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1
Cantley, Richard L. "Fine-Needle Aspiration Cytology of Cellular Basaloid Neoplasms of the Salivary Gland." Archives of Pathology & Laboratory Medicine 143, no. 11 (September 11, 2019): 1338–45. http://dx.doi.org/10.5858/arpa.2019-0327-ra.
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Context.— Cellular basaloid neoplasms of the salivary gland represent a diverse group of benign and malignant neoplasms with significant cytomorphologic overlap on fine-needle aspiration cytology. All are marked by the presence of monotonous and usually bland basaloid epithelium. Distinction between basaloid neoplasms on fine-needle aspiration cytology is based on the presence or absence of additional features, including a second cell population (eg, myoepithelial cells), an acellular stromal component, and/or cytologic atypia within the basaloid epithelium. This review highlights the cytomorphologic features of the most common cellular basaloid neoplasms of the salivary gland, with an emphasis on classification and subclassification within the Milan System. Objective.— To provide a comprehensive review of the cytologic features of basaloid epithelial neoplasms of the salivary gland, with an emphasis on classification within the Milan System for Reporting Salivary Gland Cytopathology. Data Sources.— Peer-reviewed literature, recent textbooks, and personal experiences of the author. Conclusions.— Some basaloid neoplasms, in particular pleomorphic adenomas and adenoid cystic carcinomas, may have characteristic findings on fine-needle aspiration that allow for definitive diagnosis. In other cases, however, fine-needle aspiration can confirm a neoplastic basaloid process, but specific classification of a benign or malignant neoplasm cannot be rendered. The Milan System for Reporting Salivary Gland Cytopathology acknowledges this difficulty, and recommends benign or malignant classification only when definitive diagnostic features of a specific neoplasm are present. For indeterminate cases, the subcategorization of salivary neoplasm of uncertain malignant potential is recommended.
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Baum, Berit. "Not Just Uterine Adenocarcinoma—Neoplastic and Non-Neoplastic Masses in Domestic Pet Rabbits (Oryctolagus cuniculus): A Review." Veterinary Pathology 58, no. 5 (April 20, 2021): 890–900. http://dx.doi.org/10.1177/03009858211002190.
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With increasing numbers of pet rabbits living out their natural lifespan, rabbit oncology is stepping more and more into the limelight. On the other hand, rabbit tumors are less covered in recent editions of textbooks of veterinary pathology than before. We present 1238 cases with neoplastic and non-neoplastic masses in rabbit tissue, submitted from 2008 to 2019, supplemented by a review of the literature on neoplasms in rabbits. Cutaneous masses comprised 47% of submissions. Trichoblastoma was by far the most common skin neoplasm, and nodular suppurative panniculitis was the second most frequent skin nodule in this series. Epithelial as well as mesenchymal cutaneous neoplasms can be virally induced in rabbits (eg, Shope papilloma, myxomatosis) but were infrequent in the current cases. Mammary neoplasms comprised 21% of submitted masses and 94% of these had histologic features of malignancy. Tumors of the female reproductive tract were responsible for 9% of biopsies and were predominantly uterine adenocarcinoma. Polypoid proliferation of rectal mucosa was the most common lesion in the alimentary tract. A broad spectrum of other neoplasms was described, including sarcomas at vaccination sites and ocular posttraumatic sarcomas, comparable to lesions described in cats.
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de Moura, Joel Pereira, Sérgio Mancini Nicolau, João Norberto Stávale, Maria Aparecida da Silva Pinhal, Leandro Luongo de Matos, Edmund Chada Baracat, and Geraldo Rodrigues de Lima. "Heparanase-2 Expression in Normal Ovarian Epithelium and in Benign and Malignant Ovarian Tumors." International Journal of Gynecologic Cancer 19, no. 9 (November 2009): 1494–500. http://dx.doi.org/10.1111/igc.0b013e3181a834a2.
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Introduction:Studies have highlighted the changes that take place in the environment between the cell and the extracellular matrix during the process of neoplastic expansion. Several papers have associated the expression of heparanase 1 with various malignant tumors. Heparanase 2 is probably related to loss of cell adhesion.Objective:The aim of this study was to evaluate the expression of heparanase 2 in epithelial neoplasia of the ovaries and in samples of normal ovarian tissue.Methods:Seventy-five ovary specimens were analyzed and divided into 3 groups: 23 malignant and 35 benign epithelial ovarian neoplasia and 17 without ovarian disease. We used 2 methodological techniques for evaluating the immunoexpression of heparanase 2. The first followed the qualitative criterion of positive or negative in relation to enzymatic expression, and the second involved computerized quantification of this expression, performed on the same slides.Results:In the quantitative analysis, we found positivity indices for heparanase 2 expression of 72.2% and 87.3% in the samples of benign and malignant neoplasias, respectively. In these, the intensity of expression and the expression index were 147.2 and 121.2, respectively, for the benign neoplasia and 134.1 and 118.0 for the malignant neoplasia. Qualitatively, its expression was strong or moderate in 44.2% of the benign and 78.2% of the malignant tumors; its expression in all of the nonneoplastic samples was negative, with the exception of one that was weakly positive.Conclusions:Heparanase 2 is involved in neoplastic proliferation, but it was not exclusively associated with the malignant process. Furthermore, there was no difference in its expression between benign and malignant ovarian epithelial neoplasia.
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Lesnic, Evelina, and Alina Malic. "Particularities of the evolution of the patients with tuberculosis associated with the pulmonary neoplastic process." Public Health, Economy and Management in Medicine, no. 2(89) (August 2021): 45–50. http://dx.doi.org/10.52556/2587-3873.2021.2(89).08.
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Risk factors for pulmonary tuberculosis and pulmonary neoplastic process are interdependent. Antineoplastic treatment is a contributing factor in the reactivation of latent tuberculosis infection and the recurrence of pulmonary tuberculosis. The aim of the study was to evaluate the particularities of the evolution of patients with tuberculosis associated with pulmonary neoplastic process to identify recommendations for early detection of the neoplastic process. A retrospective, selective study was performed which included 105 patients distributed in the study group that included 50 cases with diagnosed pulmonary neoplatic process and the comparison group which consisted from 65 patients with pulmonary tuberculosis without current or previous neoplasia. Th e peculiarities of patients with associated neoplastic process was age over 55 years, urban residence, incomplete level of education, disadvantaged socio-economic peculiarities, immunosuppressive treatment (in one third of cases). Th e diagnosis of tuberculosis was established by the specialist, having a low rate of positive microbiological status and a wide range of clinical manifestations. Standardized antituberculosis treatment resulted in a low rate of therapeutic success. Conclusion: the standardized management of patients with pulmonary tuberculosis associated with the pulmonary neoplastic process led to the late detection of the neoplastic process and the completion of antituberculosis treatment with therapeutic success only in every second patient.
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Fatima, Rasheed, Sandhya M., and Sowmya T. S. "Study of histomorphological pattern of ovarian neoplastic and non-neoplastic lesions." International Journal of Research in Medical Sciences 5, no. 5 (April 26, 2017): 2095. http://dx.doi.org/10.18203/2320-6012.ijrms20171849.
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Background: The ovary is a striking exception to the Virchow’s dictum that organs that are frequently the site of primary cancer are rarely involved in secondary malignancy, and vice versa. Both primary and secondary carcinomas of the ovary are relatively frequent and show an astounding variety of pathologic patterns. The objectives were to study the histomorphological diversity of various neoplasms and non neoplastic lesions of ovary. To provide a specific diagnosis based upon the histomorphological study which is of paramount clinical significance in further management of the patient.Methods: The present study is based on histomorphological evaluation of 100 cases of ovarian neoplastic and non neoplastic lesions received at the department of Pathology, tertiary care hospital from June 2008 to Aug 2010.Results: A wide variation of age was noted. Among neoplastic lesions, majority of the cases were seen in age group of 20-39 years i.e., 50.6%. Non neoplastic lesion occurred in all age group, but majority of the incidences were seen in the age group of 20 to 40 years of age, accounting for 60% of total occurrence. the commonest ovarian tumor was serous cyst adenoma constituting 54.1% (46 cases) of all ovarian neoplasm. Mucinous cyst adenoma was the second most common tumor. There were 72 cases (85%) of benign, 2 cases (2%) of borderline and 11 cases (13%) of malignant tumors in the present study.Conclusions: The diversity of neoplasms makes it mandatory to classify the tumors accurately by histopathological features following universally accepted classification.
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González, Iván A., Douglas R. Stewart, Kris Ann P. Schultz, Amanda P. Field, D. Ashley Hill, and Louis P. Dehner. "DICER1 tumor predisposition syndrome: an evolving story initiated with the pleuropulmonary blastoma." Modern Pathology 35, no. 1 (October 1, 2021): 4–22. http://dx.doi.org/10.1038/s41379-021-00905-8.
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AbstractDICER1 syndrome (OMIM 606241, 601200) is a rare autosomal dominant familial tumor predisposition disorder with a heterozygous DICER1 germline mutation. The most common tumor seen clinically is the pleuropulmonary blastoma (PPB), a lung neoplasm of early childhood which is classified on its morphologic features into four types (IR, I, II and III) with tumor progression over time within the first 4–5 years of life from the prognostically favorable cystic type I to the unfavorable solid type III. Following the initial report of PPB, its association with other cystic neoplasms was demonstrated in family studies. The detection of the germline mutation in DICER1 provided the opportunity to identify and continue to recognize a number seemingly unrelated extrapulmonary neoplasms: Sertoli-Leydig cell tumor, gynandroblastoma, embryonal rhabdomyosarcomas of the cervix and other sites, multinodular goiter, differentiated and poorly differentiated thyroid carcinoma, cervical-thyroid teratoma, cystic nephroma-anaplastic sarcoma of kidney, nasal chondromesenchymal hamartoma, intestinal juvenile-like hamartomatous polyp, ciliary body medulloepithelioma, pituitary blastoma, pineoblastoma, primary central nervous system sarcoma, embryonal tumor with multilayered rosettes-like cerebellar tumor, PPB-like peritoneal sarcoma, DICER1-associated presacral malignant teratoid neoplasm and other non-neoplastic associations. Each of these neoplasms is characterized by a second somatic mutation in DICER1. In this review, we have summarized the salient clinicopathologic aspects of these tumors whose histopathologic features have several overlapping morphologic attributes particularly the primitive mesenchyme often with rhabdomyoblastic and chondroid differentiation and an uncommitted spindle cell pattern. Several of these tumors have an initial cystic stage from which there is progression to a high grade, complex patterned neoplasm. These pathologic findings in the appropriate clinical setting should serve to alert the pathologist to the possibility of a DICER1-associated neoplasm and initiate appropriate testing on the neoplasm and to alert the clinician about the concern for a DICER1 mutation.
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Charak, Annu, Irfan Ahmed, Bushra Rashid Sahaf, Rehana Qadir, and A. R. Rather. "Clinico-pathological spectrum of testicular and paratesticular lesions: a retrospective study." International Journal of Research in Medical Sciences 6, no. 9 (August 25, 2018): 3120. http://dx.doi.org/10.18203/2320-6012.ijrms20183656.
