In conclusion, although metastatic involvement of the spleen from endometrial adenocarcinoma is rare, it is still a potential site for disease asylum. The reported cases are increasing due to advancements in imaging modalities and more vigilant patient follow ups. Since the condition pre- sents after a period of clinical latency after curative surgery for the primary tumor and the patients remain asymptom- atic until the tumor increases in size and creates complica- tions, these patients need prolonged follow up with serial imaging to identify recurrence. Once the lesion is diag- nosed, splenectomy followed by adjuvant chemotherapy is the treatment of choice.
Given that the Facial node is an important draining and a first echelon node and its metastatic involvement in carcinomas of the oral cavity was reported to be about unexpectedly high, 24%, it is not known whether the inclusion of the facial node in a radical neck dissection specimen would alter the progression of the disease or affect recurrence and survival. Further studies are needed in this area to clarify this issue.. In this study, the metastatic involvement of the facial node was 12%. This does not support the unusually high incidence of facial node metastatic involvement as noted by Sheehan. However as the number of facial node sampled are only 25, a greater sample size would be required for a statistically significant value.
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At our center, for patients with right PTC with tumor size <4 cm, we routinely perform at least unilateral lobectomy and isthmus resection with ipsilateral central compartment neck dissection; total thyroidectomy is performed if intrao- perative frozen section examination reveals metastatic involvement of lymph nodes. For patients with bilateral PTC, we perform total thyroidectomy with bilateral central compartment neck dissection. In addition, lateral lymph node dissection is considered in patients with suspected lateral lymph node metastasis based on preoperative ultra- sonography or intraoperative exploration.
The diagnosis of metastatic lymph nodes, which has an impor- tant clinical impact, is one of the main research fields in devel- oping new imaging technologies or new contrast media. A recent study, based on ultrasound imaging of the primary tumor vascularization, showed that axillary involvement and cell proliferation are more frequent in highly vascularized tumors and that there seems to be a correlation between tumor vascularization and axillary node involvement . Dynamic CT and perfusion parameters mirror tissue vasculari- zation and might reflect angiogenic activity [22-24] and thus, theoretically, may be able to differentiate neoplastic from non- neoplastic tissue. A recent paper by Goh and colleagues  demonstrated that the inflammation of the intestinal wall is characterized by higher perfusion parameters than normal tis- sue, but by lower perfusion parameters than neoplastic tissue. The increased perfusion and permeability of inflamed tissue may be due to the effect of cytokines, which provokes vasodil- atation and increases endothelial permeability, even if not at such high levels as neoplastic tissue, where angiogenesis plays an important role. The changes occurring in lymph nodes are probably different from those of solid tissues. The results obtained in our study show a significant difference of BF in metastatic and inflammatory enlarged axillary nodes. No signif- icant differences were found in the other perfusion parameters (BV and PS), whereas the MTT values in metastatic nodes were lower than in inflammatory nodes (p = 0.07). We employed a commercially available software that was based on CT attenuation numbers obtained by a simple dynamic CT scan with intravenous (i.v.) injection of conventional contrast medium. The basic theory of CT perfusion software is based on the measure of blood supply to the ROI and its leakage into intercellular spaces. The changes induced by metastatic cells implanted in a lymph node are mainly expressed by blood ves- sel overgrowth and architectural disorganization . Neo- plastic and inflammatory infiltration have a similar behavior Figure 2
During the past few years, medical progress has re- sulted in the increase of survival rates among cancer patients, despite an increase in metastatic lesions. Among the different tumors, bone metastasis is the second most common site of metastases, and second- ary spine lesions can be found in approximately 30% of cancers (1). Spinal involvement in malignancies can be painful or associated with neurologic manifes- tations. In some instances, symptoms can be grave, especially in cases of spinal cord compression by a pathologic fracture in the cervical spine.
Metastasis to the spine are commonly spread through the Batson plexus, a valveless vertebral venous complex. Additionally, the vertebral body is the most common site to be affected compared with the posterior elements . In our study, all cases had an affected vertebral body of C2. The clinical picture of metastatic involve- ment of the upper cervical region ranges from localized pain to a variable extent of the neurological deficits and even death induced by spinal cord compression [11, 12]. Occipitocervical pain occurred in approximately 89% to 100% of patients, was not linked to daily activities and worsened in the night [13–15]. All patients in our study presented with occipitocervical pain. Furthermore, given the relatively larger sagittal diameter of the C1 and C2 level compared to the counterpart of the subaxial cer- vical spine, the neurological deficit was overt only in the later stages. Hence, the preoperative JOA score was 10.1 ± 2.2 in our study.
