scholarly journals Axillary Lymph Nodal Metastasis from Carcinoma of Unknown Primary (CUPAx)- An Orphan Disease

2021 ◽  
Author(s):  
Renuka Bangalore Nagaraj ◽  
MD Khursid Alam Ansari
Keyword(s):  
Lymph Node ◽  
Primary Tumour ◽  
Nodal Metastasis ◽  
Unknown Primary ◽  
Axillary Lymph ◽  
Poorly Differentiated Carcinoma ◽  
Ultrasound Sonography ◽  
Metastatic Nodule ◽  
Poorly Differentiated

Metastasis to axillary lymph node occurs in adenocarcinoma or poorly differentiated carcinoma, and is a rare clinical entity that needs to be understood for management and its clinical outcome. The present case is of 72-year-old female patient who had a metastatic nodule in the axilla. No breast mass was palpable. Histology identified as metastatic adenocarcinoma, however mammography and Ultrasound Sonography test (USg) failed to detect the primary tumour. Immunohistochemistry showed that the excised lymph node was positive for Estrogen Receptor (ER) and negative for Progesterone Receptor (PR), suggesting the breast as the site for the primary tumour. Since the patient refused surgery, she was under follow-up for eight months. Now, she presented with recurrence of similar axillary swelling for two months.

scholarly journals Correlation between histological grading, LVI and PNI of carcinoma oral tongue to lymph node metastasis

2018 ◽  
Vol 5 (1) ◽  
pp. 159
Author(s):  
Sumana C. Viswanatha ◽  
Naveen Hedne ◽  
Suhel Hasan
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Histopathological Examination ◽  
Tongue Cancer ◽  
Tnm Classification ◽  
Primary Tumour ◽  
Nodal Metastasis ◽  
Oral Tongue ◽  
Node Metastasis ◽  
Poorly Differentiated

<p class="abstract"><strong>Background:</strong> Squamous cell carcinoma (SCC) of oral tongue has a higher predisposition to lymph node metastasis which reduces survival by 50%. In clinical practice, TNM classification is used for treatment planning which does not provide information on the biological characteristics of the tumor.</p><p class="abstract"><strong>Methods:</strong> This prospective cross sectional observational study included 30 patients with T1 to T3, N0/+ oral tongue SCC from 1<sup>st</sup> March 2014 to 30<sup>th</sup> April 2015. Incisional biopsy was taken from the primary tumour, pathological evaluation for differentiation of the tumour and assessment of lymphovascular (LVI) and perineural invasion(PNI) was carried out. Post operative histopathological examination included differentiation, LVI and PNI. The pathological findings were correlated using chi square test.  </p><p class="abstract"><strong>Results:</strong> Majority presented with T2 stage. 27% had nodal metastasis. There was higher incidence of lymph node metastasis in moderately differentiated (MD) and poorly differentiated (PD) SCC which was not statistically significant. Significant correlation was seen between LVI and PNI to lymph node metastasis (p≤0.001).</p><p class="abstract"><strong>Conclusions:</strong> There is a higher incidence of lymph node metastasis seen in moderately and poorly differentiated SCC of oral tongue, which can be assessed on the preoperative biopsy, guiding us to be more aggressive in the management of cervical nodes in early tongue cancer.<strong> </strong>LVI and PNI are good predictors of nodal metastasis, help in assessing aggressiveness and prognosis of the disease, and are soft indicators for considering adjuvant / concurrent RT.</p>

scholarly journals Completely resected stage III melanoma controversy - 15 years of national tertiary centre experience

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Barbara Peric ◽  
Sara Milicevic ◽  
Andraz Perhavec ◽  
Marko Hocevar ◽  
Janez Zgajnar
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Rapid Development ◽  
Primary Tumour ◽  
Stage Iii ◽  
Unknown Primary ◽  
Tertiary Centre ◽  
Kaplan Meier ◽  
Stage Iii Melanoma ◽  
Resected Stage

