Aged ; Carcinoma, Renal Cell ; pathology ; secondary ; Duodenal Neoplasms ; secondary ; surgery ; Female ; Humans ; Kidney Neoplasms ; pathology ; Nephrectomy

Aged ; Carcinoma, Renal Cell ; secondary ; surgery ; Female ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Nephrectomy ; Parietal Bone ; Skull Neoplasms ; secondary ; surgery

Humans ; Carcinoma, Hepatocellular/secondary* ; Liver Neoplasms/surgery* ; Thyroid Neoplasms/surgery* ; Neoplasms, Second Primary

OBJECTIVETo study the micrometastasis distribution in liver tissue surrounding hepatocellular carcinoma (HCC), and provide reference for appropriate surgical safety margin.

METHODSThirty-six patients with HCC but without clinical metastasis underwent hepatectomy. Their specimens showing ample surgical margin were made into giant sections. Tumor micrometastasis in liver tissue around the primary tumor were examined microscopically. In each specimen, the surrounding tissue was divided into proximal(p) and distal(d) areas. In either area, three lines of demarcation 0.5 cm, 1.0 cm, and 2.0 cm away from the margin of the primary tumor were designated as L(0.5), L(1.0) and L(2.0). Therefore, the surrounding tissue was divided into six zones - Z(p0.5), Z(p1.0), Z(p2.0) and Z(d0.5), Z(d1.0), Z(d2.0). The maximum micrometastasis spread distance (MMSD) and density (D(p0.5), D(p1.0), D(p2.0) and D(d0.5), D(d1.0), D(d2.0)) in each zone were analyzed after search for micrometastasis in the giant sections.

RESULTS72.5% (111/153) micrometastases were found in form of microscopic tumor emboli. Their spread distance could be up to 6.1 cm. In 66.7% (24/36) specimens, micrometastases were found in the surrounding tissue. In 91.7% (22/24) of them, the distal MMSD was less than 3 cm. The proximal MMSD was less than 1.5 cm in 92.3% (12/13). The comparison of micrometastasis density in the different zones were D(d0.5) > D(d1.0) > D(d 2.0); D(p0.5) > D(p1.0) > D(p2.0); D(d1.0) > D(p1.0); D(d2.0) > D(p2.0) with significant differences.

CONCLUSION(1) Micrometastases of HCC exist mainly in form of microscopic tumor emboli, (2) The longer the distance from the primary focus, the lower the micrometastasis incidence, (3) In zones more than 0.5 cm away from the primary focus, tumor micrometastasis incidence is significantly lower in the proximal zones than that in the distal zones and (4) For HCC patients without clinical metastasis, a surgical margin of 3 cm wide in the distal area and 1.5 cm wide in the proximal area may reduce the rate of postoperative recurrence.

Carcinoma, Hepatocellular ; secondary ; surgery ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; pathology ; surgery ; Neoplasm Metastasis ; Neoplasm Recurrence, Local

OBJECTIVETo summarize the surgical treatment experiece and to investigate the prognosis of the patients with ovarian metastasis from colorectal cancer.

METHODSThe data of 67 patients with synchronous or asynchronous ovarian metastasis from colorectal cancer surgically treated between January 1989 and December 2005 were collected and analyzed retrospectively using Statistical Package for the Social Sciences (Release 11.5, SPSS, Inc). Prognostic factors were analyzed using chi2 test. Survival analysis was estimated by the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis was carried out by Cox regression.

RESULTSThe overall 1-, 3- and 5-year survival of these 67 patients was 71.0%, 18.7% and 9.2%, respectively. Univariate analysis revealed that the metastasis was confined in the ovary or pelvis only, unilateral/double ovarian metastasis, and operation mode were all statistically significant prognostic factors (P <0.05). Cox regression analysis showed that the operation mode was the most important prognostic factor (OR = 3.531, P <0.001).

CONCLUSIONSurgical treatment is still the most effective mode in the treatment for the ovary metastasis from colorectal cancer.

Adenocarcinoma ; secondary ; surgery ; Adenocarcinoma, Mucinous ; secondary ; surgery ; Adult ; Aged ; Carcinoma, Signet Ring Cell ; secondary ; surgery ; Colorectal Neoplasms ; pathology ; Female ; Follow-Up Studies ; Humans ; Hysteroscopy ; methods ; Middle Aged ; Ovarian Neoplasms ; secondary ; surgery ; Ovariectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

