A Giant Verrucous Carcinoma of the Penis Presenting with Urinary Sepsis and Angina

Penile verrucous carcinoma also known as Buschke-Löwenstein tumor in the genital region is an uncommon variant of penile carcinoma exhibiting slow, expansive growth. We present a case of a 63-year-old male who presented with a giant purulent penile mass causing urinary sepsis and angina. Regional lymph nodes were clinically negative and staging with CT scans of thorax and abdomen did not show any signs of lymph node or distant metastases. After resuscitation, radical penectomy was performed and a perineal urethrostomy was created. Histological examination revealed a Buschke-Löwenstein tumor of the penis with no invasion of corpus cavernosum and urethra.

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Metastases to the regional lymph nodes, lymph node recurrence, and distant metastases in nonadvanced papillary thyroid carcinoma

Surgery Today ◽

10.1007/bf00311254 ◽

1995 ◽

Vol 25 (4) ◽

pp. 324-328 ◽

Cited By ~ 34

Author(s):

Kiminori Sugino ◽

Yoshio Kure ◽

Hiroyuki Iwasaki ◽

Osamu Ozaki ◽

Takashi Mimura ◽

...

Keyword(s):

Lymph Node ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lymph Nodes ◽

Distant Metastases ◽

Papillary Thyroid ◽

Regional Lymph Nodes ◽

Lymph Node Recurrence

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Origins of lymphatic and distant metastases in human colorectal cancer

Science ◽

10.1126/science.aai8515 ◽

2017 ◽

Vol 357 (6346) ◽

pp. 55-60 ◽

Cited By ~ 162

Author(s):

Kamila Naxerova ◽

Johannes G. Reiter ◽

Elena Brachtel ◽

Jochen K. Lennerz ◽

Marc van de Wetering ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Primary Tumor ◽

Phylogenetic Trees ◽

Evolutionary Relationship ◽

Distant Metastases ◽

Human Colorectal Cancer ◽

Regional Lymph Nodes ◽

Primary Tumors

The spread of cancer cells from primary tumors to regional lymph nodes is often associated with reduced survival. One prevailing model to explain this association posits that fatal, distant metastases are seeded by lymph node metastases. This view provides a mechanistic basis for the TNM staging system and is the rationale for surgical resection of tumor-draining lymph nodes. Here we examine the evolutionary relationship between primary tumor, lymph node, and distant metastases in human colorectal cancer. Studying 213 archival biopsy samples from 17 patients, we used somatic variants in hypermutable DNA regions to reconstruct high-confidence phylogenetic trees. We found that in 65% of cases, lymphatic and distant metastases arose from independent subclones in the primary tumor, whereas in 35% of cases they shared common subclonal origin. Therefore, two different lineage relationships between lymphatic and distant metastases exist in colorectal cancer.

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Metastatic Spread of Stage I Melanoma of the Skin

Tumori Journal ◽

10.1177/030089168306900513 ◽

1983 ◽

Vol 69 (5) ◽

pp. 449-454 ◽

Cited By ~ 29

Author(s):

◽

Natale Cascinelli ◽

Ferdinando Preda ◽

Maurizio Vaglini ◽

Sergio Orefice ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Primary Tumor ◽

Regional Lymph Node ◽

Distant Metastases ◽

Stage I ◽

Regional Lymph Nodes ◽

Prognostic Criteria ◽

Regional Node ◽

Node Metastases

1164 patients with stage I melanoma of the skin who were submitted to wide excision only of the primary tumor were studied to evaluate the rates of regional lymph node and distant metastases. Of these, 516 (44.3%) had a recurrence of the disease which was at regional lymph nodes in 264 (22.7%), at distant sites in 91 (7.8%), and simultaneously at regional lymph nodes and distant sites in 161 (13.8%). Most of the patients had a relapse within 5 years: regional node metastases were most frequently observed during the first 3 years, and distant metastases appeared later. The ratio regional:distant metastases was not different (P > 0.05) when subgroups of patients were considered according to prognostic criteria (sex, site of origin, levels, thickness, ulceration). Sex, levels, thickness and ulceration were found to be significantly related with the frequency of recurrences (regional and distant). It is concluded that the prognostic criteria considered do not predict whether the tumor will metastasize to regional nodes or to distant sites.

