Relationship between tumor growth characteristics and preferential sites of growth

The anterior-posterior incidence of spontaneous mammary tumor development and the anterior-posterior gradient of growth potential among transplanted tumors was studied in C3H/He and C3Hf/He mice. The relative incidence of spontaneous tumor development in the five mammary gland pairs showed no anterior-posterior bias, but it was in proportion to the quantity of tissue in the individual mammary glands. The transplantability and growth rate of 164 spontaneous C3H/He and 67 spontaneous C3Hf/He mammary carcinomas were tested and compared in anterior and posterior subcutaneous sites and at mammary implantation sites. Initially, in their early transplant generations, most subcutaneous tumor implants (67%) grew significantly better near the shoulder than in an implantation site near the hip. At the same time, implants from the same tumor tissue grew equally well in anterior (#2) and posterior (#4) mammary glands. Without exception, all transplanted tumors grew better in a mammary gland than at a subcutaneous site. Some tumors (12%) that initially would grow only in mammary glands gained subcutaneous transplantability with increased growth rate. With increasing growth rate, the tumors' anterior subcutaneous growth preference decreased. Anterior subcutaneous growth preference was not related to immunologic tumor characteristics. Implants of slow-growing tumors grew better in the anterior subcutaneous implantation site where the greater blood flow improved their growth conditions and survival rate.     

Superior vena cava syndrome caused by supraclavicular lymph node metastasis of renal cell carcinoma

A 65-year-old woman presented with gross hematuria in February 1997. Left renal tumor was revealed and radical nephrectomy was performed. Pathological examination revealed papillary renal cell carcinoma, pT3aN1M1 (ipsilateral adrenal gland). Interferon-α was administered for 1 year. Two years after the nephrectomy, metastasis to the left supraclavicular lymph node appeared. Seven years after the nephrectomy, the metastatic tumor invaded the brachiocephalic vein and extended to the superior vena cava (SVC), compatible with SVC syndrome. Although interferon-α and external-beam radiotherapy was performed, she died in February 2005. Autopsy revealed a left supraclavicular lymph node metastasis invading the thyroid gland, mediastinum, and brachiocephalic vein. The tumor thrombus descended via the SVC into the right atrium. The right lung artery was obstructed by tumor thrombus. There were no visceral metastases and no local recurrence.     

Pancreatic carcinoma coexistent with pancreatic pseudocyst which penetrated into the stomach

We report a case of pancreatic adenocarcinoma coexisting with a pancreatic pseudocyst, which showed gradual disappearance during preoperative examinations. The patient, an 83-year-old woman, had upper abdominal and back pain, and abdominal computed tomography (CT), on December 6, 1997, revealed an 11.0 ≧ 5.8 cm cystic mass in the pancreas. On December 11, abdominal magnetic resonance imaging showed that the cyst had reduced in size to 3.8 ≧ 2.4 cm, and was enveloped in a large solid tumor. Repeat abdominal CT, on January 5, 1998, showed disappearance of the cystic lesion, while an obvious pancreatic tumor had invaded the posterior wall of the stomach and the left adrenal gland. Distal pancreatectomy combined with total gastrectomy and left adrenal glandectomy were performed on January 7, 1998. Histological examination revealed a moderately differentiated ductal adenocarcinoma with an abscess in the tumor, which had developed a fistula to the ulceration of the stomach. The large cyst presented on admission seemed to have penetrated into the stomach, and had disappeared within 1 month. Received: June 28, 1999 / Accepted: February 28, 2000     

Transforming growth factor-beta and breast cancer: Lessons learned from genetically altered mouse models

Transforming growth factor (TGF)-βs are plausible candidate tumor suppressors in the breast. They also have oncogenic activities under certain circumstances, however. Genetically altered mouse models provide powerful tools to analyze the complexities of TGF-βaction in the context of the whole animal. Overexpression of TGF-β can suppress tumorigenesis in the mammary gland, raising the possibility that use of pharmacologic agents to enhance TGF-β function locally might be an effective method for the chemoprevention of breast cancer. Conversely, loss of TGF-β response increases spontaneous and induced tumorigenesis in the mammary gland. This confirms that endogenous TGF-βs have tumor suppressor activity in the mammary gland, and suggests that the loss of TGF-β receptors seen in some human breast hyperplasias may play a causal role in tumor development.     