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Background: Both neoplastic and non neoplastic conditions affect the testis. Although non neoplastic testicular lesions are more common, still most of the studies were done on testicular neoplasms only. Hence the present study was undertaken to study histopathological spectrum of testicular and paratesticular lesions, their age distribution and clinical presentation.Methods: This is a retrospective study of 77 cases of orchidectomy specimens, testicular biopsies and paratesticular lesions received in the department from Jan 2015 to June 2018.Results: Non neoplastic testicular lesions were more common than neoplastic (90.1% Vs 9.8%) with majority in the second and third decade. Undescended testis comprised 46.1% of the total orchidectomy specimens followed by Torsion/Infarction testis (15.3%). None of the undescended testis showed tumour unlike western countries. Majority of patients presented with empty scrotum (31.16%) and testicular/scrotal swelling (18.11%). Only 5 cases of testicular neoplasm were diagnosed during the study period amounting to only 1.42 cases per year. All were germ cell tumours (4 classic seminoma and 1 yolk sac tumour).Conclusions: Non neoplastic testicular lesions were more common than neoplastic lesions. Complete neonatal examination for testicular descent should be mandatory to avoid late presentations and future malignancies. Germ cell tumours formed the bulk of testicular tumours.
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Escobar, P. F., R. Patrick, L. Rybicki, N. Al-Husaini, C. M. Michener, and J. P. Crowe. "Primary gynecological neoplasms and clinical outcomes in patients diagnosed with breast carcinoma." International Journal of Gynecologic Cancer 16, Suppl 1 (January 2006): 118–22. http://dx.doi.org/10.1136/ijgc-00009577-200602001-00019.
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The purpose of this study was to quantify and describe nonmammary neoplasms (n-MN), particularly gynecological neoplasms, in a patient population previously diagnosed with breast cancer. Data were collected prospectively in our institutional review board–approved registry for patients diagnosed with infiltrating breast cancer or ductal carcinoma in situ. Patients who developed a second, n-MN were identified; neoplastic site, time to development after breast cancer, and clinical outcomes were recorded. FIGO stage was recorded for patients who developed a gynecological neoplasm. Synchronous bilateral breast cancer was defined as a second, contralateral diagnosis made within 12 months of the first and, similarly, synchronous n-MN were defined as those identified within 1 year of a breast cancer diagnosis. Outcome curves were generated using the method of Kaplan and Meier, and compared using the log-rank test. Of 4126 patients diagnosed with breast cancer, 3% developed a n-MN, the majority of which were nongynecological and asynchronous to the initial breast cancer diagnosis. Three percent of patients diagnosed with breast cancer were diagnosed with a second, n-MN. Among patients who developed a n-MN, most developed a nongynecological cancer more than 1 year after the initial breast cancer diagnosis, and their outcomes were significantly worse than those patients who did not develop a n-MN.
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Bokemeyer, C., and H. J. Schmoll. "Secondary neoplasms following treatment of malignant germ cell tumors." Journal of Clinical Oncology 11, no. 9 (September 1993): 1703–9. http://dx.doi.org/10.1200/jco.1993.11.9.1703.
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PURPOSE The current study investigates the frequency and outcome of secondary malignancies in patients treated for testicular cancer at Hannover University Medical School between 1970 and 1990. PATIENTS AND METHODS One thousand twenty-five patients with a median follow-up duration of 61 months (range, 12 to 240) were included in the analysis. Follow-up was complete in 1,018 patients (99%). Histology was seminoma in 324 patients (38.7%) and nonseminomatous germ cell tumor in 624 patients (61.3%). At the time of median follow-up, 814 patients (79.9%) were alive. RESULTS Fourteen patients developed a secondary neoplasm (cumulative incidence, 1.38%; 95% confidence interval [CI], 0.75 to 2.30); 13 patients had solid tumors and one had secondary lymphoblastic leukemia with a t(4; 11) translocation including band 11q23. None of 224 patients on surveillance strategy (with or without retroperitoneal lymph node dissection [RPLND]) developed a second neoplasm, compared with four of 413 patients (0.97%; 95% CI, 0 to 1.9) after cisplatin-based chemotherapy (not significant) and nine of 332 patients (2.7%; 95% CI, 0.9 to 4.5) after radiotherapy (P = .02). The cumulative incidence of a secondary neoplasia of 1.76% (95% CI, 0.97 to 2.94) in patients treated by radiotherapy and/or chemotherapy was significantly higher compared with patients on surveillance protocols (P = .03). Chemotherapy containing standard-dose etoposide did not increase the risk of occurrence of secondary neoplasms. A significantly elevated relative risk of 7.53 (range, 3.4 to 14.3) compared with the male German population was only found for patients treated by radiotherapy. CONCLUSION Compared with patients who have other curable malignant tumors, an incidence of 1.38 of secondary neoplasms after a median follow-up duration of 61 months is low. The highest risk for secondary neoplasia after treatment of testicular cancer is associated with the use of radiotherapy. Following chemotherapy, no significantly elevated risk was observed. In conclusion, the benefits of curative treatment far outweigh the risk of secondary cancer in patients with malignant germ cell tumors.
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Torres, L. N., J. M. Matera, C. H. Vasconcellos, J. L. Avanzo, F. J. Hernandez-Blazquez, and M. L. Z. Dagli. "Expression of Connexins 26 and 43 in Canine Hyperplastic and Neoplastic Mammary Glands." Veterinary Pathology 42, no. 5 (September 2005): 633–41. http://dx.doi.org/10.1354/vp.42-5-633.
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Gap junctions are the only communicating junctions found in animal tissues and are composed of proteins known as connexins. Alterations in connexin expression have been associated with oncogenesis; reported studies in rodent and human mammary glands, which normally express connexins 26 and 43, confirm these alterations in malignancies. Mammary neoplasms represent the second most frequent neoplasm in dogs, and since there are no reports on the study of connexins in canine mammary glands, the present study investigated the expression of connexins 26 and 43 in normal, hyperplastic, and neoplastic mammary glands of this species, to verify if altered patterns of connexin staining are related to higher cell proliferation and malignant phenotypes. A total of 4 normal, 8 hyperplastic mammary glands, 9 benign, and 51 malignant mammary gland neoplasms were submitted for the immunostaining of connexins 26 and 43, E-cadherin, and proliferating cell nuclear antigen (PCNA). Normal, hyperplastic, and benign neoplastic mammary glands showed a punctate pattern for connexin 26 and 43 staining and an intercellular E-cadherin staining. Malignant neoplasms, especially the most aggressive cases with high cell proliferation rates, presented either fewer gap junction spots on the cell membranes or increased cytoplasmic immunostaining. Malignant tumors also expressed a less intense immunostaining of E-cadherin; the expression of this adhesion molecule is important for the transportation of connexins to cell membranes and in forming communicating gap junctions. Deficient expression of E-cadherin could be related to the aberrant connexin localization and may contribute to the malignant phenotype. In conclusion, the expression and distribution of connexins and E-cadherin are inversely correlated to cell proliferation in malignant mammary neoplasms of dogs and may well be related to their more aggressive histologic type and biologic behavior.
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Kampmeier, P., R. Spielberger, J. Dickstein, R. Mick, H. Golomb, and JW Vardiman. "Increased incidence of second neoplasms in patients treated with interferon alpha 2b for hairy cell leukemia: a clinicopathologic assessment [see comments]." Blood 83, no. 10 (May 15, 1994): 2931–38. http://dx.doi.org/10.1182/blood.v83.10.2931.2931.
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Abstract We report that there is an unexpectedly high incidence of second neoplasms in patients after treatment of hairy cell leukemia (HCL) with interferon alpha 2b (IFN). In a cohort of 69 patients with HCL entered in a protocol using IFN as the primary treatment, and followed thereafter for a median of 91 months (range, 0.2 to 109 months), 13 patients (19%) developed a second neoplasm. Six neoplasms were of hematopoietic origin, whereas the remaining seven were adenocarcinomas. The expected number of second tumors in this cohort is three (based on calculations from the National Cancer Institute's SEER data), so the excess frequency (observed:expected) is 4.33. However, the excess frequency is even greater for the hematopoietic neoplasms; the expected frequency is 0.15, whereas six hematopoietic tumors occurred, for an observed:expected ratio of 40. In general, the second neoplasms have behaved aggressively, and the median survival after diagnosis of the second neoplasm was only 8.8 months. Although we cannot entirely exclude the possibility that IFN therapy has some direct oncogenic effect, we suspect that increased frequency of second tumors is related to prolonged survival of patients who are immunocompromised because of HCL and thus prone to develop second tumors. If so, the frequency of second neoplasms in patients with HCL may be even greater in the future with continued improvements in therapy.
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Roshal, Mikhail, and Sindhu Cherian. "Frequent Coincident Clonal Hematopoietic Expansions In Patients with Hairy Cell Leukemia." Blood 116, no. 21 (November 19, 2010): 2428. http://dx.doi.org/10.1182/blood.v116.21.2428.2428.
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Abstract Abstract 2428 Hairy cell leukemia is usually an indolent clonal proliferation of mature B cells involving blood, bone marrow, and spleen and is often characterized by progressive cytopenias. Patients with HCL have been observed to be at increased risk for a subset non-hematopoietic and hematopoietic neoplasms in some, but not all epidemiologic studies. The reason for such an increase is not entirely clear and has been postulated to be either due to immunosuppressive therapy that is used to treat HCL, an immunosuppressive effect of HCL itself, and/or to the intrinsic cancer susceptibility of the HCL patients. The finding of an increased cancer burden of HCL patients at diagnosis and lack of consistent association with any specific therapy is somewhat supportive of the last explanation. Aside from the epidemiologic studies, reports of second hematologic malignancies in patients with HCL are mostly contained in case reports and series containing very few HCL patients. To our knowledge no large systematic studies of additional clonal hematopoietic proliferations that can be detected in routine clinical specimen in patients with hairy cell leukemia have been performed. We identified 115 patients with hairy cell leukemia documented by flow cytometry in our institution between the years of 2004 and 2010. To qualify for the study the case had to have a clonal mature B cell population with expression of the canonical hairy cell leukemia antigens CD25, CD11c and CD103 on a population with increased side scatter. Immunophenotypic variants lacking one or more of these antigens were excluded to avoid sample contamination with HCL-variant and marginal zone lymphoma. Whenever possible correlation with clinical and morphologic evaluation was also performed. Of those patients 12 (10.4%) had one or more additional clonal hematopoietic proliferations identified either at diagnosis or in a subsequent sample. 7/12 patients had both neoplastic proliferations present at the time of diagnosis while the remaining 5 patients developed the second neoplasm after an established history of hairy cell leukemia. Compared to patients without additional neoplasms, the patients with additional clonal populations were older (average age 66 (47–85) vs. 56 (27–95) year old, p<0.01, two tailed t test). Compared to younger patients, HCL patients over age 60 had a significantly increased probability of having a second hematopoietic neoplasm (20% vs. 5.3%, OR 3.8, p<0.001, two tailed Chi-squared test). The majority 8/12 had another B cell neoplasm while the remainder had evidence of a plasma cell neoplasm. Two patients had coincident chronic lymphocytic leukemia (CLL) with an additional five patients presenting with a monoclonal B lymphocytosis (MBL) having a CLL like immunophenotype. One patient developed mantle cell lymphoma. One patient had three additional neoplastic populations which included a clonal B cell population negative for CD5, CD10, CD11c, or CD103, most consistent with either a marginal zone lymphoma or a lymphoplasmacytic lymphoma, a small clonal plasma cell population suggestive of monoclonal gammopathy of undetermined significance, and an MBL population with a CLL like immunophenotype. Five patients had a plasma cell neoplasm (three with clinical diagnosis of multiple myeloma). We have also identified a clear case of bi-clonal hairy cell leukemia that to our knowledge has only been reported once in the literature and never using contemporary diagnostic criteria. Our study demonstrates that additional clonal hematopoietic proliferations associated with HCL are common. Increased vigilance for coincident hematopoietic neoplasms may be warranted particularly in older patients with this disease. Disclosures: No relevant conflicts of interest to declare.