AbstractBackgroundTwo prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of systemic adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients’ treatment from Slovenian national CM register to leading international clinical guidelines.Patients and methodsSince 2000, all Slovenian CM patients with primary tumour ≥ TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. A retrospective analysis of 2426 sentinel lymph node (SLN) biopsies and 789 lymphadenectomies performed until 2015 was conducted using Kaplan-Meier survival curves and log-rank tests.ResultsPositive SLN was found in 519/2426 (21.4%) of patients and completion dissection (CLND) was performed in 455 patients. The 5-year overall survival (OS) of CLND group was 58% vs. 47% of metachronous metastases group (MLNM) (p = 0.003). The 5-year OS of patients with lymph node (LN) metastases and unknown primary site (UPM) was 45% vs. 21% of patients with synchronous LN metastasis. Patients with SLN tumour burden < 0.3 mm had 5-year OS similar to SLN negative patients (86% vs. 85%; p = 0.926). The 5-year OS of patients with burden > 1.0 mm was similar to the MLNM group (49% vs. 47%; p = 0.280).ConclusionsStage III melanoma patients is a heterogeneous group with significant OS differences. CLND after positive SLNB might still remain a method of treatment for selected patients with stage III.

Axillary lymph node metastases from unknown primary: A French multicentre study

2018 ◽  
Vol 223 ◽  
pp. 103-107
Author(s):  
Lobna. Ouldamer ◽  
Marie Cayrol ◽  
Mathilde Vital ◽  
Claire Fièvre ◽  
Marion Druelles ◽  
...  
Keyword(s):  
Lymph Node ◽  
Multicentre Study ◽  
Lymph Node Metastases ◽  
Axillary Lymph Node ◽  
Unknown Primary ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Metastases

scholarly journals Pineal Gland Metastasis From Poorly Differentiated Carcinoma of Unknown Primary Origin

2020 ◽  
Vol 11 ◽  
Author(s):  
Joshua A. Cuoco ◽  
Michael W. Kortz ◽  
Michael J. Benko ◽  
Robert W. Jarrett ◽  
Cara M. Rogers ◽  
...  
Keyword(s):  
Pineal Gland ◽  
Unknown Primary ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Primary Origin ◽  
Unknown Primary Origin

Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?

1997 ◽  
Vol 15 (5) ◽  
pp. 2056-2066 ◽  
Author(s):  
R Lenzi ◽  
K R Hess ◽  
M C Abbruzzese ◽  
M N Raber ◽  
N G Ordoñez ◽  
...  
Keyword(s):  
Median Survival ◽  
Proportional Hazards ◽  
Primary Carcinoma ◽  
Unknown Primary ◽  
Entire Group ◽  
Poorly Differentiated Adenocarcinoma ◽  
Prognostic Features ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Unknown Primary Carcinoma

PURPOSE The objectives of this study were to assess clinical outcomes and prognostic factors in unselected, consecutive patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA). PATIENTS AND METHODS The 1,400 patients analyzed were referred to our unknown-primary tumor (UPT) clinic from January 1, 1987 through July 31, 1994. Clinical data from these patients were entered into a computerized data base for storage, retrieval, and analysis. Survival was measured from the time of diagnosis; survival distribution was estimated using the product-limit method. Multivariate survival analyses were performed using proportional hazards regression and by recursive partitioning. RESULTS Nine hundred seventy-seven patients were diagnosed with unknown-primary carcinoma (UPC) and 337 of these patients had PDC or PDA. No clinical differences were identified among patients with PDC, PDA, or UPC patients with other carcinoma or adenocarcinoma subtypes. PDC patients enjoyed better survival than PDA patients. Poor cellular differentiation was not an important prognostic variable. Variables predictive of survival included lymph node metastases, sex, number of metastatic sites, histology (PDC v PDA), and age. Although chemotherapy did not appear to influence survival for the entire group of PDC or PDA patients, a subset of patients with good prognostic features experienced median survival durations of up to 40 months. CONCLUSION The long median survival and chemotherapy responsiveness of UPC patients with PDC and PDA could not be confirmed. However, subpopulations with prolonged median survival durations could be defined, and the value of chemotherapy in this group remains to be determined. Identification and exclusion of treatable or slow-growing malignancies may account for the poor survival of the PDC and PDA patients reported in this study.

scholarly journals Quantifying the Impact of Axillary Surgery and Nodal Irradiation on Breast Cancer–Related Lymphedema and Local Tumor Control: Long-Term Results From a Prospective Screening Trial

