Unknown primary

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  • Harrison's Internal Medicine Chapter 95. Carcinoma of Unknown Primary Carcinoma of Unknown Primary: Introduction Carcinoma of unknown primary (CUP) is a biopsy-proven (mainly epithelial) malignancy for which the anatomic site of origin remains unidentified after an intensive search. CUP is one of the 10 most frequently diagnosed cancers worldwide, accounting for approximately 3–5% of all cancer cases.

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  • Management of Disseminated CUP Patients who present with liver, brain, and adrenal metastatic disease usually have a poor prognosis. Beside primary peritoneal carcinoma, carcinomatosis presenting as CUP in other settings is not uncommon. Gastric, appendicular, colon, pancreas, and cholangiocarcinoma are all possible primaries, and imaging, endoscopy, and pathologic data help in the evaluation. Traditionally, platinum-based combination chemotherapy regimens have been used to treat patients with CUP.

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  • Role of Imaging Studies Chest x-rays are always obtained in CUP workups but are often negative, especially with low-volume disease. CT scans of the chest, abdomen, and pelvis can be used to help find the primary, evaluate the extent of disease, and select the most favorable biopsy site. Older studies suggested that the primary tumor site is detected in 20–35% of patients who undergo a CT scan of the abdomen and pelvis, although by current definition these patients would not be considered as having CUP. ...

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  • There are 20 subtypes of cytokeratin (CK) intermediate filaments with different molecular weights and differential expression in various cell types and cancers. Monoclonal antibodies to specific CK subtypes have been used to help classify tumors according to their site of origin; commonly used CK stains in CUP are CK7 and CK20. CK7 is found in tumors of the lung, ovary, endometrium, and breast and not in those of the lower gastrointestinal tract, whereas CK20 is normally expressed in the gastrointestinal epithelium, urothelium, and Merkel's cells.

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  • Role of Immunohistochemical Analysis Immunohistochemical stains are peroxidase-labeled antibodies against specific tumor antigens that are used to define tumor lineage. The number of available immunohistochemical stains is ever-increasing. However, in CUP cases, more is not necessarily better, and immunohistochemical stains should be used in conjunction with the patient's clinical presentation and imaging studies to select the best therapy. Communication between the clinician and pathologist is essential. No stain is 100% specific, and over-interpretation should be avoided.

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  • Treatment algorithm for tomography; chemotherapy. PET, positron squamous cell CUP. tomography; RT, CT, computed radiation; C, emission Treatment of Favorable Subsets of CUP Women with Isolated Axillary Adenopathy Women with isolated axillary adenopathy with adenocarcinoma or carcinoma should be treated for stage II or III breast cancer. These patients should undergo a breast MRI if mammogram and ultrasound are negative. Radiation therapy to the ipsilateral breast is indicated if the breast MRI is positive.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Classification of unknown primary tumors with a data-driven method based on a large microarray reference database

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  • Carcinoma of unknown primary (CUP) is a biopsy-proven (mainly epithelial) malignancy for which the anatomic site of origin remains unidentified after an intensive search. CUP is one of the 10 most frequently diagnosed cancers worldwide, accounting for approximately 3–5% of all cancer cases. Most investigators do not consider lymphomas, metastatic melanomas, and metastatic sarcomas that present without a known primary tumor to be CUP because these cancers have specific stage- and histology-based treatments that can guide management. ...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Triple malignancy in a single patient including a cervical carcinoma, a basal cell carcinoma of the skin and a neuroendocrine carcinoma from an unknown primary site: A case report and review of the literature

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  • Nosocomial FUO (See also Chap. 125) The primary considerations in diagnosing nosocomial FUO are the underlying susceptibility of the patient coupled with the potential complications of hospitalization. The original surgical or procedural field is the place to begin a directed physical and laboratory examination for abscesses, hematomas, or infected foreign bodies. More than 50% of patients with nosocomial FUO are infected. Intravascular lines, septic phlebitis, and prostheses are all suspect.