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Pytel, Nicholas, Erik Dedekam, Shahriar M. Salamat, and Diane Puccetti. "NCMP-22. SECOND MALIGNANCIES FOLLOWING TREATMENT FOR PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN PEDIATRIC PATIENTS: A SINGLE-INSTITUTIONAL RETROSPECTIVE REVIEW." Neuro-Oncology 22, Supplement_2 (November 2020): ii127. http://dx.doi.org/10.1093/neuonc/noaa215.533.
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Abstract Second malignant neoplasms following treatment for primary central nervous system (CNS) tumors in children are rare occurrences but may often have dire consequences, particularly, if thought to be induced by prior therapies. The authors retrospectively reviewed pediatric patients with primary CNS malignancies from the University of Wisconsin over the last 25 years (1994 – 2019) with any secondary malignant neoplasm and determined seven patients met criteria. Treatment modalities were reviewed with all patients receiving surgery, chemotherapy, and radiotherapy for treatment of their first malignancy. The second neoplasms found included 4 high-grade gliomas, 1 meningioma, 1 thyroid carcinoma, and 1 myelodysplastic syndrome. The median latency time between diagnoses was 9 years (range 4 -17 years). The outcomes varied according to histopathology of the second neoplasm with the high-grade glioma patients all deceased from progressive disease. The high-grade gliomas were thought to have been induced by prior radiation in most cases. The remaining patients are still alive, at the time of this writing, and in follow up after treatment for their second neoplasm. Thus, long-term follow up is essential for children treated for a primary CNS tumor given the variety of second neoplasms that could arise with differential consequences. In addition to our single institutional outcomes, we will also present an updated review of the literature of pediatric patients with primary CNS tumors and second malignancies.
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Pytel, Nicholas, Erik Dedekam, M. Shahriar Salamat, and Diane Puccetti. "RARE-41. SECOND MALIGNANCIES FOLLOWING TREATMENT FOR PRIMARY CENTRAL NERVOUS SYSTEM TUMORS IN PEDIATRIC PATIENTS: A SINGLE-INSTITUTIONAL RETROSPECTIVE REVIEW." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii451. http://dx.doi.org/10.1093/neuonc/noaa222.751.
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Abstract Second malignant neoplasms following treatment for primary central nervous system (CNS) tumors in children are rare occurrences but may often have dire consequences, particularly, if thought to be induced by prior therapies. The authors retrospectively reviewed pediatric patients with primary CNS malignancies from the University of Wisconsin over the last 25 years (1994 – 2019) with any secondary malignant neoplasm and determined seven patients met criteria. Treatment modalities were reviewed with all patients receiving surgery, chemotherapy, and radiotherapy for treatment of their first malignancy. The second neoplasms found included 4 high-grade gliomas, 1 meningioma, 1 thyroid carcinoma, and 1 myelodysplastic syndrome. The median latency time between diagnoses was 9 years (range 4 -17 years). The outcomes varied according to histopathology of the second neoplasm with the high-grade glioma patients all deceased from progressive disease. The high-grade gliomas were thought to have been induced by prior radiation in most cases. The remaining patients are still alive, at the time of this writing, and in follow up after treatment for their second neoplasm. Thus, long-term follow up is essential for children treated for a primary CNS tumor given the variety of second neoplasms that could arise with differential consequences. In addition to our single institutional outcomes, we will also present an updated review of the literature of pediatric patients with primary CNS tumors and second malignancies.
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Tavernier, Emmanuelle, Stephane de Botton, Nathalie Dhedin, Claude-Eric Bulabois, Oumedaly Reman, Norbert Vey, Frederic Garban, et al. "Secondary or Concomitant Neoplasms among Adults Diagnosed with Acute Lymphoblastic Leukemia (ALL) and Treated According to the LALA-87 and LALA-94 Trials." Blood 106, no. 11 (November 16, 2005): 1826. http://dx.doi.org/10.1182/blood.v106.11.1826.1826.
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Abstract Second malignant neoplasms are a serious complication after successful treatment of childhood ALL. Although treatment intensity and outcome were not comparable, with improvements in survival, it is important to evaluate the rate and the type of second neoplasms in adults with ALL. We analyzed the data from the GET-LALA group. A cohort of 1493 patients, aged 15 to 60 years and enrolled on two successive multicenter protocols between 1987 and 2002, was observed to determine the incidence of second neoplasms and associated risk factors. The median follow-up time from diagnosis was 6 years. By February 2005, secondary or concomitant neoplasms were documented in 23 patients (median age: 36 years, range:18–57) including 9 acute myeloid leukemias, 4 non Hodgkin lymphomas, 5 skin tumors, and 5 other solid tumors (1 lung cancer, 1 tongue carcinoma, 1 thymoma, 1 condrosarcoma, 1 histiocytosis). Neoplasms developed 0.5 to 13.8 years (median, 4.5 years) after the diagnosis of ALL. 22 patients were in first remission, one was in second remission. The overall cumulative risk of secondary neoplasms was 2.1% at 5 years, 4.9% at 10 years, 9.4% at 15 years. The cumulative risk of developing a second hematologic malignancy was 1.8% at 5 years, 2.2% at 10 years, 3.3% at 18 years; that of developing a solid tumor was 0.2% at 5 years, 2.8% at 10 years, 6.2% at 15 years. The development of secondary neoplasm was not associated with the use of any specific cytotoxic agent. However, risk of skin tumor increased with radiation dose and transplantation (p = 0.01). Overall survival after the diagnosis of a second malignant neoplasm was 55% at 10 years. However, the median overall survival in patients developing acute myeloid leukemia was of 5.7 months. Considering the low-survival rate of this large unselected adult ALL cohort (32% at 10 years), considering the poorer results comparing to childhood ALL treatment, the risk of secondary or concomitant neoplasm remains probably under estimated. Larger series with long-term follow-up are, however, mandatory. Figure Figure
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Gupta, Urvashi, Ruchi Shrestha, Ashok P. Samdurkar, and Anita Shahi. "A Histopathological Study of Neoplastic Lesions of Conjunctiva." Journal of Universal College of Medical Sciences 4, no. 1 (January 24, 2018): 32–35. http://dx.doi.org/10.3126/jucms.v4i1.19077.
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BACKGROUND: Ocular malignant tumors are relatively rare compared to other eye lesions, require immediate diagnosis and management. But ignorant care due to unawareness of persons can result into debility, loss of vision, and occasionally life is jeopardized.1 The aim of the study is to determine the frequency of most common neoplastc lesions of conjunctiva with histopathologically confirmed diagnosis. MATERIAL AND METHODS: It was a retrospective cross-sectional study done in a period of two years (January 2011 December 2012) that included120 patients who presented with conjunctival lesions to the pathology department of Universal College of Medical Science, Bhairahawa, Nepal. RESULTS: In this study out of 120 biopsies which were histopathologically diagnosed as conjunctival neoplasms were categorized into benign, dysplastic and malignant lesion and was common after second decade of life. Majority of cases (75 cases, 62.5%) were categorized as benign lesion with predominance of squamous papilloma (n=25) and nevus (n=21), followed by malignant lesion (27 cases, 22.5%) and dysplastic lesions (18 cases, 15%). Amongst malignancies, squamous cell carcinoma (SCC) was the most prevalent and a case of malignant melanoma was studied. Dysplastic lesion included conjunctival intraepithelial neoplasia (CIN) with and without squamous papilloma. CONCLUSION: Histopathology plays an important role in diagnosis of conjunctival lesions and rules out different categories of neoplastic lesions on routine basis. In this study Squamous cell carcinoma (SCC) 20.01% is the most common malignant tumor of conjunctiva. The next majority of cases diagnosed as the verrucuous carcinoma 1.66% and malignant melanoma 0.83% maximum case of malignant cases diagnosed in the age group of more than 50 years. Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 32-35
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Labrador, Jorge, Covadonga Garcia Diaz, Beatriz Cuevas, Rodolfo Alvarez, Maria Victoria Cuevas, Gerardo Hermida, Tomas Jose Gonzalez-Lopez, and Pilar de Vicente. "Incidence of Second Malignancies in the History of Chronic Lymphocytic Leukemia." Blood 138, Supplement 1 (November 5, 2021): 4693. http://dx.doi.org/10.1182/blood-2021-148016.
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Abstract Introduction The occurrence of other neoplasms in patients diagnosed with chronic lymphocytic leukemia (CLL) is a known but insufficiently studied complication, highlighting the need for further research. Our study aims to analyze the incidence of other malignancies in CLL. Methods We performed a retrospective observational study of patients diagnosed with CLL between 2000-2016 at our center. Variables collected included: demographics, stage at diagnosis, treatment, response to treatment, death, other neoplasm (type, date of diagnosis, outcome), biomarker profiles studied by karyotyping, FISH, immunoglobulin heavy chain gene variable region mutational status, and TP53 mutational status. A descriptive study was performed. Quantitative variables are described as medians with their range, and qualitative variables as percentages. The relationship between qualitative variables and the development of second malignancies was performed using Chi-square and Fisher's exact test. Survival analyses were performed using the Kaplan-Meier method and the difference between groups was analyzed using the log-rank test. Results A total of 182 patients were evaluated, 104 men (57%) and 78 women (43%); median age: 74 years (39 - 97). Most patients were diagnosed at early stages (74% at Rai stage 0 and 84% at Binet stage A) and the median CIRS scale score at diagnosis was 4 (0 - 15). With a median follow-up of 76 months (20-212), 77/182 (42%) patients had received ≥1 line(s) of treatment: 1: 53%, 2: 26%, 3: 8%, ≥4: 13%. Forty-nine cases (27%) were reported with other malignancies in addition to CLL; cases with Richter transformation (n=5, 2.7%) were excluded. The diagnosis of CLL preceded the other neoplasm in 33/182 cases (18%): 8 hematologic and 27 non-hematologic neoplasms. Half of the hematologic malignancies involved MGUS (n=4), 1 mutated JAK2 (V617F) cMPN, 1 AML and 1 MALT lymphoma. As for non-hematologic tumors, non-melanoma skin cancer accounted for 30% of cases (n=8), followed by breast cancer (n=5, 18.5%). Neoplasms of the stomach, colon, liver, bladder and prostate together accounted for 37%, in the same proportion each (n=2, 7.4%). The remaining neoplasms corresponded to lung and bronchus, kidney, melanoma and pancreas. Five of the 27 patients had a third solid organ neoplasm, with non-melanoma skin cancer again being the most frequent (n=2). The other neoplasms were lung, small bowel and thyroid. The incidence of second neoplasms was higher in treated patients (26% vs. 12.4%, p=0.019). The incidence of a second hematologic malignancy was related to treatment administration (9%) compared to 1% in untreated patients (p=0.011), especially in those with ≥ 3 lines (37.5% vs. 3%), p=0.024. We could not find any association between the variables analyzed and the development of second non-hematologic malignancies. The development of second neoplasms after the diagnosis of CLL did not have a negative impact on the overall survival of these patients. Conclusions The incidence of second malignancies is high in patients with CLL, being higher in those patients who have received treatment, and especially in those with a greater number of lines received. In contrast, the development of solid tumors did not seem to be affected by treatment administration, which should motivate further investigation in specific subgroups of patients. In our series, the development of second neoplasms after the diagnosis of CLL did not have a negative impact on the overall survival of these patients. Disclosures Gonzalez-Lopez: Novartis: Other: Advisoryboard and speakers honoraria, Research Funding; Amgen: Other: Advisory board and speakers honoraria, Research Funding; Sobi: Other: Advisory board honoraria; Grifols: Other: Advisory board honoraria.
