Late Distant Metastasis Research Articles

Factores pronósticos en el carcinoma adenoide quístico de glándulas salivares

ObjectiveAdenoid cystic carcinoma (ACC) is a relatively rare tumor which is characterized by its long clinical history, with multiple recurrences and late distant metastasis. The aim of the present study is to show our experience in the management of this tumor and the relationship of different clinico pathological parameters with its prognosis. Material and methodsA retrospective study was carried out between 1984 and 2004 in 28 patients with ACC of the salivary glands, analyzing the most outstanding clinico- pathological variables in this tumor related to the prognosis of the tumor and the survival. ResultsThe overall survival rates at 5, 10 and 15 years were 88%, 69% and 52% respectively. Ten (36%) patients presented local recurrence and 10 (36%) presented distant metastasis (four of which also have local recurrence). Although the differences were not statistically significant, the patients with solid histological subtype (p=0.17), with positive margins status (p=0.2), with perineural invasion (p=0.59), and those treated with surgery alone (p=0.19), presented a worse survival. Discussion/conclusionOur study confirms that the ACC is a tumor with a high tendency to local recurrence and development of distant metastasis, even long term, which means a close follow- up for life. Nevertheless, it also demonstrates that acceptable survival rates can be obtained with aggressive treatment.

Survival of cervix cancer patients in Harare, Zimbabwe, 1995–1997

The survival experience of 284 patients with cancer of the cervix uteri registered by the population-based Zimbabwe National Cancer Registry in 1995-1997 is described. The vital status of these subjects was established by linkage with death registration and by retrieval of patient files from medical records departments. Untraced patients were contacted at home. Of the 284, 177 (62.3%) were dead and 76 (26.8%) were alive at the closing date of the study (31 December 1999), with only 31 cases (10.9%) lost to follow-up. Overall observed and relative survival at 3 years were 44.2% and 45.2%, respectively. Half of the cases (139) had been referred and treated in the radiotherapy department. Survival was significantly greater in the first 3 years for patients who received radiotherapy treatment compared to those that had not, but this difference had disappeared by the fourth year of follow-up. Many cases presented late (distant metastasis), and extent of disease was an important determinant of survival; cases with metastases had a risk of death some 3 times that of patients with localized disease. The results demonstrate the importance of earlier diagnosis and availability of effective treatment in the African context.

Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up.

Adenoid cystic carcinoma (ACC) accounts for approximately 10% of all neoplasms of the salivary glands. Late distant metastases and local recurrences are responsible for a rather low long-term survival rate. To study the metastasizing pattern of ACC of the salivary glands in 51 patients. Fifty-one patients with an ACC in the intraoral/sublingual salivary glands (n = 30), parotid gland (n = 8), submandibular gland (n = 2), maxillary sinus (n = 6), and nasal cavity (n = 5) have been studied. The male-female ratio was 1:1, the mean age was 54.3 (range, 19-81) years. In 30 cases treatment consisted of surgery and radiotherapy. In 13 cases surgery alone was carried out. The average follow-up time was 117.8 (range, 1-171) months. In 28 cases (54.9%) distant metastases occurred, and in 3 patients (5.8%) regional lymph node metastases occurred. In 12 of the 28 patients with distant metastases (42.8%), only the lungs were involved, whereas in 5 of the 28 patients (17.8%), the distant metastases occurred in other organs (eg, bones and brain). In 11 of the 28 patients (39.2%) metastases were found both in the lungs and other organs. Twenty-four of the 51 patients (47.0%) died because of their tumor. The average time between the occurrence of lung metastases and death was 32.3 months and between the occurrence of metastases elsewhere and death 20.6 months. Distant metastases of ACC of the salivary glands occur most often in the lungs. Although these lung metastases are the first to occur, these patients die later than patients with distant metastases in other organs. The value of annual chest films or other tests for the presence of distant metastases during follow-up after surgical removal of an ACC seems rather questionable.

Adenoid cystic carcinoma of the head and neck.

Adenoid cystic carcinoma of the head and neck is relatively rare and is characterized by slow evolution, multiple recurrences, protracted clinical course, and late distant metastasis. This article presents its peculiar clinical course, response to therapy, and long-term treatment results by analyzing 67 cases treated from 1979 to 1991 at the Seoul (Korea) National University Hospital. The most common primary site was the parotid gland in the major salivary glands and the nose and paranasal sinuses in the minor salivary glands. The local control rate was 71.1% at 5 years and 44.3% at 8 years. Late-occurring distant metastases did not allow a plateau in survival curves, even after 8 years. Our study also revealed that surgery combined with postoperative radiotherapy could yield better local control.

Intradural Recurrence With Chondrosarcoma of the Spine A Case Report and Review of the Literature

Known for its resistance to chemotherapy and radiation therapy, chondrosarcoma remains largely a surgically managed tumor predisposed to local recurrence and late distant metastasis. A 42-year-old man with known thoracic chondrosarcoma developed progressive low back pain, lower extremity weakness, and urinary incontinence. Magnetic resonance imaging and computed tomographic myelography demonstrated multiple filling defects throughout the lumbosacral region. Surgical excision of these lesions disclosed intradural, extramedullary drop metastases of the chondrosarcoma. The spread of neoplasms within the dural space is uncommon, accounting for less than 5% of spinal metastases, and has not previously been reported for chondrosarcoma.

Carcinoid Tumor of the Larynx

Typical carcinoid neoplasms of the larynx are extremely rare tumors. The total number of known and documented cases is likely no more than 13. The neoplasm mainly affects males at an average age of 58 years and appears grossly as a polypoid or sessile submucosal nodule with an average 1.8 cm in size. Their predominant location is the supraglottis with the arytenoid and the aryepiglottic fold being the most frequent sites. Histologically, they are characterized by organoid architecture, uniform cellular features and lack of pleomorphism, necrosis and mitosis. Typical laryngeal carcinoids are less aggressive than their atypical counterparts but late distant metastasis and death may occur. The management of these neoplasms is conservative surgery.

Adenoid-cystic carcinoma (cylindroma) of the trachea. An analysis of nine cases (author's transl)

Nine patients with an adenoid-cystic carcinoma of the trachea are describes. It is a rare tumour which grows relatively slowly; it has a tendency for early invasion of neighbouring tissues, but late distant metastases. A correct diagnosis can be made by the radiologist. The trachea should be visible on every film of the thorax and should be inspected. In particular, a diagnosis of therapy-resistant asthma should direct the attention of the radiologist to the trachea.