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  • Humans know a great deal about relationships among words. This paper discusses relationships among word pronunciations. We describe a computer system which models human judgement of rhyme by assigning specific roles to the location of primary stress, the similarity of phonetic segments, and other factors. By using the model as an experimental tool, we expect to improve our understanding of rhyme. A related computer model will attempt to generate pronunciations for unknown words by analogy with those for known words. ...

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  • Combined methods have led to further refinements with, for example, high visuospatial resolution afforded by MRI combined with metabolic information from the lesion site (measured with 18F-fluorodeoxyglucose positron emission tomography; FDG-PET) to indicate location and malignancy of gliomas, which in turn informs radiosurgical targeting. Kapsalaki et al. (Chapter 7) consider MRS spectroscopic profiles for differentiation among ring enhancing lesions including high grade gliomas, abscesses and post-radiation necrosis.

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  • The health effects of violence against women are serious, far-reaching, and intertwined. Health care providers have the opportunity and the obligation to identify cases of abuse. For many women in developing countries, a visit to a health clinic for reproductive or child health services may be their only contact with the health care system. The health care sector can capitalize on this opportunity by ensuring a supportive and safe environment for clients, helping providers ask about abuse, and helping women receive the care they need.

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  • Your Marketing major will cover all the essential components of marketing including consumer behaviour, marketing management, strategy, research and analysis. You’ll explore the strengths and weaknesses of many of the theories on which the conventional approach to marketing is based. You’ll also discover that marketing is not about routinely applying a standard set of techniques but instead about using knowledge and experience to give each issue its own specific strategy.

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  • Property, plant and equipment is carried at cost less accumulated depreciation. Assets manufactured by the Company include direct manufacturing costs, production overheads and interest charges incurred during the construction period. Government grants are deducted from the cost of the related asset. Depreciation is calculated using the straight-line method over the expected economic life of the asset. Depreciation of special tooling costs is based on the expected future economic benefit of these tools.

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  • ersonal “lives” were, generally not migrated into archives because of their on-going nature although nearly all photos were treated as archival. The rationale was that photos are fundamentally archives and this had to do with the mindset that Windows established by making “My Pictures” a special folder, that would lead people to store all photos in one folder hierarchy. Most of Bell’s photos are in a folder called “A Big Shoebox”. Over time, however, we also ended up storing photos throughout the folder hierarchy because all items pertaining to a single subject, e.

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  • A project has discrete steps budgeted into time, and it is in finite steps that project management can go awry. Someone who has never run the kind of project being detailed is likely to assign steps and values that are unrealistic. Therefore, project management is best done by someone who has completed a similar project before and knows the steps that go into it. Like many management principles, project management isn’t new. Henry Laurence Gantt, a mechanical engineer and disciple of scientific management first published the Gantt chart in 1910.

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  • Despite a variety of processes and the availability of raw-material sources, the widespread utilisation of annual plants in pulping has not been technically or economically feasible in Western countries due to the lack of a simple and environmentally efficient pulping method and the problems associated with raw material storage and logistics. An ideal non-wood pulping process is simple and environmentally efficient and can be applied on a small scale.

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  • Melanoma and Other Tumors Melanoma is the most common primary tumor of the eye (Fig. 29-18). It causes photopsia, an enlarging scotoma, and loss of vision. A small melanoma is often difficult to differentiate from a benign choroidal nevus. Serial examinations are required to document a malignant pattern of growth. Treatment of melanoma is controversial. Options include enucleation, local resection, and irradiation. Metastatic tumors to the eye outnumber primary tumors. Breast and lung carcinoma have a special propensity to spread to the choroid or iris.

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  • One unsolved issue concerns the role of the clonal B-cell receptor (BCR) in disease progression. Despite the fact that low expression of the BCR correlates with reduced induction of protein tyrosine kinase activity and defective intracellular calcium mobilization and tyrosine phosphorylation [66] this receptor conserves the capacity of antigen recognition and signaling, controlling thereby key behaviors of tumor cell, like proliferation and cell survival. Individual patients have different responses to IgM ligation which are related to VH gene status.

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