scholarly journals Metastatic Poorly Differentiated Carcinoma of Unknown Primary Site

2020 ◽  
Keyword(s):  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated

Poorly differentiated carcinoma of unknown primary site: clinical usefulness of immunoperoxidase staining.

1991 ◽  
Vol 9 (11) ◽  
pp. 1931-1938 ◽  
Author(s):  
J D Hainsworth ◽  
E P Wright ◽  
D H Johnson ◽  
B W Davis ◽  
F A Greco
Keyword(s):  
Yolk Sac ◽  
Primary Site ◽  
Unknown Primary ◽  
Immunoperoxidase Staining ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Long Term Survivors

To assess the clinical utility of immunoperoxidase tumor-cell staining in patients with poorly differentiated carcinoma of unknown primary site, we performed a battery of stains on tumors from 87 patients treated between August 1978 and April 1983. Poorly differentiated carcinoma or poorly differentiated adenocarcinoma was diagnosed on the basis of light microscopic examination, and all patients were treated before the technology of immunoperoxidase staining was routinely used. Therefore, results of immunoperoxidase staining can be correlated with clinical outcome in this group of similarly treated patients with a long median follow-up. Immunoperoxidase staining confirmed the diagnosis of poorly differentiated carcinoma in 49 patients (56%) and yielded other diagnoses in 14 patients (16%): melanoma, eight; lymphoma, four; prostatic carcinoma, one; and yolk sac carcinoma, one. In 24 patients (28%) the immunoperoxidase staining pattern was inconclusive; electron microscopy was usually helpful in clarifying the diagnosis in these patients. Seventy-five patients (86%) received combination chemotherapy with a cisplatin-based regimen, and 24 patients (28%) had a complete response. Nine of these patients were later given specific diagnoses by immunoperoxidase staining (lymphoma, four; melanoma, four; yolk sac tumor, one). All patients with an immunoperoxidase diagnosis of lymphoma also had clinical features compatible with lymphoma and are long-term survivors. Patients with immunoperoxidase features suggesting melanoma were surprisingly responsive to chemotherapy, with three of seven complete responses and two long-term survivors. Patients with melanoma diagnosed by immunoperoxidase staining should not be excluded from a trial of cisplatin-based therapy. Immunoperoxidase staining is useful in the routine evaluation of metastatic poorly differentiated carcinoma of unknown primary site, as it can occasionally suggest the lineage of the tumor and have specific therapeutic implications.

Overexpression of Her-2 in Patients With Poorly Differentiated Carcinoma or Poorly Differentiated Adenocarcinoma of Unknown Primary Site

2000 ◽  
Vol 18 (3) ◽  
pp. 632-632 ◽  
Author(s):  
John D. Hainsworth ◽  
Wayne J. Lennington ◽  
F. Anthony Greco
Keyword(s):  
Tumor Location ◽  
Primary Site ◽  
Immunohistochemical Method ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Poorly Differentiated Adenocarcinoma ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Her 2

PURPOSE: To determine the frequency of Her-2 overexpression in patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma of unknown primary site. PATIENTS AND METHODS: Tumor specimens from 100 patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma were stained for the Her-2 protein using the Dako immunohistochemical method. Clinical and pathologic characteristics of patients with and without Her-2 overexpression were compared. RESULTS: Staining for Her-2 overexpression was successful in 94 of 100 patients. Ten (11%) of 94 tumor specimens overexpressed Her-2. Eight of 10 overexpressors had poorly differentiated adenocarcinoma, and all overexpressors had predominant tumor location above the diaphragm, usually in the mediastinum or lungs. CONCLUSION: Her-2 overexpression occurs in a minority of patients with poorly differentiated carcinoma/adenocarcinoma of unknown primary site. Because most overexpressors had poorly differentiated adenocarcinoma, further evaluation of patients with adenocarcinoma of unknown primary site is necessary to determine the frequency of Her-2 overexpression in this common subgroup. Evaluation of the efficacy of trastuzumab in Her-2 overexpressors with carcinoma of unknown primary site is indicated.

scholarly journals Poorly differentiated mesenteric carcinoma of unknown primary site detected by abscess formation: case report

2014 ◽  
Vol 12 (1) ◽  
pp. 4 ◽  
Author(s):  
Yukinori Yamagata ◽  
Yukari Ando ◽  
Keisuke Matsusaka ◽  
Hisako Karube ◽  
Haruna Onoyama ◽  
...  
Keyword(s):  
Case Report ◽  
Primary Site ◽  
Abscess Formation ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated

Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience.