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BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

Problems in oncology ◽

10.37469/0507-3758-2018-64-3-335-344 ◽

2018 ◽

Vol 64 (3) ◽

pp. 335-344

Author(s):

Aleksey Karachun ◽

Yuriy Pelipas ◽

Oleg Tkachenko ◽

D. Asadchaya

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Stomach Cancer ◽

Current Status ◽

Regional Lymph Nodes ◽

Systematic Analysis ◽

Tumor Spread ◽

Special Value

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.

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T stage-dependent lymph node and distant metastasis and the accuracy of lymph node assessment in rectal cancer

European Surgery ◽

10.1007/s10353-021-00714-y ◽

2021 ◽

Author(s):

Henry Ptok ◽

Frank Meyer ◽

Roland S. Croner ◽

Ingo Gastinger ◽

Benjamin Garlipp

Keyword(s):

Rectal Cancer ◽

Overall Survival ◽

Lymph Node ◽

Lymph Nodes ◽

False Negative ◽

Cumulative Risk ◽

Distant Metastases ◽

Number Of Patients ◽

Tumor Stages ◽

The Impact

Summary Objective To analyze data obtained in a representative number of patients with primary rectal cancer with respect to lymph node diagnostics and related tumor stages. Methods In pT2-, pT3-, and pT4 rectal cancer lesions, the impact of investigated lymph nodes on the frequency of pN+ status, the cumulative risk of metachronous distant metastases, and overall survival was studied by means of a prospective multicenter observational study over a defined period of time. Results From 2000 to 2011, the proportion of surgical specimens with ≥ 12 investigated lymph nodes increased significantly, from 73.6% to 93.2% (p < 0.001; the number of investigated lymph nodes from 16.2 to 20.8; p < 0.001). Despite this, the percentage of pN+ rectal cancer lesions varied only non-significantly (39.9% to 45.9%; p = 0.130; median, 44.1%). For pT2-, pT3-, and pT4 rectal cancer lesions, there was an increasing proportion of pN+ findings correlating significantly with the number of investigated lymph nodes up to n = 12 investigated lymph nodes. Only in pT3 rectal cancer was there a significant increase in pN+ findings in case of > 12 lymph nodes (p = 0.001), but not in pT2 (p = 0.655) and pT4 cancer lesions (p = 0.256). For pT3pN0cM0 rectal cancer, the risk of metachronous distant metastases and overall survival did not depend on the number of investigated lymph nodes. Conclusion In rectal cancer, at least n = 12 lymph nodes are to be minimally investigated. The investigation of fewer lymph nodes is associated with a higher risk of false-negative pN0 findings. In particular, in pT3 rectal cancer, the investigation of more than 12 lymph nodes lowers the risk of false-negative pN0 findings. An upstaging effect by the investigation of a possibly maximal number of lymph nodes could not be detected.

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Hepatocellular carcinoma with regional lymphadenopathy caused by sarcoid-like reaction: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01146-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Tomoko Mizota ◽

