromatography using diethylaminoethyl-Sephadex A-50 and Con-A Sepharose affinity columns. The latter method indicated that HGR-Ag is not a glycoprotein, and Western blot analysis indicated a molecular weight of 80-90 kd. Purified antigen was used to produce antibody. This new antibody, designated H1H2, was shown to be an immunoglobulin G1 by immunodiffusion assay. Histological/immunohistochemical studies using the H1H2 antibody on paraffin and frozen tissue sections showed HGR-Ag to be intracellular rather than membrane-associated. The immunoreactivity of H1H2 was highest in malignant astrocytomas, glioblastomas, and normal fetal brain tissue. Neurinomas and certain carcinomas of other organs showed lesser, variable reactivity to H1H2. The strength of the antigen-antibody binding was correlated with the degree of malignancy in human gliomas. H1H2 bound to fetal brain tissue and undifferentiated neural tumors, but not to normal adult brain tissue, so HGR-Ag is probably a fetal oncoantigen.

Tissue polypeptide antigen expression in human prostate tumors

Thirty-seven specimens of benign and malignant prostatic tumors were studied for the localization of tissue polypeptide antigen (TPA) by an avidin-biotin-peroxidase complex technique. In addition, 23 metastases of prostatic carcinoma in other organs and 12 nonepithelial tumors of prostate also were studied. All benign and malignant tumors of epithelial origin, including their metastasis, stained positively. Nonepithelial tumors were uniformly negative. In the metastatic lesions, small foci of tumor cells and even single tumor cells could be identified by TPA staining. Immunohistochemical localization of TPA appeared to be a useful tool for assessing the micrometastases of prostatic carcinoma in other organs, especially lymph nodes, or elucidating the epithelial origin of an otherwise undifferentiated prostatic cancer.

Familial occurrence of differentiated, nonmedullary thyroid carcinoma.

AbstractFamilial occurrence of differentiated, nonmedullary thyroid carcinoma in 23 patients from 11 families is reported. Five patients were male and 18 were female. The familial relationship of patients was “parent and child” in 12 cases from 6 families, and “siblings” in 11 cases from 5 families. Carcinoma of other organs was noted in other members in 8 families. Histological examination revealed 18 papillary, 2 follicular, and 2 anaplastic carcinomas (the 2 anaplastic carcinomas were considered to be transformed from preexisting differentiated carcinoma). In 1 case, the histological type was unknown. The average diameter of the primary lesion was 29.9 mm. Cervical lymph node metastasis was found in 77.8% and local recurrence in 28.6% of the patients. Solid and invasive growth was dominant. On HLA typing, phenotypes of B7 and DR1 were significantly redominant in familial patients compared with nonfamilial patients and normal Japanese. Moreover, the haplotype of B7‐Cw7‐DR1 was observed in 5 of 13 patients tested.It is suggested from these observations that some types of differentiated, nonmedullary thyroid carcinoma may show familial occurrence and that they may have common factors with regard to the genetic and immunologic basis of the disease.

A CASE REPORT OF APOCRINE CARCINOMA OF THE BREAST WITH RAPID GROWTH AND METASTASIS

Many cases of mammary cancer, except for special types, show a relatively favorable prognosis, in comparison with carcinoma of other organs. However, we recently encountered a case showing rapid growth and metastasis in which the period between onset and death was short, 13 months. The patient, a 29-year-old woman, first noted a small finger-tip-sized mass in her left breast, and visited a nearby hospital. In spite of therapy by hormone injection in hospital, the mass increased. About 3 months after onset, she visited our hospital. On the basis of a diagnosis of malignant tumor following biopsy, surgery with radiotherapy was undertaken, but the patient died from remote systemic metastasis about 8 months after surgery, i.e., about 13 months after onset. The pathological diagnosis was apocrine carcinoma. The results obtained from this case suggested that some cases of apocrine carcinoma have the potential to be highly malignent, requiring careful attention to the treatment.