乳腺肿块微血管密度与血氧近红外光参数的相关性研究

Objective: To detect the reliability of near-infrared parameters of blood oxygen of mammary gland phyma from the microvessel density of tumor. Methods; 181 cases of mammary gland phyma who had accepted the examination of the near-infrared TBO-I dual-wave length mammary gland phyma detector were classified by near-infrared parameters of blood oxygen, and were performed the pathologic examination to ascertain whether the tumor was benign or malignant. Among these cases, intratumoral microvessel density of 20 cases of malignant phyma and 20 cases of benign phyma were confirmed by S-P immunohistochemical method, then the relationship between near-infrared parameters and microvessel density were analyzed by medical statistics. Results: (1) The microvessel density and blood concentration of 28 cases of the "high blood" tumor were 24.56 ± 8.110 and 1.891 ± 0.850 respectively. The microvessel density and blood concentration of 12 cases of the "low blood" tumor were 17.98 ± 8.729 and 0.698 ± 0.283 respectively. There was significant difference between the "high blood" and "low blood" tumors (P ＜ 0.05). (2) The intratumoral microvessel density and blood concentration were linearly correlated respectively, and the linear correlation coefficient r = 0.4208 (P ＜ 0.05) in 40 cases of mammary gland phyma.Conclusion: The intratumoral microvessel density and blood concentration of benign or malignant mammary gland phyma were linearly correlated. Blood concentration (one of near-infrared parameters) is reliable to be used as diagnosis criterion of malignant mammary gland phyma.     

Rat mammary gland carcinogenesis after local injection of N-hydroxy-N-acyl-2-aminofluorenes: relationship to metabolic activation

A single local injection of 2.5 µmol of N-hydroxy-N-formyl-2-aminofluorene(N-hydroxy-FAF), N-hydroxy-N-acetyl-2-aminofluorene (N-hydroxy-AAF),or N-hydroxy-N-propionyl-2-aminofluorene (N-hydroxy-PAF) toeach of the six left mammary glands of female Sprague-Dawleyderived CD rats gave a mammary tumor incidence, after 12 months,of 53% for the N-acetyl (42% adenocarcinoma, 11% fibroadenoma),41% for the N-formyl (8% adenocarcinoma, 11% sarcoma, 22% fibroadenoma),and 33% for the N-propionyl (11% adenocarcinoma, 22% fibroadenoma)derivatives of N-hydroxy-N-2-aminofluorene. Latent periods formalignant tumor appearance (adenocarcinoma or sarcoma) was 210days, 148 days, and 177 days, respectively, with no malignanttumors occurring in the vehicle-treated animals. In contrast,latent periods for benign tumor appearance (fibroadenoma) was263 days for control animals, 289 days for the N-hydroxy-AAF,324 days for the N-hydroxy-FAF, and 317 days for the N-hydroxy-PAFanimals. When N-acetyl-2-aminofluorene (AAF) was applied asabove there was only an 8% mammary tumor incidence (4% adenocarcinoma,4% fibroadenoma) with a latent period of 207 days for malignanttumor (adenocarcinoma) and 221 days for benign tumor (fibroadenoma)appearance. Arylhydroxamic acid N,O-acyltransferase activityhas been demonstrated in the mammary glands of male, and lactatingand non-lactating female Sprague-Dawley derived CD rats by meansof a nucleic acid binding assay. Mammary gland cytosol catalyzedtRNA adduct formation to a greater extent with N-hydroxy-FAF.AAF was not activated by this enzyme. Ammonium sulfate fractionationdemonstrated the presence of two enzymes, one specific for N-hydroxy-FAF(70–80% fraction), the other specific for N-hydroxy-AAFand N-hydroxy-PAF (40–70% fraction). Moreover, gel filtrationchromatography of mammary gland cytosol demonstrated the presenceof two enzymes of differing acyl specificity. Mammary glandmicrosomes catalyzed the formation of tRNA adducts, but onlywith the N-hydroxy-FAF derivative. Assays that tested the mutagenicpotential of the arylhydroxamic acids in Salmonella typhimuriumTA-1538 with either mammary gland cytosol or microsomes demonstratedthe order of mutagenicity to be N-hydroxy-FAF » N-hydroxy-AAF> N-hydroxy-PAF. A similar order of mutagenicity was demonstratedwithout an external metabolic activation system. These datademonstrate the presence of two distinct enzymes in the ratmammary gland that activate arylhydroxamic acids.     