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Izycka-Swieszewska, Ewa, Ewa Bien, Joanna Stefanowicz, Edyta Szurowska, Ewa Szutowicz-Zielinska, Magdalena Koczkowska, Dawid Sigorski, Wojciech Kloc, Wojciech Rogowski, and Elzbieta Adamkiewicz-Drozynska. "Malignant Gliomas as Second Neoplasms in Pediatric Cancer Survivors: Neuropathological Study." BioMed Research International 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/4596812.
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This study presents a unique series of malignant supratentorial gliomas in children previously cured from non-CNS primary cancer. On neuroimaging these tumors were not specific, so the patients were suspected of cerebral recurrence of their primary neoplasm: leukemia in four children and sarcoma in one child. Histologically, the group contained four glioblastomas and one anaplastic astrocytoma. Three patients underwent neurosurgical resection, while the other two underwent stereotactic diagnostic biopsy only. Despite combined oncological treatment, four children died during 20 months, and only one glioblastoma patient continued to live for another twelve years. Microscopically, the neoplasms consisted of small cells with some morphologic features of astrocytic lineage, having scanty or prominent processes. Microvascular proliferation and focal or diffuse necrosis were encountered in four cases. The GFAP reactivity in neoplastic cells was low or nil, together with the expression of Olig2, vimentin, and nestin. In two cases a subpopulation of synaptophysin-positive cells was present. Molecular immunohistochemical profiling revealed the expression of phosphorylated forms of PI3Kp110 and AKT, in parallel to a strong PTEN and p53 positivity. The tumors were of IDH1R132H-wild type and immunoreactive for ATRX, HER3, and EGFR. Secondary malignant gliomas in pediatric cancer survivors pose a diagnostic challenge. The present study shows that these tumors are of IDH wild type, PI3K/AKT-activated, having no PTEN and EGFR mutations. Therefore, the biopsy of brain tumors in such patients is crucial both for accurate diagnosis and material preservation for molecular typing.
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Koletsky, A. J., J. R. Bertino, L. R. Farber, L. R. Prosnitz, D. S. Kapp, D. Fischer, and C. S. Portlock. "Second neoplasms in patients with Hodgkin's disease following combined modality therapy--the Yale experience." Journal of Clinical Oncology 4, no. 3 (March 1986): 311–17. http://dx.doi.org/10.1200/jco.1986.4.3.311.
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From 1969 to 1982, 183 patients with previously untreated stages IIIB and IV Hodgkin's disease and relapsing Hodgkin's disease after radiation therapy were treated with combination chemotherapy plus low-dose irradiation (CRT). One hundred fifty patients who achieved a complete response (CR) were analyzed for risk of developing a second neoplasm. Median follow-up has been 8.3 years. Actuarial survival of all patients is 74% at 10 years with a relapse-free survival of 68%. An additional 24 patients with stage IIIA disease were also treated with CRT. There were 22 CRs at risk who were analyzed. Median follow-up has been 3+ years with an actuarial survival of 90% at five years and a relapse-free survival of 83%. Second neoplasms have developed in 14 of 172 patients at risk: acute nonlymphocytic leukemia (ANLL; five patients); aggressive histology non-Hodgkin's lymphoma (NHL; three patients); and a variety of solid neoplasms (six patients). Time to second neoplasm diagnosis after initial treatment ranged from 12 to 141 months. Five patients were older than 40 years. At the time of diagnosis of the second malignancy, 11 patients were free of Hodgkin's disease (for 36 to 141 months) and three were receiving therapy for recurrent Hodgkin's disease. The 10-year actuarial risk (%) of developing ANLL was 5.9 +/- 2.8; for NHL, the risk was 3.5 +/- 2.4, and for solid neoplasms, 5.8 +/- 3.0. Our results suggest that combination chemotherapy plus low-dose irradiation does not appear to significantly increase the risk of developing second neoplasms above that already reported for combination chemotherapy when administered as either initial or salvage treatment of Hodgkin's disease.
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Indelicato, Daniel, Kathryn Tringale, Julie Bradley, Raymond Mailhot Vega, Christopher Morris, Dana Casey, and Suzanne Wolden. "RONC-03. Secondary Neoplasms in Children with Central Nervous System (CNS) Tumors Following Radiotherapy in the Modern Era." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i176—i177. http://dx.doi.org/10.1093/neuonc/noac079.657.
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Abstract PURPOSE: To assess reduction of secondary radiation-induced neoplasms over the past two decades, focusing on children with CNS tumors who received intensity modulated radiotherapy (IMRT) or proton therapy (PT). METHODS: A total of 1044 children received radiotherapy for a primary CNS tumor at 2 institutions between 1999 and 2020, including 99 treated with IMRT and 945 treated with PT. Median age was 8.7 years old. Median follow-up was 6.0 years and included 83 and 510 patients with >5 years follow-up in the IMRT and proton cohorts, respectively. Cumulative incidence method provided estimates of secondary neoplasms encompassing benign and malignant solid tumors as well as leukemia. Multiple variables were assessed using proportional hazard regression for competing risks. RESULTS: Ten-year overall survival was 87.4%. Patients treated with IMRT were significantly older, with a median age of 10.4 vs 8.4 years old (p <0.001), but were more likely to receive craniospinal irradiation (31.3% vs 14.2%, p <0.001) or alkylating chemotherapy (50.5% vs 29.7%, p <0.001). The 5- and 10-year cumulative incidence of second neoplasm was 0.7% and 2.3%, respectively. On multivariate analysis, age <5 (4.9% vs 0.7% at 10 years) and tumor predisposition syndrome (34.3% vs 1.5% at 10 years) were significantly associated with a second neoplasm (p < 0.01 for each). On both univariate and multivariate analyses, PT was not associated with a lower incidence of second neoplasm. Following IMRT, 1/2 second solid tumors occurred outside the target volume, compared to 2/11 after PT. CONCLUSION: Following modern radiotherapy, approximately 2% of children with a CNS tumor will develop a second neoplasm within 10 years of treatment. Compared to IMRT, PT was not associated with an overall reduction in second neoplasms. More events and follow-up beyond 10 years are needed to determine if proton therapy reduces the incidence of second solid tumors occurring specifically in the low dose region.
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Awasthi, Ashish, Jamie Barbour, Andrew Beggs, Pradeep Bhandari, Daniel Blakeway, Matthew Brookes, James Brown, et al. "Enhanced neoplasia detection in chronic ulcerative colitis: the ENDCaP-C diagnostic accuracy study." Efficacy and Mechanism Evaluation 8, no. 1 (January 2021): 1–88. http://dx.doi.org/10.3310/eme08010.
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Background Chronic ulcerative colitis is a large bowel inflammatory condition associated with increased colorectal cancer risk over time, resulting in 1000 colectomies per year in the UK. Despite intensive colonoscopic surveillance, 50% of cases progress to invasive cancer before detection. Detecting early (precancer) molecular changes by analysing biopsies from routine colonoscopy should increase neoplasia detection. Objectives To establish a deoxyribonucleic acid (DNA) marker panel associated with early neoplastic changes in ulcerative colitis patients. To develop the DNA methylation test for high-throughput analysis within the NHS. To prospectively evaluate the test within the existing colonoscopy surveillance programme. Design Module 1 analysed 569 stored biopsies from neoplastic and non-neoplastic sites/patients using pyrosequencing for 11 genes that were previously reported to have altered promoter methylation associated with colitis-associated neoplasia. Classifiers were constructed to predict neoplasia based on gene combinations. Module 2 translated analysis to a NHS laboratory, assessing next-generation sequencing to increase speed and reduce cost. Module 3 applied the molecular classifiers within a prospective diagnostic accuracy study, in the existing ulcerative colitis surveillance programme. Comparisons were made between baseline and reference colonoscopies undertaken in a stratified patient sample 6–12 months later. Setting Thirty-one UK hospitals. Participants Patients with chronic ulcerative colitis, either for at least 10 years and extensive disease, or with primary sclerosing cholangitis. Interventions An optimised DNA methylation classifier tested on routine mucosal biopsies taken during colonoscopy. Main outcome Identifying ulcerative colitis patients with neoplasia. Results Module 1 selected five genes with specificity for neoplasia. The optimism-adjusted area under the receiver operating characteristic curve for neoplasia was 0.83 (95% confidence interval 0.79 to 0.88). Precancerous neoplasia showed a higher area under the receiver operating characteristic curve of 0.88 (95% confidence interval 0.84 to 0.92). Background mucosa had poorer discrimination (optimism-adjusted area under the receiver operating characteristic curve was 0.68, 95% confidence interval 0.62 to 0.73). Module 2 was unable to develop a robust next-generation sequencing assay because of the low amplification rates across all genes. In module 3, 818 patients underwent a baseline colonoscopy. The methylation assay (testing non-neoplastic mucosa) was compared with pathology assessments for neoplasia and showed a diagnostic odds ratio of 2.37 (95% confidence interval 1.46 to 3.82; p = 0.0002). The probability of dysplasia increased from 11.1% before testing to 17.7% after testing (95% confidence interval 13.0% to 23.2%), with a positive methylation result suggesting added value in neoplasia detection. To determine added value above colonoscopy alone, a second (reference) colonoscopy was performed in 193 patients without neoplasia. Although the test showed an increased number of patients with neoplasia associated with primary methylation changes, this failed to reach statistical significance (diagnostic odds ratio 3.93; 95% confidence interval 0.82 to 24.75; p = 0.09). Limitations Since the inception of ENDCaP-C, technology has advanced to allow whole-genome or methylome testing to be performed. Conclusions Methylation testing for chronic ulcerative colitis patients cannot be recommended based on this study. However, following up this cohort will reveal further neoplastic changes, indicating whether or not this test may be identifying a population at risk of future neoplasia and informing future surveillance programmes. Trial registration Current Controlled Trials ISRCTN81826545. Funding This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership, and will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 1. See the NIHR Journals Library website for further project information.
