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Chemopreventive Agents
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Metastasis is a complex process involving the spread of tumor cells from the primary tumor to distant sites where secondary and tertiary tumors can form (Figure 12.4). The Epithelial-Mesenchymal Transition (EMT) is an essential event in the initial phase of metastasis, a process which also occurs during normal embryonic development, tissue regeneration, and wound healing. However, the EMT process is often not completed in tumor cells which are frequently in multiple transitional states and expressing mixed epithelial and mesenchymal genes. These hybrid cells can move collectively as clusters and behave more aggressively than normal cells, with the transition in gene expression often triggered by complex signaling pathways such as those controlled by the transcription factors SNAI1/2, ZEB1/2, and Twist. However, the role of these transcription factors in EMT is complex, and their functions are not tissue specific.
Breast Imaging with 99mTc-Tetrofosmin
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Enrico del Vecchio, Luigi Mansi, Pier Francesco Rambaldi, Vincenzo Cuccurullo, Biagio Pecori, Mario Quarantelli, Decio Capobianco, Marco Bresciani
Many studies reported a satisfactory sensitivity and specificity in the detection of primary tumors. Nevertheless unsatisfactory values are obtained for lesions <1 cm. The possibility of uptake in benign lesions with main reference to fibroadenomas has been reported. TF is reliable tracer also for diagnosis of local recurrence and of axillary lymph node metastases. Its capability to detect distant metastases has been also demonstrated.
Non-Melanoma Skin Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Irene De Francesco, Sean Whittaker, Stephen L. Morris
EMPD is a rare intra-epithelial adenocarcinoma, characterized by the presence of malignant Paget cells lying within the epidermis of the skin. The etiology is unknown. It is usually a primary tumor but may be associated with an underlying adjacent or distant invasive carcinoma. Approximately 25% of cases have an underlying cutaneous adnexal carcinoma, and 10–15% have an subjacent or distant internal carcinoma.279 In the later stages, the epidermal pagetoid cells are thought to represent metastases, and the prognosis is associated with the underlying malignancy, with a mortality rate of 50% or higher.
Bilateral Diffuse Uveal Melanocytic Proliferation Initially Presented as Glaucoma
Published in Ocular Immunology and Inflammation, 2023
Fangyu Zhao, Liying Hu, Ruru Guo, Zhiqing Li, Jian Ji, Wei Liu
Although several cases have been reported, clear guidelines on managing BDUMP are still lacking. Treatments are mainly focused on the primary tumor, including tumor resection, targeted medicine, radiotherapy, chemotherapy, plasmapheresis, etc. Plasmapheresis has been frequently reported to improve or stabilize vision,7,8,16 owing to the removal of circulating growth factors or antibodies that are responsible for benign melanocytic proliferation.6 However, once plasmapheresis is stopped, there would be a quick relapse of subretinal fluid, and vision would continue to decrease.8 Although plasmapheresis was reported to be beneficial for vision stabilization, it might enhance cancer growth in turn, because plasma exchange can remove the auto-antibodies or other factors involved in the autoimmune response against the systemic tumor.15 Palliative chemotherapy can also contribute to the regression of BDUMP lesions and the improvement of visual acuity. Carlos Menezes et al.17 showed that after six cycles of palliate chemotherapy, the vision was improved from 2/10 to 3/10, the BDUMP lesions were partially regressed, the pigmentation was decreased, the exudative detachment was resolved and the choroidal thickness was normalized. In addition, chemotherapy also led to partial regression of the primary tumor, indicating that the condition of BDUMP is roughly paralleled with that of the primary malignancies.
Current status and novel insights into the role of metastasectomy in the era of immunotherapy
Published in Expert Review of Anticancer Therapy, 2023
Efstathia Liatsou, Diamantis I. Tsilimigras, Panagiotis Malandrakis, Maria Gavriatopoulou, Ioannis Ntanasis-Stathopoulos
In the era of effective immunotherapies and targeted therapies, the role of metastasectomy needs to be re-defined. Patients with limited metastatic melanomas can have durable long-term survival with targeted therapies even without the need for surgery although this patient group was traditionally more frequently treated with resection [87]. Recent studies have suggested an added benefit with surgery when metastatic disease can collectively be removed. Recent reports have also suggested a role of surgery in the treatment of metastases resistant to immunotherapy or targeted therapies, i.e. last resort when other options have failed [88]. Nevertheless, there is large heterogeneity in the nature of primary disease and disease biology among patients with different primary tumors. To date, metastasectomies are more often performed in the setting of metastatic melanomas, RCC, and less frequently for metastatic CRC or small bowel cancer. We would like to include a comprehensive overview of all available data in the literature; therefore we opted to discuss all these cancer types, despite the fact that metastasectomy might not be the standard of care.
Successful outcome following resection of metachronous pancreatic metastasis from a rhabdomyosarcoma
Published in Acta Chirurgica Belgica, 2021
M. Monge, H. Chiavelli, J. Pinson, E. Papet, L. Schwarz, J. J. Tuech
Metastatic tumors to the pancreas are rarely clinically detectable but their frequency in autopsy series ranges from 3% to 11% [3]. In living patients, isolated metastatic disease to the pancreas has been diagnosed infrequently, even though most patients with PM have widespread disease [4]. These uncommon metastatic lesions arise most frequently from renal-cell carcinoma, colon lung and breast cancer [5–7]. In most cases, differential diagnosis with primary tumors is difficult. Although rare, metastatic disease should always be considered in patients with isolated pancreatic lesions and a history of a previous malignancy, including soft tissue sarcoma, regardless of the disease free interval. Usually at CT scan, like in our case, metastatic lesions appear hypodense with peripheral rim of enhancement after contrast injection. Fine needle biopsy is safe and non invasive diagnostic method with high accuracy rate, which may be helpful to confirm the diagnosis. In our case since, the patient presented a solitary lesion, we had decided to directly perform the pancreatic resection.