Cancer of the Cervix Uteri
Jennifer L. Kelsey, Nancy G. Hildreth in Breast and Gynecologic Cancer Epidemiology, 2019
Good evidence exists that invasive cervical cancer is usually preceded by carcinoma in situ, which is in turn frequently preceded by cervical dysplasia. However, what has been called cervical dysplasia actually consists of a variety of lesions and the term “dysplasia” is used differently by various pathologists. These reservations notwithstanding, what has been called cervical dysplasia most often occurs in the 20- to 29-year age group, carcinoma in situ in the 30- to 39-year group, and invasive cervical cancer after the age of 40.4 Carcinoma in situ is frequently found at the margins of invasive cancers,5 and in situ lesions are sometimes found in previous biopsies of patients who develop invasive cancer.6 Furthermore, women with dysplasia are at high risk for carcinoma in situ, while women with carcinoma in situ are at high risk for invasive cervical cancer. Stern and Neely,7 for instance, found from a follow-up study in a clinic population that about 85% of the women developing carcinoma in situ or invasive carcinoma had been in the 1% of the population previously classified as having dysplasia.
Introduction to Cancer
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
The multiple genetic changes that result in cancer may take many years to accumulate. During this time, the biological behavior of the premalignant cells slowly changes from the properties of normal cells to cancer-like properties. Premalignant tissue can have a distinctive appearance under the microscope, and among the distinguishing traits are an increased number of dividing cells, variation in nuclear size and shape, variation in cell size and shape, loss of specialized cell features, and loss of normal tissue organization. Dysplasia is an example of an abnormal type of excessive cell proliferation characterized by a loss of normal tissue arrangement and cell structure in premalignant cells. These early neoplastic changes are distinct from hyperplasia, a reversible increase in cell division caused by an external stimulus, such as a hormonal imbalance or chronic irritation. The most severe cases of dysplasia are referred to as carcinoma in situ, meaning an uncontrolled growth of cells that remains in the original location and has not progressed to invading other tissues. Nevertheless, a carcinoma in situ may develop into an invasive malignancy and is usually removed surgically, if possible. The various mechanisms of cellular DNA damage are described below.
Bladder cancer
Anju Sahdev, Sarah J. Vinnicombe in Husband & Reznek's Imaging in Oncology, 2020
The majority of urothelial carcinomas arise on the lateral bladder walls (approximately 47%) or in the region of the trigone (approximately 20%). At the time of presentation, approximately one-third of patients with urothelial bladder tumours have multifocal disease, and indeed the whole of the bladder epithelium may be abnormal, showing areas of squamous metaplasia and CIS. The presence of carcinoma in situ is associated with an increased incidence of recurrence and an increased risk of development of invasive disease (8,9). Unlike other premalignant ‘in situ’ conditions, CIS of the bladder is recognized as a high-grade malignancy by definition because of its high rates of progression and recurrence. While malignant bladder cancer appears to be on the decline, rates of CIS are increasing in males in the UK (10). Urothelial cancers may be associated with synchronous or metachronous development of tumours elsewhere in the urinary tract, including the renal pelvis and ureter.
Mohs micrographic surgery as treatment option for non-basal cell or squamous cell carcinomas in the United States
Published in Journal of Dermatological Treatment, 2020
Carolina Puyana, Lacey Zimmerman, Maria M. Tsoukas
Females are more likely to undergo MMS compared to males, and this procedure is most commonly performed on the face and external ear, compared to any other location on the body. This may be due to the superior cosmetic outcomes obtained with MMS compared to CSE as more tissue is preserved with MMS. Further, tissue sparing is especially important for the function of portions of the face, such as the eyelids, lips, and nose (6). Our multivariate analysis demonstrated that fibrous histiocytoma has the highest likelihood of being treated with MMS compared to nevi and melanomas. Interestingly while fibrous histiocytomas most often occur on the limbs (70–75%), it occurs on the head and neck in about 10% of cases (13). Adnexal carcinomas, sebaceous, and eccrine adenocarcinomas also had a high likelihood of being treated with MMS. Adnexal carcinomas are rare cutaneous malignancies of sweat gland or pilosebaceous origin. Recent case series and reviews suggest MMS is a useful and possibly superior treatment for these (14). Sebaceous adenocarcinoma commonly occurs on the eyelids and other accessory structures of the eye (15). Eccrine adenocarcinoma can arise in many places on the body, but common places include the head, neck, face and ears, making these areas amenable to MMS (16). Our analysis also showed that carcinoma in situ is the most likely to be treated with MMS compared to other stages. It is well known that carcinoma in situ is treated surgically. This is consistent with our finding that neither chemotherapy nor radiation is significantly related to the utilization of MMS.
Penile Sparing Techniques For Penile Cancer
Published in Postgraduate Medicine, 2020
Due to the rarity of the malignancy, there are no randomized prospective clinical trials comparing different PST to each other or to the gold standard treatments of partial and total penectomy. The selection of PST depends on the location of the tumor, tumor grade, and stage (based on biopsy, exam, and possibly imaging), provider experience, and the patient’s wishes/priorities (Table 2). For carcinoma in situ (Tis), circumcision, cryotherapy, excision, or topical chemotherapy can be utilized as a primary or combination therapy, with the majority of lesions managed successfully with surgical intervention [47]. Laser ablation, circumcision, glansectomy, glans resurfacing, and Mohs micrographic surgery can all be utilized for the management of small, localized penile cancer. Tumors involving only the foreskin may simply be managed by circumcision, but involvement of the glans may require glans resurfacing, or glansectomy depending on its extent. Superficial tumors involving the mid or proximal shaft may be amenable to wide local excision with the addition of a split-thickness skin graft for larger tumors [3,4,48,49].
Lymph node dissection for upper tract urothelial carcinoma: A systematic review
Published in Arab Journal of Urology, 2021
Vinson Wai-Shun Chan, Chris Ho Ming Wong, Yuhong Yuan, Jeremy Yuen-Chun Teoh
The PRISMA flow diagram is presented in Figure 1. A total of 587 records were identified by the literature search, and 10 additional records were sought from reference lists of the included studies. After the removal of duplicates, 565 records remained. Amongst these records, 22 were included in the qualitative synthesis, and 12 cohort studies in 14 records were included in the quantitative analysis. These studies are reported in Table 1 [5,9–21]. Five studies reported a description of their associated LND templates and these are presented in Table 2 [9,14–19]. The RoB assessments for these studies are presented in Figure 2. Owing to the lack of randomised control trials in the area, selection bias was high amongst all studies. Performance bias is unlikely in these studies. Blinding and outcome data were not well described amongst studies; hence risk of detection and attrition bias was unclear. Reporting bias was low amongst studies, while confounders like age, grade and T-stage were well accounted for in most studies. Carcinoma in situ (CIS) and adjuvant therapies were however less accounted for as confounders.
Related Knowledge Centers
- Biopsy
- Cancer Staging
- Ductal Carcinoma In Situ
- Dysplasia
- Precancerous Condition
- Neoplasm
- Cancer
- Cutaneous Squamous-Cell Carcinoma
- Lobular Carcinoma In Situ
- Tnm Staging System