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Rehemtulla, Alnawaz. "Neoplasia: The Second Decade." Neoplasia 10, no. 12 (December 2008): 1314–24. http://dx.doi.org/10.1593/neo.81372.
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Meadows, A. T., E. Baum, F. Fossati-Bellani, D. Green, R. D. Jenkin, B. Marsden, M. Nesbit, W. Newton, O. Oberlin, and S. G. Sallan. "Second malignant neoplasms in children: an update from the Late Effects Study Group." Journal of Clinical Oncology 3, no. 4 (April 1985): 532–38. http://dx.doi.org/10.1200/jco.1985.3.4.532.
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This paper presents an update from the Late Effects Study Group on 292 cases of second malignant neoplasms (SMN) occurring in individuals who were diagnosed with their first neoplasm in childhood. Data are presented regarding the types of first and second neoplasm, the therapy administered, and the predisposing factors. Of the 292 cases (308 SMN), the most common primary was retinoblastoma followed by Hodgkin's disease, soft-tissue sarcomas, and Wilms' tumor. This is not similar to the relative frequency of these cancers in children but rather reflects specific risk factors. Bone sarcomas were the most common SMN among the 208 SMN developing in previously irradiated sites while acute leukemia was the most common SMN unassociated with radiation. Known predisposing conditions to cancer were present in 73 cases; retinoblastoma was the most common of these, followed by neurofibromatosis. There were ten patients with three and three patients with four malignant neoplasms. In 14 patients, the cause of SMN was not suggested by known risk factors as these patients had negative family histories and received no radiation or chemotherapy. We note, therefore, that although most cases of SMN in survivors of childhood cancer can be attributed to radiation, genetic disease, chemotherapy, or combinations of these, unrecognized predisposition or chance may also play a role.
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Bhatia, Smita, Harland N. Sather, Olga B. Pabustan, Michael E. Trigg, Paul S. Gaynon, and Leslie L. Robison. "Low incidence of second neoplasms among children diagnosed with acute lymphoblastic leukemia after 1983." Blood 99, no. 12 (June 15, 2002): 4257–64. http://dx.doi.org/10.1182/blood.v99.12.4257.
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Second malignant neoplasms are a serious complication after successful treatment of childhood acute lymphoblastic leukemia (ALL). With improvement in survival, it is important to assess the impact of contemporary risk-based therapies on second neoplasms in ALL survivors. A cohort of 8831 children diagnosed with ALL and enrolled on Children's Cancer Group therapeutic protocols between 1983 and 1995 were observed to determine the incidence of second neoplasms and associated risk factors. The median age at diagnosis of ALL was 4.7 years. The cohort had accrued 54 883 person-years of follow-up. Sixty-three patients developed second neoplasms, including solid, nonhematopoietic tumors (n = 39: brain tumors n = 19, other solid tumors n = 20), myeloid leukemia or myelodysplasia (n = 16), and lymphoma (n = 8). The cumulative incidence of any second neoplasm was 1.18% at 10 years (95% confidence interval, 0.8%-1.5%), representing a 7.2-fold increased risk compared with the general population. The risk was increased significantly for acute myeloid leukemia (standardized incidence ratio [SIR] 52.3), non-Hodgkin lymphoma (SIR 8.3), parotid gland tumors (SIR 33.4), thyroid cancer (SIR 13.3), brain tumors (SIR 10.1), and soft tissue sarcoma (SIR 9.1). Multivariate analysis revealed female sex (relative risk [RR] 1.8), radiation to the craniospinal axis (RR 1.6), and relapse of primary disease (RR 3.5) to be independently associated with increased risk of all second neoplasms. Risk of second neoplasms increased with radiation dose (1800 cGy RR 1.5; 2400 cGy RR 3.9). Actuarial survival at 10 years from diagnosis of second neoplasms was 39%. Follow-up of this large cohort that was treated with contemporary risk-based therapy showed that the incidence of second neoplasms remains low after diagnosis of childhood ALL.
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Popova, Vanya S. "Two Clinical Cases of Secondary Neoplasia After Remission of Hodgkin’s Disease." Journal of Biomedical and Clinical Research 15, no. 1 (June 1, 2022): 83–86. http://dx.doi.org/10.2478/jbcr-2022-0012.
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Summary Hodgkin’s disease is one of the most common lymphomas in young people. In such cases, long-lasting hematological remissions are achievable using therapeutic regimens, including combined radiotherapy and chemotherapy. This publication aims to present clinical cases from our practice in patients with Hodgkin’s disease in whom the occurrence of second neoplasia is probably causally related to the treatment of Hodgkin’s lymphoma. We present two clinical cases of women with established secondary neoplasia (breast carcinoma, diffuse large B cell lymphoma) 20 years after treatment for Hodgkin’s disease had been completed. The probability of developing another neoplastic disease, leading to increased mortality in these patients, requires updating the recommendations for secondary prevention in oncology.
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Ronchi, Andrea, Martina Di Martino, Alessandro Caputo, Pio Zeppa, Giuseppe Colella, Renato Franco, and Immacolata Cozzolino. "Fine-Needle Aspiration Cytology Is an Effective Diagnostic Tool in Paediatric Patients with Mucoepidermoid Carcinoma as Secondary Neoplasm." Acta Cytologica 64, no. 6 (2020): 520–31. http://dx.doi.org/10.1159/000508395.
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<b><i>Background:</i></b> Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. <b><i>Summary:</i></b> This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. <b><i>Key Messages:</i></b> MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.
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Kleber, Martina, Kerstin Höck, Gabriele Ihorst, Bernd Koch, Ralph Waesch, Ola Landgren, and Monika Engelhardt. "Second Malignant Neoplasms Following Multiple Myeloma: A Cohort Study On 744 Patients Treated 1997-2011." Blood 122, no. 21 (November 15, 2013): 3100. http://dx.doi.org/10.1182/blood.v122.21.3100.3100.
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Abstract Introduction Second malignant neoplasms after first-line therapy and maintenance-therapy have been reported in clinical studies; however, no risk factors have been established. Moreover, second malignant neoplasms is gaining increasingly more attention as multiple myeloma patients live longer and data from randomized studies suggest there are associations between certain newer drugs and the risk of developing second malignant neoplasms. Clinical trials are not statically powered to define risk factors for second malignant neoplasms. Methods We have conducted a large study designed to define the rate of second malignant neoplasms in a well-characterized clinical multiple myeloma cohort. We identified 744 consecutive patients treated at our institution between 1997-2011 and analyzed 1. onset of second malignant neoplasms, 2. patient characteristics (age, gender, familiar risks, smoking status, immune status), 3. frequency of different neoplasms, 4. potential multiple myeloma specific risk factors and 5. possible treatment-related risk factors (novel agents, autologous stem cell transplantation [single vs. tandem (t)-ASCT], allogeneic (allo-) SCT, frequency of alkylating agents, cycles/lines of therapy and ionizing radiation). Results 118 (16%) multiple myeloma patients developed second malignant neoplasms. Prior or synchronous malignant neoplasms were observed in 83 patients (63%) and second malignant neoplasms developed subsequent to multiple myeloma in 49 (37%) patients. Overall, most (77%) of these neoplasms were solid tumors; whereas hematological neoplasms with 23% were prominently observed subsequent to multiple myeloma. Furthermore, multiple myeloma who developed second malignant neoplasms (versus those who did not) were older, predominantly male, had IgG-MM and more CTx-cycles, use of steroids, alkylators, lenalidomide/thalidomide and radiotherapy, but lacked laboratory abnormalities nor did they have more ASCTs or bortezomib therapy. The risk of dying of multiple myeloma due to disease progression remained substantially higher than that of developing a second malignant neoplasm (cumulative incidence at 20 years: 78% vs. 11%, respectively). However, since multiple myeloma prognosis increases and death at 20 years of follow-up decreases, the development of second malignant neoplasms remains highly relevant (Figure 1; comparison of the SEER database with our UKF data). Conclusions Matching the SEER database with our data (Figure 1) confirms the rate of second malignant neoplasms at 20 years of follow-up at around 10%, whereas death from other causes (multiple myeloma) seems to substantially decrease. Further comparison is currently under way and will expand our knowledge on the development of second malignant neoplasms. Our prior (Hasskarl J.,..Engelhardt M. 2011) and previous analyses suggest that physicians need to discuss individual risk-benefit ratios with patients and stay updated as more knowledge becomes available on this topic. It is likely that second malignant neoplasms in multiple myeloma patients remain important given that the prognosis in multiple myeloma has substantially increased and patients live significantly longer. Disclosures: Kleber: Celgene: Educational grant Other. Engelhardt:Celgene: Educational grant Other.
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Thway, Khin, Ian Judson, and Cyril Fisher. "Clear Cell Sarcoma-Like Tumor of the Gastrointestinal Tract, Presenting as a Second Malignancy after Childhood Hepatoblastoma." Case Reports in Medicine 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/984369.
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Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLGT) is a rare malignant neoplasm arising within the wall of the small bowel, stomach, or large bowel, predominantly in children and young adults. It is an aggressive tumor with a high rate of local recurrence, metastases, and early death from disease. Histologically, it is composed of relatively monomorphic ovoid or round cells with clear to eosinophilic cytoplasm, arranged in sheets and sometimes papillary or alveolar architectures, often with CD68-positive osteoclast-like giant cells in variable numbers, and is associated withEWSR1-CREB1gene fusions. Its pathogenesis is unknown, and histologically it can be easily confused with a variety of intra-abdominal neoplasms. We describe a case of CCSLGT with molecular characterization, presenting as an acutely obstructing small bowel mass in a 33-year-old male, which occurred as a second malignant neoplasm 20 years after treatment with surgery, radiotherapy, and cisplatin and doxorubicin chemotherapy for childhood hepatoblastoma. This gives further insight into the clinical setting of this highly aggressive neoplasm and highlights the use of radiation therapy as a possible etiologic factor.
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Dieckmann, K. P., and V. Loy. "Prevalence of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms." Journal of Clinical Oncology 14, no. 12 (December 1996): 3126–32. http://dx.doi.org/10.1200/jco.1996.14.12.3126.
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PURPOSE Testicular intraepithelial neoplasia ([TIN], so-called carcinoma in situ of the testis) is hypothesized to be the precursor of testicular germ cell neoplasms. According to previous studies, it can be detected by testicular biopsy. Since patients with a unilateral testicular tumor are at high risk of a second testicular tumor, it seemed feasible to examine the prevalence of contralateral TIN in patients with testicular germ cell cancer and correlate it with the known prevalence of bilateral testicular tumors. The aim was to provide more evidence for the role of TIN as the preinvasive stage of testicular cancer. PATIENTS AND METHODS Nineteen hundred fifty-four consecutive patients with a unilateral testicular germ cell tumor underwent contralateral biopsy. All specimens were examined immunohistologically. RESULTS TIN was observed in 4.9% (95% confidence interval [CI], 3.95% to 5.91%). Testicular atrophy and a history of undescended testis were more frequently observed in patients with contralateral TIN, but only atrophy was shown to be independently associated by multivariate analysis. Patients with testicular atrophy have a 4.3-fold increased risk of having contralateral TIN. Sixty-four percent of TIN cases were found in normal testes. Patients with TIN were significantly younger than those without (P < .0017). Three patients developed a second testicular tumor despite a negative biopsy for TIN. CONCLUSION The prevalence of contralateral TIN corresponds well to the known prevalence of bilateral testicular tumors. Testicular atrophy is a strong indicator for the presence of TIN, but approximately 60% of TIN cases occur without atrophy. The present data are in accordance with the theory that TIN is an early step in the histogenesis of testicular germ cell neoplasms.