1992 ◽  
Vol 10 (6) ◽  
pp. 912-922 ◽  
Author(s):  
J D Hainsworth ◽  
D H Johnson ◽  
F A Greco
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Tumor Location ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated Carcinoma ◽  
Peripheral Lymph ◽  
Poorly Differentiated

PURPOSE We previously reported excellent responses to cisplatin-based chemotherapy in a minority of patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA) of unknown primary site. We have continued to study and to treat these patients, and now report clinical characteristics, treatment results, and prognostic factors in a large group of patients identified prospectively. PATIENTS AND METHODS Between February 1978 and December 1989, we treated 220 patients with PDC or PDA of unknown primary site. The median age was 39 years; 48% of patients had predominant tumor location in the mediastinum, retroperitoneum, or peripheral lymph nodes. Specialized pathologic studies resulted in the identification of specific tumor types in only a few cases. All patients received cisplatin-based chemotherapy; between 1978 and 1984, 116 patients received cisplatin, vinblastine, and bleomycin (PVeB) +/- doxorubicin, and 104 patients treated since January 1985 received cisplatin and etoposide +/- bleomycin. RESULTS One hundred thirty-eight patients (63%) had objective responses to therapy, and 58 (26%) had complete response. Thirty-six patients (16%) are currently disease-free at a median of 61 months following therapy (range, 11 to 142 months). Actuarial 10-year survival is 16%. Favorable prognostic factors identified by Cox regression analysis include: (1) predominant tumor location in the retroperitoneum or peripheral lymph nodes, (2) tumor limited to one or two metastatic sites, (3) no history of cigarette use, and (4) younger age. CONCLUSION Patients with PDC or PDA of unknown primary site represent another group of patients for whom potentially curative therapy is available. Patients with this syndrome should be distinguished from patients with well-differentiated adenocarcinoma of unknown primary site, and should receive a trial of cisplatin-based chemotherapy.

Poorly differentiated carcinoma of unknown primary site: correlation of light microscopic findings with response to cisplatin-based combination chemotherapy.

1987 ◽  
Vol 5 (8) ◽  
pp. 1275-1280 ◽  
Author(s):  
J D Hainsworth ◽  
E P Wright ◽  
G F Gray ◽  
F A Greco
Keyword(s):  
Light Microscopy ◽  
Germ Cell ◽  
Combination Chemotherapy ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Term Survival ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Histopathologic Features

We have previously reported complete responses and long-term survival in patients with metastatic poorly differentiated carcinoma (PDC) of unknown primary site who received intensive cisplatin-containing chemotherapy regimens. We reviewed the light microscopic specimens from 113 patients with PDC in an attempt to identify common histopathologic features in the chemotherapy-responsive subgroup, and to rule out the presence of previously unrecognized germ cell tumors. Relatively few diagnoses more specific than PDC could be made. We could identify no histopathologic features by light microscopy that distinguished responsive from unresponsive neoplasms. Only one patient was found to have a previously unrecognized yolk sac carcinoma, and in five other patients the possibility of a germ cell neoplasm was considered in the differential diagnosis by at least one reviewer. The remaining tumors had no histologic features suggestive of germ cell neoplasms. Ninety-six patients had received combination chemotherapy (89 with cisplatin-containing regimens); 27 patients (28%) achieved complete remission, and 16 remain free of disease at a median of 65 months after completion of therapy. Patients with PDC of unknown primary site who are responsive to cisplatin-containing chemotherapy regimens cannot be reliably identified by light microscopy. At present, all such patients should be considered for an empiric trial of chemotherapy with cisplatin-based regimens, since cure is achievable in a minority.

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