No abstract available.
Biopsy, Fine-Needle/*adverse effects ; Carcinoma, Hepatocellular/*secondary ; Female ; Humans ; Liver Neoplasms/*pathology ; Male ; *Neoplasm Seeding

Lung cancer with pleural seeding has poor prognosis and is generally treated by intravenous anticancer chemotherapy only. We performed intrapleural perfusion hyperthermic-chemotherapy in two lung cancer patients with pleural seeding. Herein, we report our outcome with literature review.
Drug Therapy ; Humans ; Hyperthermia, Induced ; Lung Neoplasms* ; Lung* ; Neoplasm Seeding ; Perfusion* ; Pleural Effusion ; Pleurodesis ; Prognosis

OBJECTIVE: To evaluate the impact of energy and access methods on extrahepatic tumor spreading and the ablation zone in an ex vivo subcapsular tumor mimic model with a risk of extrahepatic tumor spreading. MATERIALS AND METHODS: Forty-two tumor-mimics were created in bovine liver blocks by injecting a mixture of iodine contrast material just below the liver capsule. Radiofrequency (RF) ablations were performed using an electrode placed parallel or perpendicular to hepatic surface through the tumor mimic with low- and high-power protocols (groups 1 and 2, respectively). Computed tomography (CT) scans were performed before and after ablation. The presence of contrast leak on the hepatic surface on CT, size of ablation zone, and timing of the first roll-off and popping sound were compared between the groups. RESULTS: With parallel access, one contrast leak in group 1 (1/10, 10%) and nine in group 2 (9/10, 90%) (p < 0.001) were identified on post-ablation CT. With perpendicular access, six contrast leaks were identified in each group (6/11, 54.5%). The first roll-off and popping sound were significantly delayed in group 1 irrespective of the access method (p = 0.002). No statistical difference in the size of the ablation zone of the liver specimen was observed between the two groups (p = 0.247). CONCLUSION: Low-power RF ablation with parallel access is proposed to be effective and safe from extrahepatic tumor spreading in RF ablation of a solid hepatic tumor in the subcapsular location. Perpendicular placement of an electrode to the capsule is associated with a risk of extrahepatic tumor spreading regardless of the power applied.
Animals ; Catheter Ablation ; Electrodes ; Iodine ; Liver ; Liver Neoplasms, Experimental ; Methods ; Neoplasm Seeding

We report a case of malignant fibrous histiocytoma (MFH) of the right buttock with multiple metastases to the lung, bone, and small intestine. He received resection and end-to-end anastomosis of the jejunum for the jejunal metastatic tumor, and mass excision of the metastatic tumor of the left femur followed by closed reduction and internal fixation and palliative radiotherapy. In addition, he received palliative radiotherapy to the metastatic pulmonary tumor with suspicious invasion into the thoracic aorta. However, one month after the completion of the aggressive local treatments, metastatic tumors recurred in the abdominal cavity, an extremely unusual site, resulting in peritoneal dissemination. He died of progressive disease 5 months after the initial diagnosis.
Abdominal Cavity ; Aorta, Thoracic ; Buttocks ; Femur ; Histiocytoma, Malignant Fibrous ; Intestine, Small ; Jejunum ; Lung ; Neoplasm Metastasis ; Neoplasm Seeding ; Peritoneal Cavity

OBJECTIVETo investigate the correlation between clinicopathologic factors and peritoneal dissemination in colorectal cancer, and the impact of surgery on the prognosis of patients with peritoneal dissemination.

METHODSBased on the clinical database built in 1994, the clinicopathologic data and the result of follow-up of all colorectal cancer patients were analyzed retrospectively.

RESULTOne hundred and fifty cases (7.40%) in all 2019 patients with primary colorectal cancer were found complicated with peritoneal dissemination. The clinicopathologic factors in patients with peritoneal dissemination were significantly correlated with tumor penetrating through serosa, lymph node metastasis, undifferentiated carcinoma, ascites, different pathological type, circumference of tumor, neoplastic intestinal obstruction, and Dukes staging. Peritoneal dissemination was associated with tumor penetrating through serosa, different pathological type on multivariate analysis. The 1-, 3-, 5-year survival rate of the patients with peritoneal dissemination were 70.4%, 38.1%, 30.2%; The 1-, 3-, 5-year survival rate of the patients undergoing radical resection were significant better than those in the cases undergoing palliative operation or palliative resection (P < 0.05).