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Karthikeyan, Vilvapathy Senguttuvan, Sarath Chandra Sistla, Ramachandran Srinivasan, Debdatta Basu, Lakshmi C. Panicker, Sheik Manwar Ali, and Nagarajan Rajkumar. "Metachronous Multiple Primary Malignant Neoplasms of the Stomach and the Breast: Report of Two Cases With Review of Literature." International Surgery 99, no. 1 (January 1, 2014): 52–55. http://dx.doi.org/10.9738/intsurg-d-13-00056.1.
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Abstract Multiple primary malignant neoplasm is the occurrence of a second primary malignancy in the same patient within 6 months of the detection of first primary (synchronous), or 6 months or more after primary detection (metachronous). Multiple primary malignant neoplasms are not very frequently encountered in clinical practice. The relative risk for a second primary malignancy increases by 1.111-fold every month from the detection of the first primary malignancy in any individual. We present 2 patients treated for carcinoma of the breast who developed a metachronous primary malignancy in the stomach to highlight the rare occurrence of multiple primary malignant neoplasms. These tumors were histologically dissimilar, with distinct immunohistochemical parameters. The importance lies in carefully identifying the second primary malignancies, not dismissing them as metastases, and treating them accordingly.
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Burns, Ethan A., Cesar Gentille, Saro Kasparian, and Sai Ravi Pingali. "A Case of Histiocytic Sarcoma Arising from Mycosis Fungoides." Case Reports in Hematology 2019 (October 3, 2019): 1–7. http://dx.doi.org/10.1155/2019/7834728.
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Histiocytic sarcoma (HS) is an uncommon malignant neoplasm arising from mature histiocytes and most commonly characterized by the immunophenotypic expression of CD68, CD163, or lysozyme. Although rare, HS arising as a second primary malignancy following hematolymphoid neoplasms has been reported. To our knowledge, this is the first reported case of HS occurring as a second primary malignancy in a patient with mycosis fungoides (MF), with the retained immunophenotype markers CD30 and CD4.
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Child, Christopher J., Daniel Conroy, Alan G. Zimmermann, Whitney W. Woodmansee, Eva Marie Erfurth, and Leslie L. Robison. "Incidence of primary cancers and intracranial tumour recurrences in GH-treated and untreated adult hypopituitary patients: analyses from the Hypopituitary Control and Complications Study." European Journal of Endocrinology 172, no. 6 (June 2015): 779–90. http://dx.doi.org/10.1530/eje-14-1123.
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ObjectiveSpeculation remains that GH treatment is associated with increased neoplasia risk. Studies in GH-treated childhood cancer survivors suggested higher rates of second neoplasms, while cancer risk data for GH-treated and untreated hypopituitary adults have been variable. We present primary cancer risk data from the Hypopituitary Control and Complications Study (HypoCCS) with a focus on specific cancers, and assessment of recurrence rates for pituitary adenomas (PA) and craniopharyngiomas (CP).DesignIncident neoplasms during HypoCCS were evaluated in 8418 GH-treated vs 1268 untreated patients for primary malignancies, 3668 GH-treated vs 720 untreated patients with PA history, and 956 GH-treated vs 102 untreated patients with CP history.MethodsUsing population cancer rates, standardised incidence ratios (SIRs) were calculated for all primary cancers, breast, prostate, and colorectal cancers. Neoplasm rates in GH-treated vs untreated patients were analysed after propensity score adjustment of baseline treatment group imbalances.ResultsDuring mean follow-up of 4.8 years, 225 primary cancers were identified in GH-treated patients, with SIR of 0.82 (95% CI 0.71–0.93). SIRs (95% CI) for GH-treated patients were 0.59 (0.36–0.90) for breast, 0.80 (0.57–1.10) for prostate, and 0.62 (0.38–0.96) for colorectal cancers. Cancer risk was not statistically different between GH-treated and untreated patients (relative risk (RR)=1.00 (95% CI 0.70–1.41), P=0.98). Adjusted RR for recurrence was 0.91 (0.68–1.22), P=0.53 for PA and 1.32 (0.53–3.31), P=0.55 for CP.ConclusionsThere was no increased risk for all-site cancers: breast, prostate or colorectal primary cancers in GH-treated patients during HypoCCS. GH treatment did not increase the risk of PA and CP recurrences.
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Rugge, Massimo, Alberto Meggio, Cecilia Pravadelli, Mattia Barbareschi, Matteo Fassan, Maria Gentilini, Manuel Zorzi, Giovanni De Pretis, David Y. Graham, and Robert M. Genta. "Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: a 5-year prospective study of 1755 patients." Gut 68, no. 1 (January 6, 2018): 11–17. http://dx.doi.org/10.1136/gutjnl-2017-314600.
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ObjectiveOperative link on gastritis assessment (OLGA) staging for gastritis ranks the risk for gastric cancer (GC) in progressive stages (0–IV). This prospective study aimed at quantifying the cancer risk associated with each gastritis stage.DesignA cohort of 1755 consecutive patients with dyspepsia underwent initial (T-0) oesophagogastroduodenoscopy with mapped gastric biopsies, OLGA staging and assessment of Helicobacter pylori infection. Patients were followed for 55 months (median); patients with stages II III and IV underwent a second endoscopy/restaging (T-1), and those with stages 0 and I were followed clinically and through in-depth clinical and record checking. Endpoints were OLGA stage at T-1 and development of gastric epithelial neoplasia.ResultsAt T-0, 77.6% of patients had stage 0, 14.4% stage I, 5.1% stage II, 2.1% stage III and 0.85% stage IV. H. pylori infection was detected in 603 patients at T-0 and successfully eradicated in 602 of them; 220 had a documented history of H. pylori eradication; and 932 were H. pylori naïve-negative. Incident neoplastic lesions (prevalence=0.4%; low-grade intraepithelial neoplasia (IEN)=4; high-grade IEN=1; GC=2) developed exclusively in patients with stages III–IV. The risk for epithelial neoplasia was null in patients at stages 0, I and II (95% CI 0 to 0.4), 36.5 per 1000 person-years in patients at stage III (95% CI 13.7 to 97.4) and 63.1 per 1000 person-years in patients at stage IV (95% CI 20.3 to 195.6).ConclusionsThis prospective study confirms that OLGA staging reliably predicts the risk for development of gastric epithelial neoplasia. Although no neoplastic lesions arose in H. pylori-naïve patients, the H. pylori eradication in subjects with advanced stages (III–IV) did not abolish the risk for neoplastic progression.
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Milone, Jorge H., Juan J. Napal, Javier A. Bordone, Virginia Prates, Cecilia Garcia, Victor H. Morales, and Orlando J. Etchegoyen. "Second Neoplasm after Bone Marrow Transplant (BMT)." Blood 106, no. 11 (November 16, 2005): 5404. http://dx.doi.org/10.1182/blood.v106.11.5404.5404.
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Abstract Introduction: the second neoplasm, are pathologies described during the post transplant evolution, often associated to immunosuppression. The post transplant lymphoproliferative syndromes, habitually associated to viruses are the most frequent. The BMT is a procedure clearly different from the rest of the transplants, and this difference would also be observed on the incidence and type of tumor in its evolution. The incidence of second malignancies after BMT is low, and is related to the use of chemotherapy, particulary alkylating. agents radiotheraphy and immunosuppression. Objective: To analyze the incidence and characteristics of second neoplasm of the patients undergoing BMT in our Institute. Results: Between 06/93 and 04/05 over a total of 416 transplants, 132 Allogenic and 284 Autologous, 6 cases of second tumor in variable intervals post procedure were stated. Table 1. The data reflects an incidence of second neoplasias of 1,4% (6/416). None of then received radiotherapy in conditioning. No lymphoproliferative syndrome was observed; 2 cases of acute leukemias; being the rest solid tumors with expected evolutions for each pathology. Table 1 Case Disease Conditioning BMT 2nd Tumor Time betwen BMT-Tumor Evolution 1 MM L-PAM AUTO Lung Cancer 120 months Dead 2 CML BuCy ALLO Colon Cancer 72 months Dead 3 MDS BuCy ALLO Merckel cells tumor 60 months Dead 4 NHL CBV AUTO AML 65 months Dead 5 NHL CBV AUTO Bladder Cancer 58 months Alive 26 months 6 NHL CBV AUTO AML 4 months Dead
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Armstrong, Gregory T., Wei Liu, Wendy Leisenring, Yutaka Yasui, Sue Hammond, Smita Bhatia, Joseph P. Neglia, Marilyn Stovall, Deokumar Srivastava, and Leslie L. Robison. "Occurrence of Multiple Subsequent Neoplasms in Long-Term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 29, no. 22 (August 1, 2011): 3056–64. http://dx.doi.org/10.1200/jco.2011.34.6585.
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Purpose Childhood cancer survivors experience an increased incidence of subsequent neoplasms (SNs). Those surviving the first SN (SN1) remain at risk to develop multiple SNs. Because SNs are a common cause of late morbidity and mortality, characterization of rates of multiple SNs is needed. Patients and Methods In a total of 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, analyses were carried out among 1,382 survivors with an SN1. Cumulative incidence of second subsequent neoplasm (SN2), either malignant or benign, was calculated. Results A total of 1,382 survivors (9.6%) developed SN1, of whom 386 (27.9%) developed SN2. Of those with SN2, 153 (39.6%) developed more than two SNs. Cumulative incidence of SN2 was 46.9% (95% CI, 41.6% to 52.2%) at 20 years after SN1. The cumulative incidence of SN2 among radiation-exposed survivors was 41.3% (95% CI, 37.2% to 45.4%) at 15 years compared with 25.7% (95% CI, 16.5% to 34.9%) for those not treated with radiation. Radiation-exposed survivors who developed an SN1 of nonmelanoma skin cancer (NMSC) had a cumulative incidence of subsequent malignant neoplasm (SMN; ie, malignancies excluding NMSC) of 20.3% (95% CI, 13.0% to 27.6%) at 15 years compared with only 10.7% (95% CI, 7.2% to 14.2%) for those who were exposed to radiation and whose SN1 was an invasive SMN (excluding NMSC). Conclusion Multiple SNs are common among aging survivors of childhood cancer. SN1 of NMSC identifies a population at high risk for invasive SMN. Survivors not exposed to radiation who develop multiple SNs represent a population of interest for studying genetic susceptibility to neoplasia.
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Ta, B. M., G. T. Gallagher, R. Chakravarty, and R. H. Rice. "Keratinocyte transglutaminase in human skin and oral mucosa: cytoplasmic localization and uncoupling of differentiation markers." Journal of Cell Science 95, no. 4 (April 1, 1990): 631–38. http://dx.doi.org/10.1242/jcs.95.4.631.