PET/CT in staging of breast cancer patients. A total of 234 patients were retrospectively evaluated. PET/CT was performed preoperatively in 114/234 and postoperatively in 120/234 patients. Initial staging was performed based on histopathological results in 125/234 and clinical results in 109/234 patients, according to the American Joint Committee on Cancer (AJCC) classification. All patients had a normal abdominal ultrasound and chest x-ray. Following PET/CT imaging, modification in the staging was performed in patients with the metastatic findings. In 42/234 (17.9%) patients hypermetabolic extra-axillary regional lymph nodes and in 65/234 patients (27.7%) distant metastatic involvement were detected with PET/CT. Modification in the staging was applied in 82/234 (35%) patients. Patient management was changed in 69/234 (29.4%) cases. The percentage of patients with upstaging, according to each stage, was as follows: IIA: 18.6%, IIB: 30%, IIIA: 46.3%, IIIB: 68.8%, and IIIC: 20.8%. In 43/43 patients, 99m Tc-methylene diphosphonate (MDP) bone scan did not show additional bone metastasis. In 5/32 patients, meta-
Microscopically, prostatic carcinosarcomas demonstrated the definitional mix of carcino- matous (epithelial) and sarcomatous (mesen- chymal) elements, with heterologous compo- nents, predominantly osteoid and chondroid, being identified in over half of cases (Table 3). Immunohistochemical stains showed the carci- nomatous components to be positive for con- ventional epithelial markers such as cytokera- tin AE1/AE3, cytokeratin CAM 5.2 and epithelial membrane antigen (EMA), and, in a small cohort of samples, to overexpress the p53 anti- Table 4. Clinical outcomes for prostatic carcinosarcomas: Metastatic involvement by prostatic carci- nosarcoma is seen in approximately half of cases, with overall survival averaging slightly less than two years in patients with continuous follow-up
Human breast cancer cells T47D, ZR-75-1, SKBR3, BT-20, MDA-MB-468 and MDA-MB-231 were purchased from the American Type Culture Collection (ATCC) (Manassas, VA) and cultured as recommended by ATCC. T47D, ZR-75-1 and SKBR3 are epithelial cells with low invasive and metastatic ability. BT-20 and MDA-MB-468 are moderately invasive and metastatic. MDA-MB-231 is a highly invasive and metastatic triple negative mesenchymal breast cancer cell line [46, 47]. Human breast cancer cells SUM159PT (labeled SUM159 throughout) were purchased from Asterand, Inc. (Detroit, MI). These cells were cultured in F-12 media supplemented with 5% fetal bovine serum, 10mM HEPES buffer, 5μg/ml insulin, 1μg/ml hydrocortisone and 1% Penicillin/Streptomycin. SUM159 cells are triple negative with strong abilities to invade and metastasize . ATCC authenticates these cell lines using short tandem repeat analysis. All the cell lines were expanded and frozen immediately after receipt. The cumulative culture length of the cells was less than 6 months after recovery. Early passage cells were used for all experiments. All the cell lines were frequently tested for mycoplasma contamination using a mycoplasma detection kit from Sigma. All of the cells were maintained at 37°C with 5% CO 2 in a humidified atmosphere.
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metastasizing. The microRNA-200 (miR-200) family, which regulates the mesenchymal-to-epithelial transition, is enriched in the serum of patients with metastatic cancers. Ectopic expression of miR-200 can confer metastatic ability to poorly metastatic tumor cells in some settings. Here, we investigated whether metastatic capability could be transferred between metastatic and nonmetastatic cancer cells via extracellular vesicles. miR-200 was secreted in extracellular vesicles from metastatic murine and human breast cancer cell lines, and miR-200 levels were increased in sera of mice bearing metastatic tumors. In culture, murine and human metastatic breast cancer cell extracellular vesicles transferred miR-200 microRNAs to nonmetastatic cells, altering gene expression and promoting mesenchymal-to-epithelial transition. In murine cancer and human xenograft models, miR-200–expressing tumors and extracellular vesicles from these tumors promoted metastasis of otherwise weakly metastatic cells either nearby or at distant sites and conferred to these cells the ability to colonize distant tissues in a miR-200–dependent manner. Together, our results demonstrate that metastatic capability can be transferred by the uptake of extracellular vesicles.
