Exophytic endobronchial epidermoid carcinoma

Exophytic endobronchial epidermo?d carcinoma is a rare clinical entity. The authors describe and systematically analyzed 34 cases, collected during 35 years. There was a preponderance of male patients; the mean age at presentation was 58 years. The tumors were nearly always at the T1N0 stage, and their prognosis was not better than that for other Stage I bronchogenic carcinomas. The findings suggest that they are a special subvariety of bronchogenic carcinoma, rather than tumor detected at an early stage.     

Drug therapy in advanced squamous cell carcinoma of the ORL region

This paper reviews the role of chemotherapy in advanced squamous cell carcinoma of the head and neck region (SSCHN). Two different areas of administration are discussed separately: (1) Palliative therapy in recurrent disease, and (2) chemotherapy as additional measure in first line treatment of advanced SSCHN aiming at an increase of the disease-free survival and the cure rate. Overall response rates of 80% and complete clinical remissions in about 40% of the cases can be achieved in locally untreated tumors. On the other hand, recurrent SSCHN respond not as well to chemotherapy; nevertheless, a good temporary palliative effect is reached in more than half of the patients. As example for the numerous combination programs studied in the last few years, we report some data of the two protocols evaluated at our clinic, cis-diamminedichloroplatinum/adriamycin and methotrexate/5-fluorouracil, respectively.     

Retinoid receptors in ovarian cancer: expression and prognosis.

BACKGROUND: Ovarian cancer is frequently lethal despite aggressive multimodal therapy, and new therapies are therefore needed. Retinoids are potential candidate drugs: they prevent the development of ovarian carcinoma and enhance the efficacy of cytotoxic drugs in ovarian cancer cells. At present, little is known about the retinoid receptor expression in ovarian cancer. PATIENTS AND METHODS: The retinoid receptors comprise two classes, retinoic acid receptors (RARs) and retinoid X receptors (RXRs), each with three subclasses, alpha, beta and gamma. We investigated the expression of the subtypes RARalpha, RARgamma, RXRalpha and RXRbeta by immunohistochemistry in ovarian cancers of 80 patients, and assessed their prognostic significance. In addition, we quantified the expression of retinoid receptor mRNA using real-time PCR and correlated the results with clinical characteristics. RESULTS: RARalpha and RXRbeta were highly expressed in a majority of ovarian cancers, particularly in advanced stages. High expression of RARalpha was an independent negative prognostic factor of survival in addition to FIGO stage, age and p53 accumulation. The mRNA expression of retinoid receptors did not correlate with clinical properties of the tumors. CONCLUSIONS: Retinoic acid receptors are frequently and strongly expressed in epithelial ovarian cancer and may be indicators of an adverse prognosis. This study provides the molecular basis for the therapeutic use of retinoids in ovarian cancer.     

Radiation therapy of anal epidermoid carcinoma

Between 1978 and 1984, 44 consecutive patients with anal epidermoid carcinoma were either given radiation therapy alone (cloacogenic type) or in combination with Bleomycin (squamous type). The patients with small tumors (T1-T2) were treated to 65 Gy or 60 Gy + Bleomycin directly, whereas patients with moderately advanced tumors (T3) were treated to the same radiation dose, only if no evidence of residual disease existed after 50-55 Gy (40-45 Gy + Bleomycin); if a palpable tumor still remained 3 weeks after the irradiation, surgery was performed. Patients with tumors in Stage T4 were treated to 60-65 Gy (+/- Bleomycin) followed by surgery. The outcome has so far been excellent. All but four patients, treated according to the regimen and with no initial metastases, are alive and well; two died postoperatively, one developed urinary bladder recurrence, and one liver metastases. Nineteen patients have a preserved anal function. Only one of the 9 patients also treated with an abdomino-perineal excision had viable tumor at surgery. It is concluded that patients with an anal carcinoma can be safely treated with preservation of the anus in a significant proportion of the cases, and that a combined treatment approach most likely improves survival.     

Small cell epidermoid carcinoma of the esophagus. An oat-cell-like carcinoma.

A case of small cell anaplastic epidermoid carcinoma of the esophagus is reported. The morphology of this rare esophageal neoplasm simulates that of oat cell carcinoma. Four similar cases have been previously reported. The finding of epidermoid differentiation in two of these tumors, including the present one, raises considerable doubt that any are truly oat cell carcinomas of the esophagus. Although it is theoretically possible that an oat cell carcinoma may arise in the esophagus, there is as yet no conclusive evidence for the existence of such an entity.     

Multi-modality therapy for epidermoid carcinoma of the anus.

Three patients presenting with surgically incurable epidermoid carcinoma of the anus were treated by radiation therapy and chemotherapy consisting of 5 fluorouracil and Mitomycin C. The first patient succumbed during the course of her therapy. The second patient is alive and well without definite evidence of disease nearly 1 1/2 years after initiation of therapy. The third patient underwent abdominoperineal resection after radiation and chemotherapy; pathologic examination revealed no residual carcinoma and the patient is well nearly 1 year after surgery. A fourth patient with previously treated epidermoid carcinoma of the anus presented with biopsy-proven pulmonary metastasis and was placed on the chemotherapeutic regimen alone. Six weeks later his chest X-ray showed essentially complete disappearance of the metastatic nodules. This experience suggests that multimodality therapy may increase salvage in even locally far-advanced and metastatic epidermoid anal carcinoma.     