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Expression of keratinocyte transglutaminase, a specific differentiation marker, has been examined by immunogold-silver cytochemistry in human epidermis and oral epithelium, and in oral mucosal hyperplasia and neoplasia. Two major findings have been obtained. First, considerable immunoreactivity was evident not only at the plasma membrane (the site of cross-linked envelope formation) but also in the cytoplasm of spinous cells, suggesting a cytoplasmic function for this transglutaminase. Staining at the cell border was seen principally in the granular layer of orthokeratinized epithelium (epidermis, hard palate), the outer spinous cells of ortho- and parakeratinized epithelium and in the suprabasal cells showing squamous differentiation in benign and malignant neoplasms. By contrast, diffuse cytoplasmic staining was observed in the upper spinous layer of the normal epithelium and benign lesions. The cytoplasmic immunoreactivity, which extended nearly to the basal layer in hyperkeratosis of the oral mucosa, was evident in two of three verrucous carcinomas examined. In keeping with their undifferentiated character, invasive nests of squamous cell carcinoma and basaloid epithelium in benign and neoplastic lesions were immunonegative for transglutaminase. The second major finding was that lesions of severe oral epithelial dysplasia, immunonegative for transglutaminase, were capable of expressing involucrin immunoreactivity, indicating an uncoupling of keratinocyte programming. These results suggest that immunogold-silver staining for transglutaminase may be useful in evaluating the degree of differentiation in benign and malignant oral epithelial proliferation.
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Leong, Anthony S.-Y. "Neoplastic Hematopathology: Second Edition." Pathology 34, no. 5 (2002): 485. http://dx.doi.org/10.1016/s0031-3025(16)34441-5.
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Quintavalla, Fausto, Rosanna Di Lecce, Daniele Carlini, Matteo Zanfabro, and Anna M. Cantoni. "Multifocal cutaneous non-epitheliotropic B-cell lymphoma in a cat." Journal of Feline Medicine and Surgery Open Reports 6, no. 2 (July 2020): 205511692097207. http://dx.doi.org/10.1177/2055116920972077.
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Case summary Skin tumours are the second-most common form of feline cancer after haematopoietic neoplasms and are often malignant. Cutaneous lymphoma is uncommon in cats and can be classified as epitheliotropic (typically of T-cell origin) or non-epitheliotropic (either of T-cell or B-cell origin). The present study describes a case of multifocal cutaneous non-epitheliotropic B-cell lymphoma. The skin nodules were multiple and variable in size; showed rapid progression; were alopecic and erythematous in appearance and pruritic and ulcerated; and were mostly located on the trunk. Nodule biopsies revealed the presence of uniform medium-to-large round neoplastic cells that infiltrated the dermis and subcutis. The neoplasias were consistent with a round cell cutaneous tumour and did not show evidence of epitheliotropism. Furthermore, immunohistochemical assessments indicated an immunophenotype characterised by round cells with a strong membrane and cytoplasmic positivity for the CD20 antigen, consistent with a lymphocyte of B-cell origin. Relevance and novel information Cutaneous non-epitheliotropic B-cell lymphoma in cats is rare and was previously reported to appear as single dermal and subcutaneous masses that are variable in size and generally develop in the tarsal region. To our knowledge, this is the first report to describe multifocal cutaneous non-epitheliotropic B-cell lymphoma in a cat.
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Prömmel, P., S. Pilgram-Pastor, H. Sitter, J. H. Buhk, and H. Strik. "Neoplastic Meningitis: How MRI and CSF Cytology Are Influenced by CSF Cell Count and Tumor Type." Scientific World Journal 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/248072.
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Background. Although CSF cytology and MRI are standard methods to diagnose neoplastic meningitis (NM), this complication of neoplastic disease remains difficult to detect. We therefore reevaluated the sensitivity of gadolinium (GD)-enhanced MRI and cerebrospinal-fluid (CSF)-cytology and the relevance of tumor type and CSF cell count.Methods. We retrospectively identified 111 cases of NM diagnosed in our CSF laboratory since 1990 with complete documentation of both MRI and CSF cytology. 37 had haematological and 74 solid neoplasms. CSF cell counts were increased in 74 and normal in 37 patients.Results. In hematological neoplasms, MRI was positive in 49% and CSF cytology in 97%. In solid tumors, the sensitivity of MRI was 80% and of cytology 78%. With normal CSF cell counts, MRI was positive in 59% (50% hematological, 72% solid malignancies) and CSF cytology in 76% (92% in hematological, 68% in solid neoplasms). In cases of elevated cell counts, the sensitivity of MRI was 72% (50% for hematological, 83% for solid malignancies) and of CSF cytology 91% (100% for haematological and 85% for solid neoplasms). 91% of cytologically positive cases were diagnosed at first and another 7% at second lumbar puncture. Routine protein analyses had a low sensitivity in detecting NM.Conclusions. The high overall sensitivity of MRI was only confirmed for NM from solid tumors and for elevated CSF cell counts. With normal cell counts and haematological neoplasms, CSF-cytology was superior to MRI. None of the analysed routine CSF proteins had an acceptable sensitivity and specificity in detecting leptomeningeal disease.
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Nichols, Chris, Rose Yin Geist, and Kara M. Nichols. "Clear cell neoplasm." Journal of Laryngology & Otology 106, no. 6 (June 1992): 553–55. http://dx.doi.org/10.1017/s0022215100120122.
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AbstractWe are reporting four cases of clear cell neoplasm. Local infiltration and destruction was observed in one case while in a second case, originating in the sublingual gland, metastasis to the lymph nodes occurred. The behaviour of these neoplasms has prompted the suggestion that these tumours be designated carcinomas rather that noncommittally tumours or neoplasms (Batsakis and Regezzi, 1977).The histopathological characteristics of our four cases conform to those that have been articulated and believed to be the distinctive features of these tumours (Batsakis and Regezzi, 1977). It is hoped that ours and similar reports will be helpful towards clearing the diagnostic and taxonomic confusion regarding these tumours.
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Sugiyama, K., K. Arita, K. Kurisu, and Y. Sawamura. "Second neoplasm and cerebrovascular disease in over five-year survivors with CNS germ cell tumor." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 9046. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.9046.
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9046 Background: Survivors of childhood and adolescent brain tumors are at risk for long-term effects of treatment (Tx). This study investigates details on second neoplasm and cerebrovascular disease of long-term survivors with CNS germ cell tumors (CNSGCTs). Methods: The authors reviewed clinical data on 203 institutional patients (pts) who had a CNSGCT and survived more than 5 years. Median age of initial Tx was 15.0 years and median follow-up period was 168 months (60–448 months). Results: Among these pts, 32 pts (15.4%) suffered from second neoplasm and/or cerebrovascular disease. Median age of 32 pts was 14.6 years at the initial Tx. Median interval to event was 151 months (24–456 months). The secondary events, therefore, occurred at the third decade of age. The second neoplasm included 8 cavernous angiomas, 7 GBMs, 3 meningiomas, 2 G-III glioma, 1 hemangiopericytoma, and 1 leukemia. Four cavernous angiomas caused a hematoma. The cerebrovascular disease included 14 steno-occlusive diseases of circle of Willis, 1 aneurysm, and 1 dural AVF. Four pts sufferred from both neoplasum and cerebrovascular disease. All 32 pts had previously received radiotherapy and 6 pts had undergone chemotherapy. Radiation field included whole ventricle system or whole brain involving basal cistern with the dose of more than 40 Gy, except for one who received 24 Gy followed by P-E chemotherapy. Eight of 32 pts died and 14 pts had additional sequelae due to these secondary events. Conclusions: The risk of lethal malignant neoplasm and disabling cerebarovascular disease after Tx for CNSGCTs is extremely large. Long-term follow-up system to monitor and prevent late sequelae should be established. No significant financial relationships to disclose.
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Frazzoni, Leonardo, Liboria Laterza, Alessandro Mussetto, Rocco Maurizio Zagari, Cristina Trovato, Mario De Bellis, Silvia Paggi, et al. "How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: a predictive model." Endoscopy 52, no. 03 (December 13, 2019): 220–26. http://dx.doi.org/10.1055/a-1041-2945.
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Abstract Background Patients with prior colon cancer have increased risk of metachronous colorectal neoplasms; therefore, endoscopic surveillance is indicated. Current recommendations are not risk-stratified. We investigated predictive factors for colorectal neoplasms to build a model to spare colonoscopies for low-risk patients. Methods This was a multicenter, retrospective study including patients who underwent surgery for colon cancer in 2001 – 2008 (derivation cohort) and 2009 – 2013 (validation cohort). A predictive model for neoplasm occurrence at second surveillance colonoscopy was developed and validated. Results 421 and 203 patients were included in derivation and validation cohort, respectively. At second surveillance colonoscopy, 112 (26.6 %) and 55 (27.1 %) patients had metachronous neoplasms in derivation and validation groups; three cancers were detected in the latter. History of left-sided colon cancer (OR 1.64, 95 %CI 1.02 – 2.64), ≥ 1 advanced adenoma at index colonoscopy (OR 1.90, 95 %CI 1.05 – 3.43), and ≥ 1 adenoma at first surveillance colonoscopy (OR 2.06, 95 %CI 1.29 – 3.27) were independently predictive of metachronous colorectal neoplasms at second surveillance colonoscopy. For patients without such risk factors, diagnostic accuracy parameters were: 89.3 % (95 %CI 82.0 %-94.3 %) and 78.2 % (95 %CI 65.0 %-88.2 %) sensitivity, and 28.5 % (95 %CI 23.5 %-33.9 %) and 33.8 % (95 %CI 26.2 %-42.0 %) specificity in derivation and validation group, respectively. No cancer would be missed. Conclusions Patients with prior left-sided colon cancer or ≥ 1 advanced adenoma at index colonoscopy or ≥ 1 adenoma at first surveillance colonoscopy had a significantly higher risk of neoplasms at second surveillance colonoscopy; patients without such factors had much lower risk and could safely skip the second surveillance colonoscopy. A prospective, multicenter validation study is needed.
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Navarro, Jose Tomas, Maria Joao Baptista, Mireia Morgades, Cristina Tural, Evarist Feliu, Fuensanta Millá, and Josep-Maria Ribera. "Second Malignancies After Treatment of AIDS-Related Non-Hodgking's Lymphoma." Blood 118, no. 21 (November 18, 2011): 4943. http://dx.doi.org/10.1182/blood.v118.21.4943.4943.