咽旁间隙肿瘤的CT和MRI诊断价值

目的分析咽旁间隙肿瘤的CT及MRI表现，以提高该部位病变的诊断及鉴别诊断水平。方法回顾性分析54例经病理证实的咽旁间隙肿瘤的CT及MRI表现。结果神经鞘瘤形态较规则（85．7％），涎腺肿瘤形态多不规则（63．2％），二者边界多清楚。涎腺肿瘤位于茎突前方18例（94．7％），神经鞘瘤位于颈鞘内26例（92．9％）。24例神经鞘瘤使咽旁间隙向两侧移位（85．7％），涎腺肿瘤多向前、内侧移位。涎腺肿瘤中12例（63．2％）小部分伸人腮腺深叶。神经鞘瘤多位于二腹肌后腹的深面（96．4％），涎腺肿瘤多位于二腹肌后腹的浅面（68．4％）。结论肿瘤与茎突、咽旁脂肪间隙、颈鞘、腮腺、二腹肌后腹的关系及肿瘤密度／信号及强化特点对咽旁间隙肿瘤的定位、定性诊断有重要的价值。     

Mixed germ cell tumor and hemangioblastoma in the cerebellum: report of a rare coexistence

We report a case of a cerebellar tumor consisting of a mixed germ cell tumor (GCT) and a hemangioblastoma. A 22-year-old man presented with myoclonus and cerebellar ataxia. Magnetic resonance imaging showed a tumor mass in the left cerebellar hemisphere. The tumor was totally removed, and the histological diagnosis was an undetermined neoplasm. Ten months later, the patient returned with cerebellar hemorrhage at the site of the previous tumor. An emergency craniotomy was performed, and a tumor mass adjacent to the hematoma was resected. Microscopic examination revealed a mixed GCT consisting of a germinoma, choriocarcinoma, and mature teratomatous component. An area of hemangioblastoma was also found in the same tumor mass. A retrospective examination of the histological sample from the first operation indicated a germinoma. A primary GCT of the posterior fossa is very rare, and there are no other reports of the coexistence of a GCT and a hemangioblastoma. A metastatic GCT lesion of extracranial origin should be considered when the intracranial GCT is non-germinomatous and arises in an unusual site. The most probable hypothesis for the histogenesis of this case was a hemangioblastoma complicated by a “tumor-to-tumor” metastatic lesion of testicular GCT with “burnout” of the primary site.     

Dural cerebellopontine angle metastasis from malignant parotid oncocytoma

Malignant oncocytoma of the parotid gland is a quite rare tumor, with only 40 cases with unequivocal histological diagnosis reported in the literature. No cases with intracranial metastasis have been described. The authors report a very unusual case of malignant parotid gland oncocytoma with a large dural extracerebellar metastasis occurring in the contiguous cerebellopontine angle six months after surgery for the primary tumor. Only a partial removal of the dural metastasis was possible because of the cranial nerve and vessel encasement within the mass. Surgery and irradiation resulted in one-year survival. Interestingly, no destruction and infiltration of the petrous and temporal bones were found both at radiological and surgical exploration. We may suggest that metastatic spread from the parotid region to the cerebellopontine angle occurred through the mastoid cells or by haematogenous diffusion through the meningeal branches to the posterior fossa dura from the occipital or ascending pharyngealbreak arteries.     