Masato Suzuoki ◽

Saya Kaku ◽

Kenichi Mizunuma ◽

Kazuto Ohtaka ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Lymph Node ◽

Lymph Nodes ◽

Granulomatous Inflammation ◽

Giant Cells ◽

Epithelioid Cell ◽

Imaging Modalities ◽

Hepatoduodenal Ligament ◽

Regional Lymph Nodes ◽

Multiple Imaging

Abstract Background Sarcoid-like reaction (SLR) is a histological pattern of granulomatous inflammation that is clinically differentiated from sarcoidosis. Since SLR is known to occur in several neoplasias and occasionally causes lymphadenopathy and mimics metastatic malignancy, it needs to be considered whether lymphadenopathy is due to metastasis or SLR for the choice of cancer treatment. Few cases of hepatocellular carcinoma (HCC) with SLR have been reported. Here, a case of HCC with lymphadenopathy diagnosed as SLR without metastasis is presented. Case presentation A 69-year-old woman was admitted to our hospital because of upper abdominal pain. She tested positive for hepatitis C virus ribonucleic acid. Imaging modalities showed an 81 × 65-mm-sized tumor with multiple nodules in segment 3 and a 17 × 12-mm-sized tumor in segment 5 with a common HCC enhancement pattern. In addition, a lymph node in the hepatoduodenal ligament was enlarged at 13 mm in size, suggesting the metastasis of HCC. Hepatectomy of the lateral segment and segment 5 and lymph node dissection in the hepatoduodenal ligament were performed. Both tumors in segments 3 and 5 were pathologically diagnosed as HCC without vessel invasion. The tumors contained necrotic cells and epithelioid cell granulomas with multinucleated giant cells, which is typically observed in sarcoidosis. The dissected lymph nodes also contained epithelioid cell granulomas, as well as giant cells with asteroid bodies. There was no malignancy in the lymph nodes. The pathological findings suggested the coexistence of malignancy and sarcoidosis. However, since the patient did not show any typical findings of pulmonary or cardiac sarcoidosis, the case was diagnosed as HCC with SLR in the primary lesion and regional lymph nodes. Conclusions SLR needs to be considered in the differential diagnosis when a cancer patient develops lymphadenopathy. However, lymphadenopathy due to SLR is indistinguishable from that due to metastasis even when using multiple imaging modalities. Pathological examinations may be helpful for the diagnosis.

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Extended-field intensity-modulated radiotherapy and dosage boost for lymph node metastasis are beneficial for the prognosis of FIGO IIICr and IVA cervical cancer patients with positive regional lymph nodes

10.21203/rs.3.rs-17075/v1 ◽

2020 ◽

Author(s):

Yuhua Zhao ◽

Gong Li ◽

Lei Gao

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Intensity Modulated Radiotherapy ◽

Figo Stage ◽

Concurrent Chemotherapy ◽

Regional Lymph Nodes ◽

Free Survival ◽

Node Metastasis ◽

Extended Field

Abstract Background: This study aimed to evaluate the therapeutic efficacy of extended-field intensity-modulated radiotherapy (EF-IMRT) and dosage boost for positive lymph nodes, prognostic factors, treatment failure, and toxicity for Federation of Gynecology and Obstetrics (FIGO) stage IIICr and IVA cervical cancer patients with positive regional lymph nodes.Methods: We retrospectively evaluated 34 patients with stage IIICr and IVA who had received treatment in our institute between 2013 and 2016. Patients with stage IVA cervical cancer who had been enrolled in the analysis all had positive regional lymph nodes (pelvic or/and para-aortic). All 34 patients were treated with EF-IMRT and simultaneously integrated boost-IMRT (SIB-IMRT) for lymph node metastasis with concurrent chemotherapy and brachytherapy. Positive regional lymph nodes (short-axis diameter ≥5 mm in computed tomography [CT] or magnetic resonance imaging [MRI]) remaining after SIB-IMRT were then treated with sequential boost-IMRT (SeB-IMRT). The prognostic factors for overall survival (OS); disease-free survival (DFS); local control rate (LCR); regional control rate (RCR); distant metastasis-free survival (DMFS), including age, FIGO stage, pretreatment hemoglobin (HB) level, tumor size, para-aortic lymph node (PALN) metastasis, point A equivalent dose in 2-Gy fractions (EQD2 dose), concurrent chemotherapy, and adjuvant chemotherapy cycles, were analyzed.Results: Complete response (CR) was achieved in 31 (91.2%) patients with acceptable adverse effects. Notably, the three-year OS, DFS, LCR, RCR, DMFS for these patients were 73.5%, 70.6%, 88.1%, 87.9%, and 81.6%, respectively. In particular, the three-year OS, DFS, LCR, RCR, and DMFS of patients with positive PALNs was 41.7%, 33.3%, 65.6%, 72.2%, and 60.2%, respectively. The corresponding values in patients without positive PALNs were 90.9%, 90.9%, 100%, 95.5%, and 90.9%, respectively.Conclusions: Our study suggested that the EF-IMRT and nodal dosage boost decreased regional node failure and that patients with stage IIIC1r and IVA cervical cancer without PALN metastasis who received EF-IMRT and SIB-IMRT with or without SeB-IMRT had a significant survival advantage in terms of the DFS and OS.