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Abstract Abstract 4943 Background: The use of highly active antiretroviral therapy (HAART) has dramatically improved the prognosis of AIDS-related Non-Hodgkin lymphoma (NHL), causing a remarkable increase in patients' long-term survival. On the other hand, with the introduction of HAART, the incidence of non-AIDS-related malignancies is increasing among patients with HIV infection. The incidence of second neoplasms after treatment of aggressive NHL have been reported to be higher than in the general population. Nevertheless, there is scarce information regarding second malignancies occurring in HIV-infected patients after NHL treatment. We sought for second neoplasms among patients treated of AIDS-related NHL, hence suffering from 2 conditions which may predispose them to develop malignancies: therapy for lymphoma and HIV infection. Methods: We conducted a retrospective study of patient data on AIDS-related NHL individuals diagnosed between 1989 and 2010 in our institution. Demographic, HIV infection, and lymphoma data on each case were collected. Two groups were further considered: patients who did not take HAART at all, and those who started HAART at any stage of their HIV infection. Continuous and categorical variables are presented using descriptive statistics. Survival analyses were performed using the Kaplan-Meier method and compared using the log-rank test. P-values of less than 0.05 were considered statistically significant. Results: Out of a series of 146 patients diagnosed with AIDS-related NHL, 138 patients were eligible for the study with a median follow-up of 8.24 years: 70 patients belonged to the no-HAART group, and 68 to the HAART group. Most interesting data regarding both groups are listed in table 1. Briefly, patients in the HAART group were older at the time of lymphoma diagnosis than those who did not receive it (p=0.024); in addition, there were more male patients in the no-HAART group (p=0.011). These differences show the demographic changes among HIV-infected patients in the HAART era. Furthermore, a higher number of complete responses (CR) to lymphoma treatment was observed in the HAART group (p<0.001). Overall survival (OS) and disease free survival (DFS) were significantly longer for patients who took HAART (p<0.001 and p<0.001 respectively). Four out of the 40 patients at risk (10%), developed a second malignancy in the HAART group, and none in the no-HAART one. However, no statistically significant differences were found, probably due to the low number of cases. The most important features of the 4 patients with a second malignancy are listed in table 2. All 4 patients were diagnosed with diffuse large B-cell lymphoma (DLBCL), were treated with CHOP, and had a prior diagnosis of AIDS. Two of the 4 were on HAART at lymphoma diagnosis (one of them in both virological and immunological response). The patient with hepatocarcinoma was HCV positive. As shown in table 1, three of the patients had responded to HAART when the second neoplasm (carcinoma) was diagnosed; and the reminder, who did not respond to HAART, developed a Kaposi sarcoma. All four patients died because of neoplasm progression. Conclusions: As expected, a higher frequence of second neoplasms was observed after treatment of AIDS-related NHL among patients who receive HAART. Second malignancies were non-HIV related neoplasms in patients with response to HAART. Abbreviations: CT, chemotherapy; RT, radiotherapy; IVDU: intravenous drug user. Disclosures: No relevant conflicts of interest to declare.
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Macis, Debora, Sara Gandini, Aliana Guerrieri-Gonzaga, Harriet Johansson, Paolo Magni, Massimiliano Ruscica, Matteo Lazzeroni, et al. "Prognostic Effect of Circulating Adiponectin in a Randomized 2 × 2 Trial of Low-Dose Tamoxifen and Fenretinide in Premenopausal Women at Risk for Breast Cancer." Journal of Clinical Oncology 30, no. 2 (January 10, 2012): 151–57. http://dx.doi.org/10.1200/jco.2011.35.2237.
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Adipokines are linked to obesity and insulin sensitivity and have recently been related to breast cancer risk and prognosis. We investigated the associations of plasma leptin and adiponectin with mammographic density and disease status and assessed their prognostic effect on recurrence-free survival in premenopausal women at risk for breast cancer.Patients and MethodsWe measured circulating lipids, insulin-like growth factor 1, glucose, insulin and insulin sensitivity (calculated by homeostasis model assessment [HOMA] index), leptin, adiponectin, and leptin-to-adiponectin ratio in 235 premenopausal women with pT1mic/pT1a breast cancer (n = 21), intraepithelial neoplasia (n = 160), or 5-year Gail risk of 1.3% or greater (n = 54) who participated in a 2 × 2 trial of low-dose tamoxifen, fenretinide, both agents, or placebo over a 2-year period.ResultsAt baseline, adiponectin levels were directly associated with mammographic density and HDL cholesterol and negatively associated with leptin, leptin-to-adiponectin ratio, body mass index (BMI), and HOMA index. Median adiponectin levels were lower in affected than in unaffected women (P = .006). After a median of 7.2 years and total of 57 breast neoplastic events, there was a 12% reduction in the risk of breast neoplastic events per unit increase of adiponectin (adjusted hazard ratio, 0.88; 95% CI, 0.81 to 0.96; P = .03). There was no interaction between treatment and adiponectin levels.ConclusionLow adiponectin levels are associated with a history of prior intraepithelial neoplasia or pT1mic/pT1a breast cancer and higher risk of second breast neoplastic events in premenopausal women. The associations are independent of BMI, mammographic density, and treatment. Our findings support the role of adiponectin as a potential target for premenopausal breast cancer prevention and treatment.
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Andriiaka, Artem, and Stanislav Vydyborets. "OPTIMIZATION OF DIAGNOSIS OF SECONDARY METABOLIC DISORDERS AND TREATMENT TACTICS IN PATIENTS WITH ANEMIA IN NEOPLASTIC DISEASE IN COLORECTAL CANCER." Scientific Journal of Polonia University 48, no. 5 (January 17, 2022): 132–41. http://dx.doi.org/10.23856/4817.
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Colorectal cancer is one of the most common oncological diseases, therefore, the study of this problem is an important issue in clinical practice. This problem becomes especially urgent in case of the formation of anemic syndrome in patients, which causes the emergence of a mutual burden syndrome and increases the risks for a patient. The progressive nature of anemia in colorectal cancer is accompanied by secondary metabolic disorders. The material for the study was the blood plasma of 445 patients (228 men and 217 women). Among them, 53 patients (31 women and 22 men) with iron deficiency anemia were examined and included in the first observation group (І) and 392 patients (206 men (52,55 %) and 186 women (47.45 %)) with colorectal cancer whose course of the underlying disease was burdened with anemia in neoplastic disease were included in the second observation group (II). Among the patients in the second (II) observation group, there were 222 individuals (119 men and 103 women) with malignant neoplasms of the colon (ICD-10 code: С.18), 29 individuals (16 men and 13 women) with malignant neoplasms of the rectosigmoid junction (ICD-10 code: C.19), 138 individuals (82 men and 56 women) with malignant neoplasms of the rectum (code ICD-10 C.20) and 3 patients (2 men and 1 woman) with malignant neoplasms of the anus (ICD-10 code: C.21). The age of the examined patients was from 22 to 79 years. It was found that prior to the initiation of treatment in patients with anemia in neoplastic disease, regardless of the course of colorectal cancer, there was a significant increase in the plasma level of free fractions of heparin, histamine and serotonin (p < 0,001); the ratio of histamine: serotonin was also changed in comparison with the values in the control group (p < 0,05), which indicated both an increased release of heparin, histamine and serotonin from the depot, and an impaired inactivation processes of these biologically active substances. It was correctly concluded that in addition to the baseline therapy the administration of arginine glutamate which causes both antihypoxic and membrane-stabilizing action, reliably contributes to the normalization of secondary metabolic disorders of histamine, serotonin and heparin metabolism in anemia in neoplastic disease in patients with colorectal cancer.
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Afanas’eva, Z. A., and S. F. Bakunin. "The risk of development of multiple primary malignant tumors involving the thyroid gland." Kazan medical journal 93, no. 4 (August 15, 2012): 616–23. http://dx.doi.org/10.17816/kmj1555.
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Aim. To determine the relative risk of developing other malignant tumors in patients with thyroid cancer and and the risk of developing thyroid cancer in patients with other malignancies. Methods. A retrospective analysis of 116 patients with multiple neoplasia including thyroid gland involvement was conducted for the period from 1973 to 2010. In order to estimate the relative risk of development of multiple neoplasias including thyroid gland lesions used was the following formula: relative risk = [a / (a + b)] / [c / (c + d)], where a is the number of patients with thyroid cancer with a second malignancy; b is the number of patients with thyroid cancer without a second malignancy; c is the number of patients in the population affected by the same malignant disease, as patients in group a; d is the number of people in the population without any cancer-related pathology. Results. In patients with carcinomas of the thyroid gland the relative risk is higher than in the general population for developing metachronous lymphoma (41.8 for men, 31.7 for women), renal cell carcinoma (55.6 for men, 18.5 for women), prostate cancer (35.7), lung and bronchus cancer (18.8 for women), melanoma (17.1 for women), colon cancer (16.7 for women), cervical cancer (15.8), uterine cancer (11.8), breast cancer (11.5 for women), skin cancer (9.5 in women) and the simultaneous development of renal cell carcinoma (33.8 for men and 46.3 for women), prostate cancer (24.4), melanoma (20.6 for women), cancer of the esophagus (19.4 for men, 17.8 for women), colon cancer (19.0 for men), lymphomas (12.8 for men), cervical cancer (11.3), breast cancer (11.0 for women), skin cancer (8.5 for women). The relative risk of developing metachronous cancer of the thyroid gland is higher than that in the population in patients with melanoma (108.0 in men, 50.4 for women), with malignant neoplasms of the lymphoid tissue (40.2 for men, 40.8 for women), uterine cancer (11.8), skin cancer (8.7 in women), breast cancer (8.0 for women). Conclusion. During preventive medical examinations of patients with thyroid cancer the relative risk of developing subsequent cancers must be taken into account for early diagnosis of multiple neoplasias.
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Hellmann, Andrzej, and Maria Bieniaszewska. "Myeloproliferative Neoplasms – Classification, Diagnostic and Therapeutic Options in the Light of Molecular Findings." European Oncology & Haematology 03, no. 01 (2009): 57. http://dx.doi.org/10.17925/eoh.2009.03.1.57.
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The discovery of specific molecular aberrations (gene fusions or mutations) has had a profound effect on the understanding and management of myeloproliferative disorders (MPDs). First, it has provided clear evidence that all of these disorders are of neoplastic origin. This fact resulted in the change of the nomenclature proposed in the World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissues 2008, where the term MPDs was replaced by myeloproliferative neoplasms (MPNs). Second, useful tools for diagnostic procedures were developed, i.e. polymerase chain reaction (PCR) or other molecular assays. Thanks to this, previous complicated diagnostic algorithms could be simplified and the numerical value requirements could be lowered, making the diagnosis simpler and quicker. The other implication of the molecular findings in myeloproliferative neoplasms is derived from the fact that all discovered mutations result in translation of proteins with tyrosine kinase activity. So, nowadays the majority of myeloproliferative neoplasms can be treated with target therapy using tyrosine kinase inhibitors.
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Maniar, Tapan N., Inbal Braunstein, Stephen Keefe, Sofia Hussen, Tara Abrams, Angela De Michele, and Wafik S. El-Deiry. "Childhood ALL and second neoplasms." Cancer Biology & Therapy 6, no. 10 (October 2007): 1525–31. http://dx.doi.org/10.4161/cbt.6.10.4928.
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Kumar, Sanath. "Second Malignant Neoplasms Following Radiotherapy." International Journal of Environmental Research and Public Health 9, no. 12 (December 18, 2012): 4744–59. http://dx.doi.org/10.3390/ijerph9124744.
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Levi, Fabio, Lalao Randimbison, Manuela Maspoli, Van-Cong Te, and Carlo La Vecchia. "Second neoplasms after oesophageal cancer." International Journal of Cancer 121, no. 3 (2007): 694–97. http://dx.doi.org/10.1002/ijc.22744.
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