A CASE OF DOUBLE CARCINOMA OF THE BILIARY TRACT RESECTED 14 YEARS AFTER EXTENDED RADICAL MASTECTOMY

The present paper reports a case of double cancer of the biliary tract, i.e., the gallbladder and the lower portion of the common bile duct, developing 14 years after extended radical mastectomy for left breast cancer. A 79-year-old woman with the chief complaints of jaundice and epigastric pain was admitted to the department of surgery of our hospital under the diagnosis of obstructive jaundice. After a detailed examination, the patient underwent surgery for suspected cancer in the lower portion of the common bile duct and the gallbladder. Histopathologically the tumor in the gallbladder was tubular adenocarcinoma while that in the lower portion of the common bile duct was poorly differentiated cacinoma. As no continuity was noted between the two tumors, and lymph node metastasis was negative, the case was diagnosed as double cancer of the biliary tract. The breast cancer was scirrhous carcinoma located in the AC region with negative lymph node metastasis. Thus, this was a case of asynchronous triple cancer of the breast, gallbladder and common bile duct. Double cancer of the biliary tract is comparatively rare, and an association with carcinoma of other organs has been reported in only one case with concurrent gastric cancer. The authors report the extremely rare case of triple cancer involving the breast, and present a reveiw of the literature on cancer developing in other organs after surgery for breast cancer.

One-Hundred-and-Two 5-Year Survivors of Esophageal Carcinoma after Resective Surgery

Among 492 patients with esophageal carcinoma who received resective surgery, 102 survived over 5 years. These 5-year survivors were analyzed according to many factors. Females had a better prognosis than males, and patients without lymph-node metastasis had a better 5-year survival rate than those with it. Ten patients who survived over 5 years had recurrences and received therapy. As a cause of death after 5 years, double primary carcinoma of other organs is more frequent than recurrence.

STUDIES ON DOUBLE CANCERS INVOLVING THE ESOPHAGUS AND OTHER ORGANS, WITH SPECIAL REFERENCE TO CANCERS OF THE ESOPHAGUS AND THE OTORHINOLARYNX

During the past 9 years, 57 patients with esophagela carcinomas were admitted to Shizuoka Red Cross Hospital. Among these patients, 14 cases were noticed to have, or to have had, other carcinomas of other organs, revealing a much higher frequency of observed double cancers in a single patient than had previously been reported in Japan so far. Six of thhse double concer cases were homochronous, whereas eight were heterochronous. As for the sites of organs with other carcinomas, the stomach was the most connon single organ, but otorhinolaryngeal cancers, as a whole, including carcinomas of the larynx, mouth floor and hypopharynx, were the largest in number. Seven cases were resected but curative resection was performed in only three cases, which showed poorer operative results compared with stet for single cancer of the esophagus. The results of surgical treatment of esophagela carcinoma with homochronous or heterochronous otorhinolaryngeal cancers were especially poor. The reason for this tendency was presuned to be shortness of duration between the occurrences of cancers of the otorhinolayrnx and of the esophagus and also of the difficulty in differentiating the signs and symptoms of these two types of cancer.

Renin in renal cell carcinoma--an immunocytochemical study using an antibody to pure human renin.

We have studied a series of 19 primary renal cell carcinomas using an antibody to pure human renin and the indirect PAP technique. Seven tumours contained immunoreactive renin. No renin was identified in seven cases of metastatic tumour within the kidney, but immunoreactive renin was present in two out of seven metastatic renal cell carcinomas in other organs. None of the subjects had clinical, biochemical or histological evidence of excess renin secretion. We suggest that renal cell carcinoma may commonly secrete renin and that the hormone may be biologically inactive.

Adenoid Cystic Carcinoma of the Uterine Cervix: Ultrastructure, Immunofluorescence, and Criteria for Diagnosis

An example of adenoid cystic carcinoma of the cervix was recently encountered in our laboratory and studied by histochemistry, electron microscopy, and immunofluorescence in order to compare the neoplasm with adenoid cystic tumors at other sites and to establish criteria for diagnosis. Histochemically, cervical adenoid cystic carcinoma showed the two types of mucin, epithelial and stromal, as expected in adenoid cystic carcinomas of other organs. Ultrastructurally, this tumor was characterized by redundant basal lamina forming pseudocysts, intercellular spaces, and occasional true lumens with microvilli. Immunofluorescence studies showed that the cells contain at least two antigenically different types of filaments, actin and keratin, and that the cells produce true basement membrane (collagen IV). The presence of actin suggests myoepithelial differentiation even though the tumor probably originated from the cervical reserve cells, and myoepithelium is not a known component of normal cervix. This study shows that cervical adenoid cystic carcinoma is a distinct entity which can be identified and separated from other types of cervical adenocarcinomas.

Oral florid papillomatosis (verrucous carcinoma).

