• Title/Summary/Keyword: Unknown primary origin

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Treatment Strategy of Intractable Peritoneal Carcinomatosis (난치성 복막암종증의 치료 전략에 대한 고찰)

  • Jae Gu Jung;Yun Jeong Lim
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.29-35
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    • 2013
  • Peritoneal carcinomatosis (PC) is defined as the dissemination of cancer cells in the peritoneal cavity resulting in deposition of malignant cells onto parietal or visceral peritoneal surfaces, and is associated with malignant ascites. In general, PC has been treated similarly to metastatic cancers of the primary tumor, but associated with unfavorable outcomes as compared to other sites of metastatic disease from the same primary tumor origin. It has been known to have the median survival of only 3-6 months with supportive care alone. PC is an intractable problem to physicians because of its poor prognosis and limited treatment options. Recent studies have reported that a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improved survival in PC of colorectal cancer. This paper gives overviews of the characteristics, symptoms, prognosis, and diagnosis of PC and current treatment options on PC of stomach, colorectal, and unknown primary origin.

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Pericardial Tumor: 14 cases (심낭종양[14례])

  • Park, Hee-Chul;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.118-123
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    • 1982
  • Fourteen cases of pericardia I tumor were clinically experienced from June 1966 to July 1981, for 15 years in St. Mary's Hospital, Department of Thoracic and Cardiovascular Surgery, Catholic Medical College. There were three primary tumors of the pericardium, liposarcoma, teratoma and malignant mesothelioma, and 11 metastatic pericardial tumors. In metastatic pericardial tumors, eight were originated from the lung, one was breast, and the other two cases were unknown origin. There were 6 adenocarcinoma, one small cell carcionoma ~nd one alveolar cell carcinoma in 8 cases from the lung, and 5 male and 3 female patients were composed the metastatic pericardial cancer from the lung. In clinical symptoms were dyspnea in all cases, and 9 cases had the generalized edema and enlarged liver size. Six patients had been operated, three of the primary pericardial tumor and three of metastatic pericardial tumor. Two of the primary tumors were cured satisfactorily by the mass removal, but one died due to cardiac arrest at postoperative one day. In metastatic tumors, operation were performed as two pericardial window formation and one left lower lobectomy with pericardial fenestration, but one was died in second operative day. Other nine metastatic tumors were diagnosed by needle biopsy in one case and by cell block of effusion in eight cases.

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Toceranib therapy for hepatic fibrosarcoma in a dog

  • Mi Kyung Park;Kun Ho Song
    • Korean Journal of Veterinary Service
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    • v.46 no.3
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    • pp.249-253
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    • 2023
  • A 12-year-old neutered male Maltese was brought to our hospital with loss of appetite, generalized alopecia, anemia, and a palpable abdominal mass. Ultrasonography revealed multiple abdominal masses in the liver and spleen. Subsequently, splenectomy and liver biopsy were performed, and the masses were histologically diagnosed as metastatic fibrosarcomas of unknown primary origin. The owner refused further investigations such as computed tomography and hepatectomy, therefore, we decided to initiate chemotherapy in the form of metronomic therapy with toceranib phosphate, which has several advantages, such as better tolerability, low cost, and convenience. The size and number of hepatic fibrosarcomas continued to increase despite continued administration of toceranib (10 mg/dog, PO, q48h). The dog died approximately 43 days after initiation of the toceranib treatment. To the best of our knowledge, this is the first report on toceranib therapy for metastatic hepatic fibrosarcoma in a dog.

Diagnostic Strategy of Primary Site in Metastatic Bone Tumor (전이성 골종양에서 원발병소의 진단)

  • Shin, Kyoo-Ho;Suh, Ki-Won;Jahng, Jun-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.98-104
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    • 1997
  • We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

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Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Isolated aortic valvular heart disease : analysis of etiology and surgical experience (대동맥판막질환의 임상적 고찰 -판막병리 및 임상성적에 대하여-)

  • 이승구
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.300-308
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    • 1987
  • Clinical and pathologic data were reviewed in 20 patients who had have surgery for isolated aortic valvular heart disease between April 1978 and April, 1987. Hospital mortality was 10%, with no additional late mortality during a mean follow-up period of 24.1 months. Prosthetic valve failure developed in 3 patients and two had reoperation. Niety four percent of the survivors who were in NYHA Funtional class III or IV before operation are now in class I or II. Ninety percent of all patients are still alive at a maximum follow up of 9 years. The clinical histories, gross and histologic examination of valves estabilished the causes for isolated aortic valve disease: 3 rheumatic, 2 congenital bicuspid, 2 hypertention, 2 aortitis and each one case of floppy valve, medial cystic necrosis of aorta, bacterial endocarditis. But etiology was unknown in 8 cases. Sixteen patietns had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucosaccharides and cystic changes. Myxoid degeneration was also the primary pathologic abnormality in the patients with 2 hypertention, 2 rheumatic, 1 aortitis, 1 bacterial endocarditis, 1 floppy valve, 1 congenital bicuspid. The patients with myxoid degeneration of uncertain origin were 8. Histologic finding of all of them revealed nonspecific patients with myxoid degeneration of uncertain orgin were 8. Histologic finding of all of them revealed nonspecific chronic valvulitis with myxoid degeneration. This finding may indicate that the etiology w uld be infectious.