Immunohistochemical distinction of high-grade mucoepidermoid carcinoma and epidermoid carcinoma of the parotid region

The correct diagnosis of high-grade mucoepidermoid (MEC), which is composed of solid islands of intermediate and squamous cells, may be challenging, due to its similarity to other tumours, mainly with squamous cell carcinoma (SCC). The present report employed immunohistochemical technique against different cytokeratins (CKs), in order to differentiate these two entities. : Six high-grade MEC and six SCC of the parotid region, retrieved from the files of both Oral Pathology Department of the School of Dentistry of University of S?o Paulo and Pathology Department of A.C. Camargo Hospital, were submitted immunohistochemical technique against Cks 7,8, 10, 13, 14 and 19. : High-grade MEC was positive for Cks 7, 8, 13, 14 and 19. The cases of SCC showed strong positivity for CK14, and CK10 was present only in focal areas. Our results highlight the use of CKs (especially CK14) to differentiate high-grade MEC and SCC.     

Monoclonal antibodies against the human epidermoid carcinoma A 431

About 2,000 antibody-producing hybrids were obtained by fusion of lymphocytes harvested from mice hyperimmunized with the human carcinoma line A 431 and P3-X63-Ag8-653 myeloma cells. Antibody specificity was screened in a radiobinding assay performed on glutaraldehyde-fixed cultured cells, and on paraffin-embedded sections stained with the method of avidin-biotin-peroxidase. Among the clones, 16 produced antibodies reacting with a variety of tumor lines but not with human fetal fibroblasts or peripheral blood leukocytes. On the basis of their specificity, monoclonal antibodies were classified into three groups. Some reacted only with the A431 line used as immunogen: One antibody reacted with an antigen preferentially expressed on cancer of the gastrointestinal tract and ovary; A group of monoclonal antibodies displayed a broader spectrum of reactivity defining a panel of antigens that could be tentatively classified as epithelial specific.     

An appraisal of the efficacy of bleomycin in epidermoid carcinoma of the penis

Since 1975 ten patients with advanced bidimensionally measurable epidermoid carcinoma of the penis were treated prospectively with bleomycin as a single agent. In addition, data of four patients with penile cancer treated at Memorial Hospital in 1971-72 as part of a drug-oriented prospective Phase I-II trial of bleomycin are included. Each patient had a complete evaluation including measurement of all measurable lesions by two independent observers. Standard response criteria were used. Bleomycin was given in doses of 3-20 mg/m2/day in a continuous infusion to 8 men and as a daily or weekly bolus in doses of 10-30 mg/m2 to six men. The median age of the patients was 54 years and median KPS 50%. Six patients had previously received two or more chemotherapeutic agents. All patients had Stage III-IV disease. Three (21%) of 14 patients responded including one patient who achieved a complete remission in the primary penile lesion and in malignant inguinal lymphadenopathy. Tumor regression was noted to start rapidly, i.e. within 2 weeks of starting protocol, but the duration of remission was short - median 3 months. The most frequent toxicity was mucositis which occurred in 8 cases. Three patients had a drug-related fever, two a drug rash and 2 had evidence of pulmonary toxicity. There was one instance each of an elevation of tests of liver function, and of alopecia. Within the context of this study, bleomycin has modest activity and moderately severe toxicity in patients with advanced penile carcinoma.     

Fulminating parapontine epidermoid carcinoma in a four-year-old boy.

An unique case of primary intracranial epidermoid carcinoma in a 4-year-old boy is described. Its parapontine localization and malignant features combined to produce a fulminating clinical course simulating an intra-axial mass lesion. The probable origin of the carcinoma from a benign epidermoid cyst is discussed. A review of the world's literature establishes not only the rarity of cyst-derived intracranial epidermoid carcinoma, but also its unprecedented occurrence in a child.     

Neoadjuvant chemotherapy followed by radiotherapy in epidermoid carcinoma of anus

AIM AND BACKGROUND: The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer. METHODS: Fourteen patients with epidermoid carcinoma of the anal canal were analyzed. Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m2 bolus on days 1-5) and cisplatin (60 mg/m2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks. Both inguinal lymphatics were irradiated with an identical dose schedule. The median follow-up was 78 months. RESULTS: Five-year overall survival rate and sphincter preservation rate was 85.1% and 85.7%, respectively. Response to chemoradiotherapy was the only significant factor with univariate analysis (P = 0.031). There were no complications of RTOG grade 3 or higher. CONCLUSIONS: Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.     

Muscle metastasis as initial manifestation of epidermoid carcinoma of the lung

Typical sites of squamous cell carcinoma of lung metastases include liver, brain, bones, pulmonary and adrenal glands. In advanced dissemination it can rarely involve the skeletal muscle. The patient in this case report was a 46-year-old man, with no significant medical history. He was admitted to hospital because of a large swelling on his left thigh. Investigations resulted in a diagnosis of primary squamous cell carcinoma of the lung. Biopsy of the left great adductor muscle produced similar pathology to that of the lung primary. This case report describes a skeletal muscle metastasis as the first sign of metastatic disease.