Carsinoma Doctor

Archive for the ‘Type of Carcinoma’ Category

TREATMENT

MASTECTOMY

Mastectomy is the treatment which compares with other management options and was the most used in the past decade, however, the most aggressive, as a condition that we can not use after the excision, or if they does, what will the long term. In addition, this advocate conservative treatment for invasive Ca therefore not seem logical to do so in the case of DCIS.

However, mastectomy is achieved the lowest rate of recurrence, which ranges from 0 to 3% (Table 1), so it still has some indications, such as:

1. People with cancerophobia, who do not accept the conservative treatment.
2. DCIS with multicentricity (1-2%).
3. Score alto8-9 in the Van Nuys index, of the latter, will be discussed later.

MAMMOGRAPHY

The typical presentation of high-grade DCIS are linear microcalcifications follow the pattern of a pipe.

When microcalcifications are undetermined, are associated with Ca in 22% of cases, with 76% of these type DCIS, But if the calcifications are suspicious type, 92% correspond to Ca, with 58% of these DCIS.

12% of cases of DCIS present soft tissue lesions on mammography, but associated with calcifications.

It is of note that mammography underestimated the actual size of the lesion in about two centímetros4, 7.

IMPACT

No one knows the exact incidence of DCIS in general population, however, in autopsy studies the incidence ranged from 0.2% to 1.2% in September, this variation reflects the type of study and characteristics of the population included.

In the U.S. DCIS diagnosed in the 20-40% of stereotactic biopsies and in 1985 was 7% of breast Ca, while in the decade rose to 14%, at a rate 200% higher than esperada3-5 .

Mammography appears to be solely responsible for the increased incidence of detection of DCIS and some studies show that only explains 25 to 45% are 6.

About 70 to 85% of all thyroid cancers diagnosed in the United States are papillary carcinoma are more common in women than in men. It can occur in childhood, but is typically seen in people aged 20 to 40 years. Its cause is unknown. A genetic defect may be involved. Exposure to external radiation in the neck at high doses increases the risk of developing this cancer. This papillary thyroid cancer in children has been linked to atomic bomb tests conducted in the Marshall Islands and the Chernobyl nuclear disaster in Ukraine in 1986. Radiation given through a vein (intravenously) during examinations and treatments does NOT increase the risk of developing thyroid cancer.

Symptoms
Thyroid cancer usually begins as a small bump (nodule) in the thyroid gland, which is located at the front of the neck. However, it should be emphasized that most thyroid bumps are harmless and noncancerous (benign).

Signs and tests
If you have a lump in your thyroid, your doctor will order blood tests and an ultrasound of the gland.
If the ultrasound shows that tumor size is greater than 1.0 cm, will be a special biopsy called fine needle aspiration (FNA, for its acronym in English), with which it is determined whether the tumor is cancerous or benign ( non-cancerous).
The thyroid function tests are usually normal in patients with thyroid cancer.

Cause and risk factor

Adrenocortical carcinoma is more common in children under 5 years of age and in adults between 30 and 40 years.

Adrenocortical carcinoma may be associated with a cancer syndrome that is passed down through families (inherited). Both men and women can develop this type of

The tumor can produce the hormones cortisol, estrogen and aldosterone. In women, the tumor often releases hormones, which can lead to male characteristics.

The cause is unknown and approximately 2 people per million develop this type of tumor.

Symptoms

Symptoms that suggest increased cortisol production are:

* Rounded hump of fat on the upper back, just below the neck (buffalo hump)

* Rounded face with pudgy cheeks (moon face)

* Obesity

* Stunted growth in height (short stature)

* Virilization: appearance of male characteristics, including increased body hair, especially on face, pubic hair, acne, deepening of voice and enlarged clitoris (girls)

Symptoms that suggest increased aldosterone production are the same as symptoms of low potassium and include weakness, muscle cramps, increased thirst and urination.

Endometrial carcinoma is the fourth leading cause of cancer in women after breast, lung and colon, in developed countries. Because it seemed important to evaluate the effectiveness of a noninvasive method, such as transvaginal ultrasound in screening women with risk factors for developing this disease, even more so taking into account the great curability of the same (the curable of the 10 most common cancers) if it is diagnosed and treated early.