Clinicopathologic review of 88 cases of carcinoma metastatic to the putuitary gland.

Clinical and pathologic features of 88 cases of carcinoma metastatic to the pituitary gland were reviewed.In 61 (69.3%), metastases were localized either in the posterior lobe alone or in the posterior and anterior lobes together; only 12 (13.6%) involved the anterior lobe alone. Diabetes insipidus was present in 6 patients (6.8%), one of whom also had clinical panhypopituitarism due to metastatic tumor and necrosis in the anterior pituitary lobe. Breast and lung were the most frequent primary sites in women and men, respectively. Sixty-four (72.7%) of these glands were grossly normal at necropsy. Metastases to the pituitary gland occur more frequently in the posterior lobe than in the anterior lobe, and my ve reflected clinically by diabetes insipidus in patients with diseminated carcinoma. Clinical panhypopituitarism is a rare accompaniment of anterior lobe involvement.     

乳腺癌垂体转移1例报告

目的通过报道1例乳腺癌垂体转移病例,结合相关文献,总结垂体转移癌的临床特点,以提高对垂体转移癌的认识和诊断水平。方法分析解放军第222医院1例确诊为乳腺癌垂体转移患者的临床资料,整理近期国内外关于垂体转移癌的相关文献。结果垂体转移癌十分罕见,多来源于乳腺癌和肺癌,缺乏特征性影像学表现,以尿崩症、视神经损害和垂体前叶功能障碍为主要临床表现,与腺瘤的主要鉴别要点是具有侵袭性。结论对于生长迅速、侵袭性强、同时影响垂体前后叶功能的鞍区肿瘤需注意和垂体转移癌相鉴别。     

Induction of mammary tumors in female Sprague--Dawley rats by the food-derived carcinogen 2-amino-1-methyl-6-phenyliniidazo [4,5-b]pyridine and effect of dietary fat

2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), a carcinogenfound in cooked meat, was determined to be a mammary carcinogenin female Sprague—Dawley rats on a high fat diet. Forty-three-day-oldfemale Sprague—Dawley rats received 10 doses of PhIP (75mg/kg, p.o., days 1–5 and 8–12). Two days afterthe last dose of PhIP, animals were placed on a high polyunsaturatedfat diet (23.5% corn oil) or a standard low fat diet (5% cornoil). After 25 weeks on the defined diet, mammary tumor incidence(average tumor mass ± SE) was 53% (5.7 ± 1.3 g)and 16% (2.4 ± 0.9 g) in rats on a high fat and standardlow fat diet, respectively. The histological differences inmammary gland tumors found in animals on the standard low fatdiet and the high fat diet were striking. Mammary gland tumorsfound in PhIP-treated rats on the low fat diet were all histologicallybenign. The histopathological changes in these tumors includedhypertrophic changes resembling the normal mammary gland, fibrocysticchanges, and selerosing adenosis. How ever, 80% of the mammarygland tumors found in PhIP treated rats on a high fat diet werehistologically malignant. These tumors had several malignantphenotypes including intraductal carcinoma (papillary, cribriform,and comedo type), tubular adenocarcinoma, and infiltrating ductcarcinoma. The data indicate that a high fat diet in combinationwith a heterocydic amine carcinogen derived from cooked meatmay enhance the incidence and severity of mammary gland cancer.     