To report a single case of improvement on choroidal metastasis of breast cancer after laser photocoagulation. A 52-year-old female patient who complained of visual disturbance of the right eye with multiple states of metastasis of breast carcinoma. On initial examination, the right best-corrected visual acuity was 0.63. Right fundoscopy revealed an elevated mass-like lesion temporal to the macule with serous retinal detachment. The mass had a 3.5-disc diameter. A right fluorescein angiogram revealed hypofluorescence during the prearterial and arteriovenous phase and hyperfluorescence during the venous phase. The venous phase showed almost total masking of background choroidal fluorescence at the elevated lesion because of leakage and neovascularization. The patient was treated 4 times by diode laser photocoagulation in addition to chemotherapy. Fifty days after the diode laser treatments, the funduscopy examination and fluorescein angiogram revealed that the serous retinal detachment had been absorbed, the choroid had become flat, the lesion had been reduced in size and hyperfluorescence. The right best-corrected visual acuity was improved to 0.8. Laser photocoagulation appears not to cause any problems for the patient and may be an efficient treatment for patients with choroidal breast carcinoma.
Breast Neoplasms/pathology/*surgery ; Carcinoma, Ductal, Breast/secondary/*surgery ; Choroid Neoplasms/secondary/*surgery ; Female ; Fluorescein Angiography ; Humans ; Laser Coagulation/*methods ; Lasers, Semiconductor/*therapeutic use ; Middle Aged ; Visual Acuity

OBJECTIVETo evaluate the effectiveness of a tailored approach to radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC).

METHODSUltrasound-guided percutaneous RFA was performed in 274 tumors of 228 patients located at liver periphery, including 59 near the bowel, 115 near the diaphragm, 54 near the gallbladder, and 46 near the liver surface. The tumor sizes ranged 1.2-7.0 cm [mean (3.7 +/- 1.2) cm]. A tailored treatment strategy was established for tumors in different locations. Contrast-enhanced CT was performed one month later to evaluate the early necrosis rate of the treated tumors.

RESULTSEarly tumor necrosis rate was 91.6% of the peripherally located HCC, including 91.5% of the tumors near the bowel, 90.4% near the diaphragm, 92.6% near the gallbladder, and 93.5% near the liver surface. Local tumor recurrence rates were 8.5%, 9.6%, 7.4%, and 6.5% for tumors near the bowel, diaphragm, gallbladder, and liver surface, respectively. The 1-, 2-, and 3-year survival rate of this group were 82.3%, 62.9%, and 53.7%, respectively. Major complications occurred in 3.3% of the treatment sessions, including haemorrhage (n = 2), nearby structure injury (n = 6), and needle tract seeding (n = 4).

CONCLUSIONThe tailored approach to RFA provides a promising treatment option for refractory peripherally located HCC with satisfactory tumor necrosis rate and low complication rate.

Abdominal Neoplasms ; secondary ; surgery ; Carcinoma, Hepatocellular ; secondary ; surgery ; Catheter Ablation ; adverse effects ; Humans ; Liver Neoplasms ; pathology ; surgery ; Neoplasm Recurrence, Local ; Treatment Outcome

OBJECTIVE: To explore the technique and effect of liver hanging maneuver in anterior approach for isolated complete liver caudate lobectomy. METHODS: We recruited 17 patients with liver caudate lobe tumor (13 primary hepatocellular carcinoma, 3 cholangiocarcinoma and 1 liver metastasis from colorectal cancer). Isolated complete caudate lobectomy with liver hanging maneuver was performed in 17 patients. RESULTS: All 17 patients were successfully received the above-mentioned operation. The operative time was 166-427 (211.5 ± 20.1) min and the intraoperative blood loss was 372-1 208 (472.7 ± 83.6) mL. There was no operative death. The survival rates of follow up for 1, 3 and 5 years were 76.5%, 52.9% and 23.5%, respectively. CONCLUSION Liver hanging maneuver for isolated complete resection of the caudate lobe is an ideal approach for liver neoplasms resection.
Blood Loss, Surgical ; Carcinoma, Hepatocellular ; surgery ; Cholangiocarcinoma ; surgery ; Colorectal Neoplasms ; pathology ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; secondary ; surgery ; Survival Rate

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Iatrogenic implantation has been the main cause in the majority of cases of transitional call carcinoma (TCC) with metastasis to the abdominal wall. A 66-year-old woman had undergone radical cystectomy 20 years prior to presenting. Radiological investigations revealed one mass in the left lower abdominal wall and one mass in the right inguinal area. She underwent wide excision of the lesions that revealed metastasis of TCC. This report describes this case of a woman with bladder carcinoma who developed a metastasis in the anterior abdominal wall following an apparent disease-free interval of 20 years.
Abdominal Wall/*pathology ; Aged ; Bladder Neoplasms/*pathology/*surgery ; Carcinoma, Transitional Cell/*secondary/*surgery ; Cystectomy ; Female ; Humans ; Soft Tissue Neoplasms/*secondary ; Time Factors