1. Florid Papillomatosis (FP) seems to be another form of verrucous carcinoma. 2. Besides the mouth, FP can be found in the larynx, nose, genitalia, skin, etc. 3. FP would appear to be a carcinoma with a low degree of malignancy, and is locally aggressive. They do not cause generalized metastases and rarely metastasize locally. 4. In the mouth, the lesions, either single or multiple, usually occur in adult men. The most frequent sites are the buccal mucosa and the alveolar-gingival area. They develop on a healthy mucosa, or on preexisting lesions, namely, leukoplakia, atypical lichen, abrasive cheilitis and traumatic ulcers. FP may cause fistulas and jaw destruction. 5. Histologically, three stages can be recognized: type I, with acanthosis and papillomatosis, etc., type II, with the aspect of an in situ carcinoma, and type III, carcinoma-like in aspect but with some characteristics of FP. 6. Ten percent of the cases may develop an anaplastic carcinoma or may become associated with other types of carcinomas in other organs and near the area where the FP appeared. 7. Predisposing factors are the same as those for classical carcinomas (especially smoking and chewing tobacco or betel). FP may develop on preexisting lesions similar to those described for regular carcinomas. No virus has been isolated. Some authors believe FP is a precancerous condition; we think it is a cancer with a low degree of malignancy. 8. Treatment should be initiated with cytostatic drugs, especially methotrexate, followed by electrocoagulation, radium implantation and surgery. If the lesions are small in size, methotrexate is not required. If the lesions are large or there is bone destruction, surgery is the treatment of choice after methotrexate and sometimes high-voltage therapy with 60Co. 9. A cure rate of 75% can be obtained in properly treated cases.

Familial Renal Tumours.

This paper presents a family of which at least three members suffered from renal carcinoma and hypertension, while another four died at an early age from hypertension or cardiac disease. In addition, two other members died of carcinoma of other organs. Known familial or hereditary diseases in which renal tumours occur are discussed briefly.

Radiation therapy of carcinoma of the cardia.

Although the first cancer to be treated by exposure to roentgen rays was a carcinoma of the stomach, reported by Despeignes (1) in 1896, radiation therapy of carcinoma of that organ has fallen into disrepute. There are many causes for the prevailing pessimism. Ninety per cent of all gastric carcinomas are believed to be insensitive to roentgen rays, though it should be noted that no adequate method exists for determining the radiosensitivity of any individual tumor. The mobility of the stomach makes it difficult for the roentgenologist to direct his cross-fire accurately. The concomitant irradiation of liver, pancreas, and adrenals proved a temporary deterrent. The good general health frequently associated with tumors in other locations, such as the breast and skin, is usually absent in carcinoma of the stomach, and the accompanying cachexia makes these patients less able to stand the radiation sickness, with its attendant nausea and vomiting. Aside from such handicaps, necrosis of a tumor that is radiosensitive may produce perforation and hemorrhage. Many attempts have been made to overcome these difficulties. Holfelder (3) utilized a compression diaphragm in order to reduce the distance between the target and the tumor. Attempts were made to fix the stomach to the anterior abdominal wall prior to irradiation. Scholz (4) recommended barium-filling of the stomach in order to utilize secondary radiation and to protect adrenals and pancreas. In spite of these and other efforts to solve the problem, a deep gloom was manifested by the majority of influential authors, and cancer of the stomach was generally classified as not amenable to irradiation. As recently as 1933, Kaplan (5), in a report of over a thousand unselected cancer cases, briefly dismissed the irradiation of gastric carcinoma as of little value. Pack (6), in his latest monograph on cancer of the esophagus and gastric cardia, discusses radiation therapy of carcinoma of the esophagus by Nielsen's rotation technic, but he does not mention results in carcinoma of the cardia. When evaluating the radiosensitivity of carcinomas of other organs it is not customary to group them together indiscriminately. In spite of repeated attempts, however, no reliable criteria, either gross or microscopic, have been found for predicting the sensitivity of gastric carcinomas. Pack (7), who has written extensively on this subject, utilized the classification of Ewing (2). He describes the bulky adenocarcinoma as being likely to regress under radiation treatment when situated at the cardia or fundus. Carcinoma telangiectatica, a type of medullary cancer or carcinoma simplex, is sometimes sensitive to radiation; it occurs chiefly in the fundus and cardia. The carcinomatous ulcer is described as occasionally radiosensitive, and the anaplastic small-cell gastric cancer as radiosensitive. It is interesting to note that most of these tumors are frequently located in the proximal portion of the stomach.