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metastatic lymph node ratio, metastatic N1 lymph nodes, metastatic N1 lymph node ratio, metastatic N2 lymph nodes, stations of meta- static N1 lymph nodes, metastatic N2 lymph node ratio and station 7 lymph node metasta- sis was closely related to 5-year survival rate (Table 2). Gender, age, surgical method, maxi- mum tumor diameter, stations of metastatic lymph nodes, stations of metastatic N1 lymph nodes, resected N2 lymph nodes, stations of resected N2 lymph nodes, station 10 lymph node metastasis, T stage, N stage, final stage, pathological type, differentiation, and post- operative radiotherapy had no relationship with post-operative 5-year survival rate (Table 2). The prognostic factors with statistical signifi- cance from univariate analysis as well as T-stage were recruited for multivariate analysis with Cox proportional hazards model. Results showed metastatic N2 lymph nodes and sta- tion 7 lymph node metastasis were indepen- dent risk factors affecting 5-year survival rate (Table 3; Figures 2 and 3).
Mesenchymal stem cells (MSCs) are multi-potent progenitor cells with ability to differentiate into multiple lineages, including bone, cartilage, fat, and muscles. Recent research indicates that MSCs can be efficiently recruited to tumor sites, modulating tumor growth and metastasis. However, the underlying molecular mechanisms are not fully understood. Here, we first demonstrated that human umbilical cord-derived mesenchymal stem cells (hUC-MSCs), when mixed with human cholangiocarcinoma cell lines QBC939 in a xenograft tumor model, significantly increased the cancer cells proliferation and metastatic potency. MSCs and their conditioned media (MSC-CM) could improve the drug resistance of tumor when the compound K (CK) as an anti- cancer drug, a major intestinal bacterial metabolite of panaxoside, was administered to xenograft tumor mice. Furthermore, MSCs greatly increased the colony formation and invasion of cholangiocarcinoma cells QBC939 and Mz-ChA-1. Immunochemistry studies of cholangiocarcinoma tissue chips and transplantation tumor from nude mice showed that the expression of β-catenin was important for cholangiocarcinoma development. We further demonstrated that MSCs and MSCs-CM could promote proliferation and migration of cholangiocarcinoma cells through targeting the Wnt/β-catenin signaling pathway. hUC-MSCs or MSCs-CM stimulated Wnt activity by promoting the nuclear translocation of β-catenin, and up-regulated Wnt target genes MMPs family, cyclin D1 and c-Myc. Together, our studies highlight a critical role for MSCs on cancer metastasis and indicate MSCs promote metastatic growth and chemoresistance of cholangiocarcinoma cells via activation of Wnt/β-catenin signaling.
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We report the 30-yr history of a well-documented human case of alveolar echinococcosis, with a lung lesion at presentation followed by the discovery of a liver lesion, both removed by surgery. Subsequently, within the 13 years following diagnosis, metastases were disclosed in eye, brain and skull, as well as additional lung lesions. This patient had no immune suppression, and did not have the genetic background known to predispose to severe alveolar echinococcosis; it may thus be hypothesized that iterative multi-organ involvement was mostly due to the poor adherence to benzimidazole treatment for the first decade after diagnosis. Conversely, after a new alveolar echinococcosis recurrence was found in the right lung in 1994, the patient accepted to take albendazole continuously at the right dosage. After serology became negative and a fluoro-deoxy-glucose-Positron Emission Tomography performed in 2005 showed a total regression of the lesions in all organs, albendazole treatment could be definitively withdrawn. In 2011, the fluoro-deoxy-glucose-Positron Emission Tomography showed a total absence of parasitic metabolic activity and the patient had no clinical symptoms related to alveolar echinococcosis.
research reported major parenting dimensions in different human societies. These dimensions are parental control (permissiveness-strictness) and parental warmth (acceptance-rejection). Parental behaviour, as perceived by child has great impact on child’s development the important thing is that how a child perceives the behaviour of his/her parents, rather how they behave in real. The perception of child is very important in shaping his personality. He gave different dimension, control, enforcement, position involvement, intrusiveness control though guilt, hostile control, inconsistent discipline, hostile detachment and extreme autonomy (Saxena & Saxena, 1980). Parental behaviour towards children and the perception of a child for parental behaviour, disciplinary practices used by the parents and the perception of a child of these disciplinary practices. Dimensions of parental behaviour included in the study were dominance love, hate, negligence, acceptance, rejection and punishment (Garg, 1982).