CONCLUSIONSColorectal cancer complicated with peritoneal dissemination has poorer clinicopathologic characteristics. Those with local peritoneal dissemination has rather better prognosis than those with wide peritoneal dissemination. Radical resection of the disseminated tumor can improve the prognosis of the patients.

Colorectal Neoplasms ; pathology ; surgery ; Follow-Up Studies ; Humans ; Neoplasm Invasiveness ; Neoplasm Seeding ; Peritoneal Neoplasms ; secondary ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo study the effect of enteral nutrition as replacement of mechanical bowel preparation on peritoneal and intraluminal disseminated tumor cells, recurrence and metastasis in patients with colorectal cancer.

METHODSA total of 120 colorectal cancer patients between March 2007 and December 2011 were enrolled prospectively and randomly divided into two groups. Group A (n=60) received preoperative bowel preparation with enteral nutrition fluid (30 ml·kg(-1)·d(-1)), without enema, taxative or antibiotics. Group B (n=60) underwent traditional intestinal preparation consecutively 3 days before operation, including fasting, oral antibiotic, and cleaning enema. All the patients received peritoneal lavage with 400 ml of normal saline at the time of laparotomy and 200 ml of the lavage fluid was collected. All the cases underwent distal colorectal lavage with 1000 ml of normal saline before anastomosis, and 500 ml of the lavage fluid was collected. Fluid samples were quickly sent for exfoliated cytological examination. The positive rates of exfoliated cancer cell in peritoneal cavity and intraluminal cavity, postoperative complication, recurrence and metastasis were compared between the two groups.

RESULTSIn group A, exfoliated cancer cells were found in 5 of 60 cases (8.3%) in peritoneal lavage fluid and in 9 of 60 cases (15.0%) in distal colorectal lavage fluid, while in group B, cancer cells were found in 13 of 60 cases (12.5%) and 19 of 60 cases (31.7%) respectively. There were significant differences between group A and B (P=0.041, P=0.031). Fifty-five patients in group A were followed up from 16 to 46 months after surgery, as well 57 patients in group B. Rates of local recurrence and distant metastasis in Group A and B were 5.5% vs. 7.0% and 10.9% vs. 10.5% respectively. There were no significant differences (P=0.733, P=0.984). There was no significant difference in 3-year survival rate between the two groups (80% vs. 78%, P=0.312).

CONCLUSIONSEnteral nutrition instead of traditional bowel preparation can decrease the positive rate of disseminated cancer cells in peritoneal cavity or colorectal lumen, while dose not affect recurrence and metastasis rates in patients with colorectal cancer.

Aged ; Colorectal Neoplasms ; pathology ; surgery ; Enteral Nutrition ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Seeding ; Preoperative Care

OBJECTIVETo explore the exfoliated cancer cell contamination in different surgical materials during the malignant gastrectomy.

METHODSNinety gastric cancer patients undergoing gastrectomy were prospectively enrolled in this study. The operation materials of these 90 gastrectomy were divided into 5 groups: surgical instruments (A), gloves for surgeons (B), gloves and gauzes of scrub nurse (C), gauzes for hemostasis (D), anastomosis instrument (E). The rinse fluid of materials was cultured to verify positive cancer cells. Associations among different pathological stages, differentiations, materials and positive cancer cells rates were examined.

RESULTSStage II and III patients had higher positive rates of exfoliated cancer cell contamination than stage I patients [26.5 (9/34) and 47.5% (21/46) vs. 10.0% (1/10),P=0.046]. Low differentiated adenocarcinoma group had higher positive rate than moderately and well differentiated adenocarcinoma groups [44.8% (26/58) vs. 16.7% (4/24) and 12.5% (1/8), P=0.020]. Positive cancer cell rates of 5 kinds of materials were as follows: 12.2% (11/90) in A group, 6.7% (6/90) in B group, 22.2% (20/90) in C group, 15.6% (14/90) in D group and 3.3% (3/90) in E group, and the differences were significant (P<0.01).

CONCLUSIONDifferent operation materials have different risks to be contaminated by cancer cells, which is associated with the contact frequency, cancer staging and pathological classification.