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Surgical Management of Metastatic Lung Cancer from Gestational Chorocarcinoma (임신성 융모상피암의 전이성 폐암에 대한 외과적 고찰)

  • 정진용
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.1005-1011
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    • 1991
  • Eighty-four patients with pulmonary metastases from gestational choriocarcinoma were treated at the Catholic Medical Center between August, 1985 and August, 1991. Among these 13 patients underwent thoracotomy with resection of pulmonary lesions and the results obtained were follows. 1] The ages of the patients ranged from 26 to 47 years, with a mean age of 31 years. 2] The frequency of chemotherapy before operation ranged from zero to 46, with a mean frequency of 13.6. 3] Four patients were operated upon for a solitary metastasis of the lung; 6 patients, for unilateral multiple metastases and 3 patients, for bilateral pulmonary metastases. 4] Eight patients underwent wedge resection; 1 patient, segmentectomy; 2 patients, lobectomy; 3 patients, open lung biopsy. The lung lesions of eleven patients showed hemorrhagic necrosis[among these, 2 patients combined with pulmonary tuberculosis]; one was non-necrotic choriocarcinoma; another one was metastatic lung carcinoma from endocrine cancer of unknown origin. 5] Among twelve patients who had managed with chemotherapy before thoracotomy three patients were in remission; among 13 patients who had undergone thoracotomy 6 patients were in remission. 6] The median survival time of these patients was 25.8 months with 3 postoperative deaths. Subsequently, in the patients with pulmonary metastases from choriocarcinoma, if the primary tumor is under control, there are no other metastases, and the patients should be able to tolerate the planned operation, it is necessary to undergo aggressive thoracotomy for diagnostic purposes; for therapeutic purposes only when the pulmonary lesion is the only remaining source of increased hCG excretion; for reduction of tumor volume to shorten hospitalization or to reduce the quantity of drugs.

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An Epidemiologic Study of Metastatic Bone Tumor (전이성 골종양의 역학적 연구)

  • Kim, Jae-Do;Lee, Duk-Hee;Park, Jeong-Ho;Son, Young-Chan;Hong, Yonng-Gi;Son, Jeong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.38-44
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    • 1995
  • Metastatic bone tumor is the most common bone tumor and 32.5% of all primary malignant tumors are eventually metastasize to bone. Metastatic bone tumor has been more frequently encountered disease in the orthopedic fields due to the greater longevity of life of the patients with primary visceral cancers by major advances in early detection, diagnosis, and surgical/radiotherapeutic/chemotherapeutic treatment of primary and metastatic lesions. Therefore, the epidemiologic data about the incidences and the patterns of bone metastasis is important. We reviewed 417 patients who were diagnosed and treated for metastatic bone tumor at Kosin University Medical Center from 1985 to 1993 to analyse the primary lesion, age and sex distributions, location of bone metastasis, patterns of metastasis according to the primary. The results were as follows : 1. The common origin of bone metastasis were lung(29.5%), stomach(15.3%), breast(11.3%), unknown(7.7%), cervix(5.3%), liver(4.8%) in order of frequency. 2. There were 251 men and 166 women and their mean age was 54.8 years and the peak age incidence was in 6th decades. Most cases(85.3%) were occured beyond 5th decades. 3. The preferred sites of metastatic deposits were spine(64.0%), pelvis(40.5%), rib(38.8%), femur(36.7%), skull(21.1%), humerus(13.9%), scapula(13.0%) in order of frequency. In the spine, thoracic(42.1%), lumbar(39.1%), cervical(13.2%), sacral(5.6%) vertebrae were involved in order of frequency. 4. Multiple bone metastases were more common(73.1%) than single metastasis(26.9%). 5. In the lung cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, pelvis, femur. 6. In the stomach cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, femur, pelvis. 7. In the breast cancer, the peak age incidence was 5th decades, and the preferred sites of bone metastasis were spine, rib, pelvis. 8. In the bone metastasis with unknown primary site, the peak age incidence was 7th decades, the preferred sites of bone metastasis were spine, femur, pelvis, and the common histologic types were adenocarcinoma and squamous cell carcinoma.

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Epidemiologic Study of Operative Treatment for Spinal Metastasis in Thailand : A Review of National Healthcare Data from 2005 to 2014

  • Luksanapruksa, Panya;Santipas, Borriwat;Ruangchainikom, Monchai;Korwutthikulrangsri, Ekkapoj;Pichaisak, Witchate;Wilartratsami, Sirichai
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.57-63
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    • 2022
  • Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.