A Clinical Analysis and Follow-Up Study of Five Hundred and Two Cases of Carcinoma of the Lung

An otherwise fatal disease, primary carcinoma of the lung, can be satisfactorily treated by surgical removal of the entire organ. Surgical measures short of total pneumonectomy are not efficacious. Postoperative mortality and longevity are at least as good as, if not better than, the postoperative results following the surgical treatment of carcinoma of other organs.

Carcinoma of the Breast

Breast cancer is usually accepted as an example of a radio-resistant tumour. But there are varieties which vary in sensitivity; and of great importance is the extent of the disease, the degree of which cannot be ascertained in advance although it vitally affects results. The radical treatment of carcinoma of the breast requires the application of the general principles on which the treatment of carcinoma of other organs is based, but demands special modifications which depend on the situation, extent and type of the growth, and proximity to the lung and pleura which may be seriously damaged by an overdose. It is but seldom that a case of this disease reaches the radiologist in a stage sufficiently early for radical treatment, to hold out any prospect of cure. There are three general methods available:— 1. Radium applied externally. 2. Interstitial Radium. 3. X Rays. Each of these methods may be utilised in different ways, according to clinical indications, available facilities, and the personal experience...

Pathogenesis and Radiotherapy in Carcinoma of the Thyroid

THE pathogenesis of carcinoma of the thyroid differs radically from that of carcinoma in other organs. The progressive pathologic changes in the thyroid gland pass imperceptibly from hyperplasia into simple benign or functional benign neoplasia, and further into malignant neoplasia. Even in a normal thyroid there is a tendency for wide dissemination of thyroid acini, as noted in certain fish, and a general enlargement of the whole organ may take place in the course of normal pregnancy or may be induced by changes in diet or by drugs. At least the endemic prevalence of goiters in certain localities is ascribed to lack of assimilation of iodine. Once such a hyperplasia has taken place it frequently changes in the whole organ or in some parts of it into a true benign neoplasia. Thus, the enlargement of the thyroid in colloid goiter, the most common type, is due to the distention of normal alveoli with colloid, and there is no evidence of any neoplasia. Very frequently, however, in many regions of the goiter,...

REPORT OF TWO UNUSUAL CASES OF PRIMARY CARCINOMA: I. PRIMARY CARCINOMA IN THE LIVER, WITH CIRRHOSIS OF THE LIVER, OCCURRING IN A FEMALE. II. PRIMARY CARCINOMA IN THE JEJUNUM

Article1 April 1934REPORT OF TWO UNUSUAL CASES OF PRIMARY CARCINOMA: I. PRIMARY CARCINOMA IN THE LIVER, WITH CIRRHOSIS OF THE LIVER, OCCURRING IN A FEMALE. II. PRIMARY CARCINOMA IN THE JEJUNUMREUBEN FINKELSTEIN, M.D., F.A.C.P., MENDEL JACOBI, M.D.REUBEN FINKELSTEIN, M.D., F.A.C.P.Search for more papers by this author, MENDEL JACOBI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-7-10-1319 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPrimary carcinomas in the liver and in the small intestines, especially in the jejunum, are sufficiently rare to be reported. This is especially true when some unusual features accompany the conditions.Up to about 1871, primary carcinoma in the liver was reported quite frequently, but since then, due to the more thorough examinations and the more careful observations at autopsy, many of such cases are found to be secondary to carcinoma in other organs of the body. In 36 years, from 1870 to 1906, about 18,500 autopsies were performed at Guy's Hospital, London. Among these, only 24 cases of undoubted...

SKELETAL METASTASES FROM CARCINOMA OF THE RECTUM

Since the advent of the widespread use of the roentgen ray for diagnosis, there has been a great increase in the knowledge of those neoplasms that cause osseous metastases. Carcinomas of the prostate, breast, thyroid and pulmonary bronchus, as well as hypernephromas, have been known to be the most common producers of secondary growths in the skeletal system. Primary carcinomas of other organs do cause metastases in the bones, and these occur with sufficient frequency to make their clinical recognition an important factor in the amelioration of their symptoms. Skeletal metastases occur in 10.5 per cent of rectal carcinomas according to Nisnjewitsch, 1 who found them in six of fifty-seven postmortem examinations. The determination of the true percentage of such occurrences is impossible from either a clinical or a pathologic standpoint unless the material is examined carefully with that point in view. Miyauchi 2 examined the lumbar vertebrae in thirty-five