Adult ; Aged ; Equipment Contamination ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoplasm Seeding ; Prospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Surgical Equipment

Intraperitoneal metastatic hepatocellular carcinoma (HCC) is uncommon. Although rare, it can spontaneously rupture and cause hemoperitoneum similar to primary HCC in the liver. We present a case of intraperitoneal metastatic HCC that had spontaneously ruptured and appeared as an irregularly margined hemorrhagic mass with T1 high and T2 dark signal intensities on magnetic resonance imaging. Ruptured HCC is a life-threatening emergency with high mortality rate. Spontaneously ruptured intraperitoneal metastatic HCC should be considered if a patient with a history of HCC presents with acute abdomen, although rare.
Abdomen, Acute ; Carcinoma, Hepatocellular ; Emergencies ; Hemoperitoneum ; Humans ; Liver ; Magnetic Resonance Imaging ; Mortality ; Neoplasm Seeding ; Rupture ; Rupture, Spontaneous

Radiofrequency ablation (RFA), a local ablative modality, is gaining acceptance for the treatment of liver malignancies. Despite a relatively low complication rate, tumor seeding resulting from RFA in hepatocellular carcinoma (HCC) treatment can occur. A 44-year-old woman was diagnosed with HCC. Spiral computed tomography (CT) revealed a 2.3 × 2.0-cm mass in the S5 segment, which was treated with RFA on May, 2005. Follow-up imaging, performed at 6-month intervals after RFA, showed complete tumor necrosis. In October 2009, CT revealed a heterogeneous mass, 5.7 cm in diameter, in the right ovary. Since the lesion was limited to the right ovary without evidence of spread, bilateral salpingo-oophorectomy was performed. Histopathology indicated that the metastatic spread from the HCC to the ovary was positive for hepatocyte-specific antigen on immunohistochemistry. The ovary is a rare site for HCC metastasis. Moreover, needle tract implantation of HCC in the ovary is very rare.
Adult ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Liver ; Necrosis ; Needles ; Neoplasm Metastasis ; Neoplasm Seeding ; Ovary* ; Tomography, Spiral Computed

OBJECTIVE: To explore the influence of carbon dioxide pneumoperitoneum-laparoscopic surgery on tumor cell seeding and metastases in endometrial cancer. METHODS: Twenty patients with endometrial cancer who underwent laparoscopic surgery and 10 patients with endometrial cancer who underwent laparotomic surgery were enrolled. Each patient was in preoperative clinical StageIand the uterus size in each patient was less than 12 weeks of pregnancy. Carbon dioxide pneumoperitoneum was established and maintained with CO2 insufflation at 4 approximately 6 L/min and intraperitoneal pressure of 13 mmHg with an automatic pneumoperitoneum machine. Cytologic examination of peritoneal fluid(at the beginning and end of the operation), CO2 filtrated gas and the lavage fluid of instruments during the laparoscopic surgery were performed. The protein expressions of E-cadherin,beta-catenin,P-selectin,matrix metalloproteinase-2(MMP-2),vascular endothelial growth factor (VEGF),and CD44v6 in tumor tissues before and after the operation were detected by DAKO Envision. RESULTS: There were no case of positive washing cytology in the peritoneal fluid,CO2 filtrated gas, and the lavage fluid of instruments during the laparoscopic surgery. The expressions of E-cadherin and beta-catenin proteins were obviously abnormal in endometrial cancer. The abnormal expressions of E-cadherin and beta-catenin protein between the pre- and post-operations were not significantly different in both the laparoscopic group and the laparotomic group(P>0.05).The changes of abnormal expressions of E-cadherin and beta-catenin protein were no statistical difference between the two groups(P>0.05). The positive protein expressions of P-selectin,MMP-2,VEGF,and CD44v6 were not significantly different between the pre- and post-operations both in the laparoscopic group and the laparotomic group(P>0.05),and there was also no significant difference between the laparoscopic group and the laparotomic group(P>0.05).The follow-up period in the laparoscopic group was 7 approximately 19 (14.25+/-3.65) months and 7 approximately 19 (13.10+/-4.23) months in the laparotomic group. One patient got infection in the urinary system in the laparoscopic group and one patient had lower extremity venous thrombosis in the laparoscopic group.No recurrence was detected in both groups. CONCLUSION Laparoscopic surgery for endometrial cancer has no effect on protein expressions of E-cadherin,beta-catenin,P-selectin,MMP-2,VEGF,and CD44v6 in tumor tissues. No evidence has been found that CO2 pneumoperitoneum-laparoscopic surgery may favor endometrial cancer cell seeding and metastases.
Adult ; Carbon Dioxide ; Carcinoma, Endometrioid ; surgery ; Endometrial Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; adverse effects ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Seeding ; Pneumoperitoneum, Artificial ; adverse effects