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Clinical, morphological, and molecular genetic predictors of metastatic lesions in the regional lymph nodes in breast cancer

Advances in molecular oncology ◽

10.17650/2313-805x-2018-5-3-8-16 ◽

2018 ◽

Vol 5 (3) ◽

pp. 8-16

Author(s):

Yu. A. Dergunova ◽

V. V. Podionov ◽

V. K. Bozhenko ◽

V. V. Kometova ◽

M. V. Dardyk

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Molecular Genetic ◽

Regional Lymph Nodes ◽

Genetic Characteristics ◽

Metastatic Lesions ◽

Genetic Predictors ◽

Node Metastases ◽

High Degree

Despite the sufficient amount of data accumulated in the literature, there are still no factors, on the basis of which it would be possible to estimate the regional lymph nodes status in breast cancer with a high degree of accuracy. The review presents literature data relating to the influence of clinicopathological, molecular-biological and genetic characteristics of primary tumor on lymph node metastases. Data of 66 foreign and Russian articles are included.

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Malignant pheochromocytoma in a pig

Journal of Veterinary Diagnostic Investigation ◽

10.1177/1040638711425949 ◽

2011 ◽

Vol 24 (1) ◽

pp. 207-210 ◽

Cited By ~ 5

Author(s):

Jorge Martínez ◽

Iván Galindo-Cardiel ◽

Meritxell Díez-Padrisa ◽

Emilio I. López-Sabater ◽

Joaquim Segalés

Keyword(s):

Lymph Node ◽

Adrenal Gland ◽

Lymph Nodes ◽

Immunohistochemical Staining ◽

Malignant Pheochromocytoma ◽

Endocrine Tumors ◽

Neurofilament Protein ◽

Regional Lymph Nodes ◽

The Masses ◽

Current Report

Endocrine tumors are rarely observed in pigs, and pheochromocytomas have been only punctually described. The current report describes a white and firm, 15-cm in diameter, neoplastic mass located in the adrenal gland with metastasis to regional lymph nodes in a 2.5-year-old sow. The masses had marked desmoplasia that supported a population of polygonal-to-spindle–shaped neoplastic cells arranged into cords and packets within a delicate fibrovascular stroma. Immunohistochemical staining of the tumor was positive for chromogranin and negative for neurofilament protein in adrenal and lymph node masses, which was characteristic of a malignant pheochromocytoma.

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THE EFFECT OF ANTIGENIC STIMULATION ON INCORPORATION OF PHOSPHATE AND METHIONINE INTO PROTEINS OF ISOLATED LYMPH NODE CELLS

Journal of Experimental Medicine ◽

10.1084/jem.110.2.207 ◽

1959 ◽

Vol 110 (2) ◽

pp. 207-219 ◽

Cited By ~ 24

Author(s):

Milton Kern ◽

Herman N. Eisen

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Protein Fraction ◽

Antibody Formation ◽

Antigenic Stimulation ◽

Regional Lymph Nodes ◽

Lymph Node Cells ◽

Phosphate Incorporation ◽

In Cells

Isolated lymph node cells incorporate inorganic orthophosphate into a protein fraction. The phosphorylated product is a phosphoprotein. The rate of phosphate incorporation into phosphoprotein was determined in cells isolated from regional lymph nodes at varying times after antigen injection. The rate was unaltered on the 3rd day, but was enhanced on the 4th day after injection. Parallel results were obtained with L-methionine incorporation into the same gross protein fraction. Possible relationships between antibody formation and the observed enhancement in phosphate incorporation into phosphoprotein are discussed.

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