高频超声诊断在腮腺肿瘤诊断中的价值及误诊原因分析

目的:探讨高频超声诊断在腮腺肿瘤诊断中的价值及分析其误诊的原因,以期提高高频超声诊断腮腺肿瘤的符合率。方法:回顾性分析经手术及病理证实的12例腮腺多形性腺瘤病例、10例Warthin瘤病例的高频超声特点,分析并观察肿块的大小、形态、性质、解剖部位、内部回声,应用彩色多普勒检测肿块内部血流的丰富程度。结果:高频超声诊断12例腮腺多形性腺瘤患者中,诊断为多形性腺瘤6例,正确诊断率为50%,误诊为淋巴结炎2例,误诊为血肿1例,诊断为混合性占位、性质待定3例,误诊率50%。应用高频超声诊断10例Warthin瘤患者时,诊断为Warthin瘤4例,正确诊断率为40%,误诊为多形性腺瘤3例,误诊为淋巴结炎1例,诊断为混合性占位、性质待定2例,误诊率60%。多形性腺瘤与Warthin瘤的回声强度无差异,P>0.05;后壁回声增强、血流信号强度分级有差异,P<0.05,差异有统计学意义。结论:典型的多形性腺瘤、Warthin瘤有各自的声像图特点,非典型的多形性腺瘤类似于Warthin瘤。高频超声检查在腮腺多形性腺瘤与Warthin瘤的鉴别诊断过程中,有较高应用价值。通过观察肿块的形态、边界、包膜、内部回声、后壁回声增强情况,并运用彩色多普勒检查检测内部血流情况,结合患者一般临床资料,可以提高腮腺多形性腺瘤与Warthin瘤的诊断准确率。     

Malignant neoplasm in the axilla of a male: suspected primary carcinoma of an accessory mammary gland

A 58-year-old Japanese male patient visited our hospital for evaluation of an elastic hard mass, measuring 80 × 50 mm, in the right axillary area. Incisional biopsy for suspected malignancy was performed, and histopathologic examination by hematoxylin–eosin (H&E) staining yielded a diagnosis of poorly differentiated adenocarcinoma metastatic from an unknown primary. As the tumor was immunohistochemically positive for both ER and PgR, metastatic breast cancer was strongly suspected. Ultrasonography, CT, and MRI revealed no evidence of tumors in the bilateral mammary glands. Detailed examination of the head and neck region, lung, and upper and lower gastrointestinal tract also revealed no evidence of a primary tumor. After chemotherapy, the patient underwent tumor resection with axillary lymph node dissection. On the basis of the histological features of H&E-stained specimens and immunohistochemistry of the resected tumor, this case was diagnosed as breast cancer of unknown origin in a male. The tumor could have been an axillary lymph node metastasis from an occult breast carcinoma, or primary cancer arising in an accessory mammary gland.     

Initial results of fractionated CyberKnife radiosurgery for uveal melanoma

Objective To evaluate prospectively local tumor control and morbidity after fractionated CyberKnife radiosurgery for uveal melanoma unsuitable for ruthenium-106 brachytherapy or local resection. Methods This study includes melanoma ≥7 mm in initial height, or juxtapapillary and/or juxtamacular tumors (height ≥3 mm; posterior tumor margin extending to within 3 mm of optic disk rim and/or fovea). Patients were excluded if they presented evidence of echographic extrascleral tumor extension, neovascular glaucoma, or any form of pretreatment or metastases at baseline. The eye was stabilized by the same ophthalmologist via peribulbar injection of 5 cc 2% lidocaine. CyberKnife radiosurgery was performed delivering a total dose of 60 Gy to the 80% or 85% isodose line in three fractions. The planning target volume (PTV) included the contrast-enhancing lesion on MRI plus a 1-mm margin (no margin on fovea site). Results Five patients with uveal melanoma were treated by this procedure. All patients had serous retinal detachment associated with the tumor. No grade ≥2 acute toxicities were observed. Eight-month follow-up revealed a decrease in tumor thickness in three patients and reattachment of the retina in four. The tumors remained stable in two eyes and an increase in retinal detachment was noted in one eye. Vision improved minimally in two eyes and remained stable in three. Conclusion CyberKnife fractionated radiosurgery seems to be a viable alternative local treatment modality in uveal melanoma with no serious acute side effects. Further follow-up is indicated.     

