Occurrence Of Second Primary Tumor Research Articles

The role of retinoids in preventing second lung cancers

The field cancerization hypothesis has guided the development of a series of retinoid chemoprevention trials in the upper aerodigestive tract (UADT) and lung. The hypothesis suggests that the entire epithelium of the UADT and lungs is exposed to inhaled carcinogens and at risk for the development of cancer. The term field cancerization was first used to describe the frequent occurrence of multifocal tumors and premalignant lesions in pathologic specimens from resected head and neck cancers [I]. Epithelial premalignant lesions occur most often in individuals who have been exposed to carcinogens, such as tobacco smoke. In the oral cavity, leukoplakia, whitish plaques that cannot be otherwise characterized, have been associated with the development of invasive cancer. In the lungs, squamous metaplasia, the replacement of the normal columnar epithelial lining with a squamous epithelium, frequently appears in tobacco users and in surgical specimens obtained during resection of a lung cancer. The presence of dysplasia is not necessary for the diagnosis of leukoplakia or squamous metaplasia but may be associated with the progression to cancer. The occurrence of second primary tumors (SPTs) is another important aspect of field cancerization (Table 1). The carcinogenic process that results in the initial cancer has also been associated with damage to the remainder of the epithelium. SPT’s develop in 2040% of patients successfully treated for squamous cell cancers of the head and neck and in lO-20% of patients after resection of early stage non-small cell lung cancers [2-51. SPTs develop predominantly within the exposed field, the lungs and UADT [6]. The initial description of field cancerization was based on the interpretation of histologic findings. Considerable attention is now being directed towards the molecular aspects of field cancerization. Identification of the changes that are crucial to the multistep process of carcinogenesis, would both define field cancerization and focus chemoprevention efforts.

Retinoblastoma: Clinical and histopathologic features

Retinoblastoma, the ocular tumor of childhood, is unusual in its genetic implications, the frequency of occurrence of second primary tumors, the association of a 13q14 chromosome deletion, and the high incidence of spontaneous regression. This article reviews the clinical and histopathologic features of the disease and briefly summarizes histopathologic findings regarding cell death and tumor necrosis in retinoblastoma.

Granulosa- and theca-cell tumors. Incidence and occurrence of second primary tumors.

An analysis of 936 women with granulosa- and theca-cell tumors reported to the Swedish Cancer Registry between 1958 and 1972 showed crude annual incidence rates for these lesions of 0.72 and 0.74, respectively, pre 100 000 of the female population, unchanged during the period. The age-specific incidence rates, both groups taken together, increased almost linearly from 35 to 69 years. The women displayed an increased risk of developing endometrial carcinoma and malignant lymphoma, possibly also breast, colon and thyroid carcinoma.

Peculiarities in the occurrence of adrenal cortical carcinoma.

Through clinical observations of peculiarities in the occurrence of certain childhood neoplasms, new understanding of cancer biology is being derived. The contribution from studies of adrenal cortical carcinoma (ACC) is far out of proportion to the frequency of the tumor, which develops in fewer than 15 children in the United States each year.1Etiologically interesting findings have been made in the patient or his family; eg, the spontaneous occurrence of second primary tumors, as in the two cases described by Levine in this issue of theJournal(see p 238). In 1967, findings from a relatively small series of 62 patients with ACC revealed that two had already developed astrocytomas,2as, subsequently, did a third patient.3Previously, double primaries involving ACC had been reported with amelanotic melanoma of the cheek4and with an apparent optic glioma in a child whose three maternal uncles had died of