About 27% of all cancer patients have some metastases at autopsy. Any carcinoma, lymphoma, or sarcoma may metastasize to bone, although those primary in certain organs do so much more frequently than others. Prostate, breast, lung, kidney, and thyroid are the most common carcinomas. Once in bone they may cause local destruction that is manifested […]
Thyroid carcinoma seems to have generated a considerable number of misconceptions. About 20% of these tumors are “pure” papillary, about 10% pure follicular, about 50% mixed papillary and follicular, and about 5% (range, 2%–10%) are called medullary. However, the pure papillary carcinoma usually has a few follicular elements if enough histologic sections are made, and […]
AFP and beta subunit chorionic gonadotropin (hCG) levels by EIA methods are elevated in certain gonadal tumors. In general, pure seminomas fail to produce AFP, whereas hCG production in seminoma ranges from 0%–37%. Some 70% or more of patients with embryonal cell carcinoma and malignant teratoma have elevated AFP levels, and 40%–60% or more have […]
Neuroblastoma. Neuroblastoma is the most common nonhematologic extracranial tumor of childhood and is the most frequent abdominal malignant mass lesion except for Wilm’s tumor between ages 1-4 years. Treatment by combined radiation and chemotherapy produces excellent results in sufficient patients that diagnosis has become of more than academic interest. It usually presents as an abdominal […]
In primary brain tumor, cerebrospinal fluid protein level is elevated in up to 70% of patients and cell count in about 30% of cases. One or the other is abnormal in 65%–80% of cases. Electroencephalogram (EEG) is abnormal in about 70%–75% of patients (literature range, 70%–92%), brain scan in about 80%–85% (65%–96%), and CT in […]
Tumor in the liver is most often metastatic. The liver receives metastases more frequently than any other organ, since 25%–50% of all metastasizing cancers reach the liver. The GI tract (including the pancreas), breast, kidney, lung, melanomas, and sarcomas are especially apt to produce hepatic metastases. Tests for detection include alkaline phosphatase, gamma-glutamyltransferase, liver scan […]
Chest x-ray films. Chest x-ray films have been the usual means of detecting lung cancer. Unfortunately, best results are obtained from the less common peripheral lesions rather than the more usual bronchogenic carcinomas arising in major bronchi. In general, chest x-ray films are not an efficient means of early diagnosis, and this is especially true […]
Cancer antigen 125. The cancer antigen 125 (CA 125) test uses an antibody against antigen from tissue culture of an ovarian tumor cell line. Various published evaluations report sensitivity of about 75%–80% in patients with ovarian carcinoma. There is also an appreciable incidence of elevated values in nonovarian malignancies and in certain benign conditions (see […]
Cervix. The mainstay of screening for uterine carcinoma is the Papanicolaou (Pap) smear. For Pap examination of the cervix, material is best obtained directly from the cervix by some type of scraping technique. Vaginal irrigation or vaginal pool smears are reported to be only 50%–75% as accurate as cervical scrape for detection of cervical carcinoma. […]
Mammography. Until 1960 diagnosis of mammary carcinoma depended on discovery of a breast mass by physical examination, followed by a biopsy of the lesion. It has been said that, with experience, carcinoma as small as 1 cm may be regularly detected by palpation. After 1960, x-ray study of the breast (mammography) began to receive considerable […]
