ABSTRACT
BACKGROUND: The early detection and treatment of tumor recurrences in melanoma patients is dependent on reliable, sensitive, and specific techniques to verify suspected tumor metastases. As of now, fine-needle aspiration cytology (FNAC) has yet to establish itself in the routine follow-up of melanoma patients. METHODS: FNAC procedures were performed in melanoma patients with palpable tumors or nonpalpable, ultrasonically suspicious lesions. Cytodiagnostic evaluation of fine-needle samples obtained from suspicious lesions was performed morphologically. Findings were validated either by histopathologic diagnosis or prolonged clinical follow-up. RESULTS: The cytologic examination of 739 FNACs from 330 melanoma patients was conducted within 1 day of sampling. Complications were not observed. This study showed a sensitivity of 97.9% and a specificity of 100.0%. Moreover, in 158 FNACs derived from lesions with a diameter less than 1 cm a sensitivity of 94.6% was achieved. Diagnosis of metastatic melanoma with unknown primary tumor was established in 20 cases. CONCLUSIONS: FNAC is very reliable for the early detection of melanoma metastases. FNAC is a swift method free of complications and is able to replace diagnostic surgery completely for nonmalignant lesions in a large number of patients. Moreover, FNAC is especially useful in combination with ultrasound in melanoma follow-up and can enable diagnosis of lesions smaller than 1 cm without impairment of sensitivity or specificity.
Subject(s)
Biopsy, Needle/methods , Melanoma/secondary , Neoplasm Metastasis/diagnosis , Skin Neoplasms/pathology , Ultrasonography, Interventional/methods , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasm Staging/methods , Reproducibility of Results , Sensitivity and Specificity , Ultrasonography, Interventional/standardsABSTRACT
Metastatic lesions represent 1-8% of all malignant tumors of the mouth and jaws, with rare sites of metastasis originating from different primary tumors, especially the lung and breast. The vast majority of these lesions (up to 90%) have been observed in the mandible and maxilla (5-20%). Another rare type of cancer that usually metastasizes to the lungs, lymph nodes, bones, liver or brain may occasionally also show spread to the paranasal sinuses. In the present paper we report our management of a 50-year-old male with renal cell carcinoma who developed metastases to the frontal and ethmoid sinuses.
Subject(s)
Carcinoma, Renal Cell/secondary , Ethmoid Sinus , Frontal Sinus , Kidney Neoplasms/diagnosis , Paranasal Sinus Neoplasms/secondary , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/surgery , Diagnosis, Differential , Ethmoid Sinus/pathology , Ethmoid Sinus/surgery , Frontal Sinus/pathology , Frontal Sinus/surgery , Humans , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Male , Middle Aged , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/surgeryABSTRACT
Although renal cell carcinoma is known to metastasize mainly to lungs, lymph nodes, bone, liver, brain or adrenal glands, unusual metastatic spread has been published in many case reports and autoptical studies. The gallbladder is rarely the site of distant metastases, and in most cases of gallbladder metastasis malignant melanoma is the primary tumor. A review of the literature revealed only 7 cases of renal cell carcinoma metastasizing to the gallbladder, and these were mainly found at necropsy. The case of a clinically detected gallbladder metastasis is presented.
Subject(s)
Carcinoma, Renal Cell/secondary , Gallbladder Neoplasms/secondary , Kidney Neoplasms/pathology , Carcinoma, Renal Cell/surgery , Humans , Kidney Neoplasms/surgery , Male , Middle Aged , Nephrectomy , Time FactorsABSTRACT
The case of a 26 years old patient with a primary paraaortic extragonadal yolk sac tumor is presented. After operative reduction of the tumor polychemotherapy with PEB was performed. Following chemotherapy testicular biopsy did not show histological changes typical for testicular intraepithelial neoplasia (TIN). Three years after the initial manifestation of the yolk sac tumor, a malignant tumor of the testis with components of undifferentiated teratoma and yolk sac tumor was observed. In this paper the problems of development of testicular malignancy after polychemotherapy and the validity of a small exploratory excision of testicular tissue in retroperitoneal germ cell tumors and following chemotherapy are discussed.
Subject(s)
Endodermal Sinus Tumor/diagnosis , Endodermal Sinus Tumor/therapy , Retroperitoneal Neoplasms/diagnosis , Testicular Neoplasms/secondary , Adult , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Endodermal Sinus Tumor/pathology , Humans , Male , Retroperitoneal Neoplasms/pathology , Retroperitoneal Neoplasms/therapy , Testicular Neoplasms/diagnosis , Testicular Neoplasms/therapyABSTRACT
The presence of nicotine in sweat obtained from smokers and one non-smoker exposed to tobacco smoke after 4 h to 8 days of nicotine-free time was investigated. Following stimulation of the eccrine glands, sweat samples were taken every hour for 6 h. The total nicotine concentrations, i.e. the sum of nicotine and its metabolites, were determined by radioimmunoassay. The presence of unchanged nicotine was revealed by gas chromatography/mass spectrometry.