Evidence of lymphangiogenesis in Warthin's tumor of the parotid gland

The details of the pathogenesis of cystadenolymphoma (Warthin's tumor) of the parotid gland are still unclear. Neovascularization is considered to be a pivotal factor for solid tumor progression and biological behavior of the tumor. Using double-labeling immunohistochemistry for LYVE-1 and CD34 (specific markers for lymphatic and vascular endothelial cells, respectively) this study analyzes lymphatic vessel density (LVD) and blood vessel density (BVD) in 10 Warthin's tumors and 10 pleomorphic adenomas of the parotid gland as well as in 5 normal parotid glands and 5 normal parotid lymph nodes. There was no significant difference in the intratumoral LVD and BVD among pleomorphic adenoma and normal parotid gland tissue. In contrast, the intratumoral LVD and BVD were significantly higher in Warthin's tumor than pleomorphic adenoma, normal parotid gland and parotid lymph node (P<0.0001 versus P<0.004). The increase in lymphatic vessels in Warthin's tumor suggests that epithelial tumor cells might promote lymphangiogenesis in this kind of lesions.     

Tumor-specific expression of αvβ3 integrin promotes spontaneous metastasis of breast cancer to bone

Introduction  

Studies in xenograft models and experimental models of metastasis have implicated several β3 integrin-expressing cell populations, including endothelium, platelets and osteoclasts, in breast tumor progression. Since orthotopic human xenograft models of breast cancer are poorly metastatic to bone and experimental models bypass the formation of a primary tumor, however, the precise contribution of tumor-specific αvβ3 to the spontaneous metastasis of breast tumors from the mammary gland to bone remains unclear.     

CT and MRI findings of parotid Warthin��s tumors

Objective

The aim of the study was to investigate CT and MRI findings of parotid Warthin??s tumors (parotid adenolymphomas).

Methods

CT and MRI findings of 14 patients with pathologically-confirmed Warthin??s tumor (10 males and 4 females) were retrospectively analyzed. The average age was 56 years (range 44?C77 years). Twelve patients underwent CT plain scan, of which, 10 received the further enhancement; other 2 patients performed MR plain scan, of which, 1 was enhanced. The disease course ranged from 20 days to 4 years with the average of 22 months. Ten patients had the smoking history (71.4%).

Results

A total of 22 foci were found in all 14 patients, multiple in one parotid gland in 3 patients, single in one parotid gland in 9 patients and single in bilateral glands in 2 patients (one recurred the tumor in the contralateral gland 14 years after the surgery). Sixteen (72.7%) foci or the main bodies [long diameter of 0.8?C5.0 cm with the average of (2.3 ± 1.3) cm]were located in the posterior and interior role of the superficial lobe of the parotid gland. The foci were round or oval. The boundary was smooth in 21 (95.5%) foci and blurred in 3 foci which were proved by biopsy to be accompanied with infection. Fourteen foci (77.7%) with uniform density and 4 foci with nonuniform density were found in 12 patients under CT plain. A total of 15 foci in 10 patients were enhanced, 7 (46.7%) on significant enhancement, 5 (33.3%) on moderate enhancement and 3 on slight enhancement. The margin was enhanced slightly in 3 foci. In MR images, the signal of tumor was uniform or nonunifrom, T1WI showed low signal and T2WI showed moderate or high signal. The envelope displayed signal shadow under plain scan and the enhancement was slightly.

Conclusion

For middle or elder males with the smoking history, if they have the foci in the posterior and interior parts of the parotid gland which show clear boundary and significant enhancement, especially for multiple or bilateral foci, parotid Warthin??s tumor should be considered firstly.     

血清肿瘤特异性生长因子检测对涎腺恶性肿瘤诊断的价值

目的探讨肿瘤特异性生长因子(tumor specific growth factor,TSGF)在涎腺恶性肿瘤诊断中的应用价值.方法采用福建新大陆生物技术有限公司提供的TSGF癌症快速诊断试剂盒测定63例涎腺良性肿瘤、51例非肿瘤疾病及82例涎腺恶性肿瘤患者血清中的TSGF含量.结果涎腺恶性肿瘤患者血清中的TSGF含量及阳性检出率明显高于涎腺良性肿瘤及非肿瘤组患者(P<0.01).不同类型涎腺癌患者TSGF水平差异无显著性.结论血清TSGF检测对涎腺恶性肿瘤的诊断有一定的参考价值.