In general, cardiac metastases are 20 to 40 times more common than primary cardiac malignancies, and have been reported in different studies in approximately 2%to 18% of cases at autopsies. Intramyocardial metastases arise most often in the course of malignant melanoma, leukemia, lymphoma, and lung, esophageal and breast cancers [3,4]. At the same time, heart involvement via the inferior vena cava (IVC) is a well-known phe- nomenon in clear cell renal cell carcinoma (ccRCC) cases. Renal cell carcinoma (RCC) is known for invading the renal vein and further promoting tumor thrombosis of the vena cava and even the right atrium . For these patients, long-term outcome after radical surgical treat- ment with RCC and tumor thrombus extension reaching
Biopsy from the affected site proves to be useful in the confirmative diagnosis, treatment and prognosis of metastatic lesion. A direct biopsy during surgery prior to definitive surgery is advantageous for the patients . In our case biopsy from the nodular lesion was reported as metastatic carcinoma with neuroendocrine differen- tiation based on routine H & E staining and further confirmed by immunohistochemistry which showed positiv- ity for synaptophysin, chromogranin and cytokeratin. Small cell carcinoma lung was considered in differential diagnosis but could not get supportive clinical and radiological findings to make a definitive diagnosis.
Browne and Kaldenberg (1997) found that the relationship of self-monitoring and materialism influence the success, centrality and happiness. While high self-monitoring more trust. Characterized materialistic ownership is an important element in the success and the centrality of one's existence, and play an important role to achieve happiness. While gender has an important role, on the whole men are more materialistic than in women. Men assume that branded items became essential as an element of a person's success. Men tend to believe that wealth increases happiness, especially shows that self- monitoring can be tagged high and have high involvement in the purchase of self-monitoring than the lower. Women are more high involvement in the category of the men's clothing, clothing purchased give pleasure for women, while for men is more worried if the clothes were purchased turned out to be unsuitable or miscast. Self-monitoring is more aware of the high fashion of the self-monitoring low. Women have a higher self-monitoring in buying branded clothes aimed at personal appearance so different from other women. Materialistic and purchase involvement is positively associated with the involvement product categories. Results of research and Kaldenberg Browne (1997) has limited the first, the object of the study provides a context less clothing decision. Second respondents making less prepared to frame the relationship between self-monitoring and linkage with the product. This study continues previous research, conducted in developing countries and researchers will perform in Indonesia. This study used two research subjects and mobile office wear, before the questionnaires were distributed researchers provide enough understanding to be filled with the proper respondent.
Sur8 (also known as Shoc2) is a scaffold protein that positively regulates Ras-mediated signal transduction during C. elegans vulval development . The human homolog of Sur8 is a conserved leucine-repeat rich protein involved in fibroblast growth factor receptor signaling . Sur8 is reported to interact with H-, K-, N-Ras and enhance the ability of all these Ras isoforms to activate ERK [13, 15]. However, other studies have reported Sur8 interacts only with M-Ras but not with other isoforms of Ras to regulate ERK pathway [16, 17]. Although Sur8 has been reported as a positive regulator of Ras-ERK pathway, its interaction with other signaling pathways and its involvement in pathophysiological conditions is mostly unknown.
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Notes: (A, B) The last working cannulae is inserted into vertebral body from the both side, and ITR is performed with a marrow nucleus rongeurs inserted through the working cannula from the right side. (C) AP shows the PMMA is injected into the T12 vertebral body with paravertebral space and intervertebral disk leakage. (D) AP shows the PMMA is injected into the T11, T12 and L1 vertebral body after the procedures. (E, F) Sagittal T1WI and T2WI show spinal metastatic tumor with spinal cord compression of T12 vertebra (arrow) prior to the procedure. (G, H) Sagittal T1WI and T2WI reveals low signal at T12 vertebral body (arrow) with stability of the vertebral body 6 months after PVP and ITR. Note the spinal cord compression is relieved and the spinal pain is resolved after the procedure. Abbreviations: AP, anteroposterior; PMMA, polymethyl methacrylate; PVP, percutaneous vertebroplasty; ITR, interventional tumor removal; T1WI, T1- weighted image; T2WI, T2-weighted image.
Osteosarcoma is a highly malignant tumor that contains a small subpopulation of tumor-propagating cells (also known as tumor-initiating cells) characterized by drug resistance and high metastatic potential. The molecular mechanism by which tumor- propagating cells promote tumor growth is poorly understood. Here, we report that the transcription factor forkhead box C2 (FOXC2) is frequently expressed in human osteosarcomas and is important in maintaining osteosarcoma cells in a stem-like state. In osteosarcoma cell lines, we show that anoikis conditions stimulate FOXC2 expression. Downregulation of FOXC2 decreases anchorage-independent growth and invasion in vitro and lung metastasis in vivo, while overexpression of FOXC2 increases tumor propagation in vivo. In osteosarcoma cell lines, we demonstrate that high levels of FOXC2 are associated with and required for the expression of osteosarcoma tumor-propagating cell markers. In FOXC2 knockdown cell lines, we show that CXCR4, a downstream target of FOXC2, can restore osteosarcoma cell invasiveness and metastasis to the lung.
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