2020 ◽  
Vol 38 (29) ◽  
pp. 3430-3438 ◽  
Author(s):  
George E. Naoum ◽  
Sacha Roberts ◽  
Cheryl L. Brunelle ◽  
Amy M. Shui ◽  
Laura Salama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Locoregional Control ◽  
Long Term Results ◽  
Axillary Lymph ◽  
Axillary Surgery ◽  
Breast Cancer Related Lymphedema ◽  
The Impact ◽  
Screening Trial

PURPOSE To independently evaluate the impact of axillary surgery type and regional lymph node radiation (RLNR) on breast cancer–related lymphedema (BCRL) rates in patients with breast cancer. PATIENTS AND METHODS From 2005 to 2018, 1,815 patients with invasive breast cancer were enrolled in a lymphedema screening trial. Patients were divided into the following 4 groups according to axillary surgery approach: sentinel lymph node biopsy (SLNB) alone, SLNB+RLNR, axillary lymph node dissection (ALND) alone, and ALND+RLNR. A perometer was used to objectively assess limb volume. All patients received baseline preoperative and follow-up measurements after treatment. Lymphedema was defined as a ≥ 10% relative increase in arm volume arising > 3 months postoperatively. The primary end point was the BCRL rate across the groups. Secondary end points were 5-year locoregional control and disease-free-survival. RESULTS The cohort included 1,340 patients with SLNB alone, 121 with SLNB+RLNR, 91 with ALND alone, and 263 with ALND+RLNR. The overall median follow-up time after diagnosis was 52.7 months for the entire cohort. The 5-year cumulative incidence rates of BCRL were 30.1%, 24.9%, 10.7%, and 8.0% for ALND+RLNR, ALND alone, SLNB+RLNR, and SLNB alone, respectively. Multivariable Cox models adjusted for age, body mass index, surgery, and reconstruction type showed that the ALND-alone group had a significantly higher BCRL risk (hazard ratio [HR], 2.66; P = .02) compared with the SLNB+RLNR group. There was no significant difference in BCRL risk between the ALND+RLNR and ALND-alone groups (HR, 1.20; P = .49) and between the SLNB-alone and SLNB+RLNR groups (HR, 1.33; P = .44). The 5-year locoregional control rates were similar for the ALND+RLNR, ALND-alone, SLNB+RLNR, and SLNB-alone groups (2.8%, 3.8%, 0%, and 2.3%, respectively). CONCLUSION Although RLNR adds to the risk of lymphedema, the main risk factor is the type of axillary surgery used.

The prognostic value of nodal ratios in node-positive breast cancer: AUBMC experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21072-21072
Author(s):  
A. Shamseddine ◽  
H. Hatoum ◽  
Z. Salem ◽  
Z. Abdel Khalek ◽  
N. El Saghir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Node Positive ◽  
The Impact ◽  
Positive Breast Cancer

21072 Background: Axillary lymph node metastasis has proven to be the most important factor affecting overall survival (OS) and disease free survival (DFS) in patients with breast cancer. Recent evidence suggests that axillary lymph node ratio (LNR) may be at least as important as absolute number of involved lymph nodes in predicting OS and DFS. The aim of this retrospective study is to evaluate the impact of axillary nodal ratios in node-positive breast cancer as a prognostic factor for survival. Methods: Data from 1181 patients with stage I, II and III breast cancer diagnosed at AUBMC between 1990 and 2001 were studied. The median age at diagnosis was 50 years (23 - 88); the median number of lymph nodes dissected was 17 (0 - 49). Survival was compared in 737 patients with node-positive disease according to a LNR below or more than 0.25 (defined as number of involved lymph nodes divided by total dissected axillary lymph nodes). Results: Patients with LNR = 0.25 had a median follow-up of 30 months (1.2–156) and a median DFS of 26 months (1–156). The 5-year survival was 26.2% (94/358) and the 5-year DFS was 22.9% (82/358). Patients with LNR <0.25 had a median follow-up of 36 months (1.2–157) and a median DFS of 36 months (1–157). The 5-year survival of 33.2% (245/737) and the 5-year DFS was 29.8 % (220/737). LNR showed significance as a continuous variable and a categorical variable (0, < 0.25, and = 0.25) with a p < 0.001 Conclusions: LNR significantly predicts OS and DFS in node-positive primary breast cancer. No significant financial relationships to disclose.

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