Most women with endometrial carcinoma are postmenopausal and present consultation vaginal bleeding, with invasive methods such as biopsy and curettage, the most widely used for exploration. In these cases where we want to assess whether these methods can be replaced by transvaginal ultrasound, taking into account its complications.

We also want to deepen on the use of this diagnostic imaging in patients treated with tamoxifen for having had breast cancer and those with hormone replacement therapy.

At the time of filing, over 50% of patients with esophageal cancer have metastatic disease. The use of chemotherapy for this group of patients is increasing, with the intention of gaining control of local and distant tumor, improvement of quality of life and prolonging survival.
Evaluate the effectiveness of a) chemotherapy versus best supportive care or b) different chemotherapy regimens with each other in metastatic carcinoma of the esophagus.
Only two RCTs with 42 participants compared chemotherapy with best supportive care for metastatic cancer of the esophagus. In these RCTs, showed no survival benefit for chemotherapy. Five RCTs with 1 242 participants compared different chemotherapy regimens. Because of the variation in the population of patients and chemotherapy regimens, it was not possible to make a formal pooled analysis. There was no consistent benefit of any specific chemotherapy regimen.
Authors’ conclusions

Trials are needed well-designed phase III, and adequately powered, comparing chemotherapy versus best supportive care in patients with metastatic cancer of the esophagus. Chemotherapy agents with encouraging response rates and tolerable toxicity are cisplatin, 5-fluorouracil (5-FU), paclitaxel and anthracyclines. Future trials comparing palliative treatment modalities should assess the quality of life with quality of life measures validated.

Tumor involving the urothelium and is more prevalent in men than in women (9 and 4% of the tumors, respectively). In some cases, may result from exposure to naphthylamine and other aromatic amines, and cyclophosphamide treatment, and smokers are at greater risk than nonsmokers. Only 1-3%, it is a squamous cancer, and then you typically associated with schistosomiasis, and exceptionally adenocarcinoma (1%). Regarding diagnosis, hematuria princeps is the sign as it appears in 85% of cases, then perform a cystoscopy.

Although histologically tumor is of the same nature, from the standpoint of diagnostic and therapeutic, are divided into two groups: superficial and deep. The first affect the bladder mucosa and the latter to the muscle of the bladder. The surface is treated by transurethral endoscopic resection and occasionally endocavitary chemotherapy is added to chemotherapy (thiotepa, Adriamycin, Mitomycin C) or BCG. Supportive treatment is aimed at reducing recurrence and progression. Superficial tumors must be carefully followed by endoscopic control, by its tendency to relapse (in 40-70% of patients so happens) and progression (in 20-40% of cases progress to deep). The standard treatment is radical cystectomy deep (removal of the bladder, prostate and seminal vesicles) associated with treatment with chemotherapy or radiotherapy, in order to improve local control, facilitate surgery and improve overall survival. The deep treatment had a survival rate of 50% in five years.

Objective: To study the association between different elements immunohistochemical morphologic aspects and their possible prognostic value.

Methods: A descriptive-retrospective of 651 years of breast cancer cases with immunohistochemical staining in the Vargas Hospital of Caracas from May 2001 to July 2004. We analyzed the morphological characteristics of different tumor types, using the classification of Scarff-Bloom-Richardson amended, relating to the expression of different immunohistochemical markers: estrogen receptors, progesterone receptors, c-erb B-2 and Ki-67, made by biotin-streptavidin technique.

Results: The mean age was 51.72 years. The most common tumor was infiltrating ductal carcinoma (88.7%), followed by invasive lobular carcinoma (4.6%). 5.5% of ductal carcinomas were well differentiated, moderately differentiated 42.3%, 52.2% were poorly differentiated, of these, 77% had estrogen receptor and progesterone <10%, the well-differentiated carcinomas showed variable positivity. Poorly differentiated tumors showed c-erb B-2 positive in 51.36%, well differentiated between the 81.84% were negative, the intraductal carcinoma was positive in 42.86%, usually associated with comedocarcinoma. The 94.37% of poorly differentiated tumors were Ki-67 positive.

Conclusions: infiltrating ductal carcinoma is the classic type most common malignant tumor of the mammary gland, with an average age of 51.55 years, is often differentiated, possibly involving tumors with aggressive biological behavior. This is evidenced by negativity for hormone receptors and increased expression of c-erb B-2 and Ki-67.