Cancer of unknown primary origin pathophysiology: Difference between revisions

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{{Cancer of unknown primary origin}}
{{Cancer of unknown primary origin}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}, {{RAK}}
==Overview==
==Overview==
The exact pathogenesis of [disease name] is not fully understood.
The exact [[pathogenesis]] of cancer of unknown primary origin is not fully understood. Several [[Evidence|studies]] noted consistency between [[metastatic cancer]] of unknown primary and metastases with known primary origins based on [[Chromosomal abnormalities|chromosomal abnormalitie]]<nowiki/>s and overexpression of several [[genes]].


OR
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Pathophysiology==
==Pathophysiology==
===Physiology===
The normal physiology of [name of process] can be understood as follows:
===Pathogenesis===
===Pathogenesis===
*The exact pathogenesis of [disease name] is not completely understood.
*The exact [[pathogenesis]] of cancer of unknown primary origin is not fully understood.
OR
*Cancer of unknown primary, like other cancers, arises from one [[cell]] that has managed to escape regulation and produces a [[tumor]] at a certain site (the site of origin) and consequently metastasizes to other parts of the body.
*It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
*It is thought that the site of origin of CUP remains unknown due to one or more of the following theories:<ref name="pmid19262901" />
*[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
**Remaining small and undetectable clinically
*Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
**Disappearing after metastasizing
*[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
**Elimination by body's defense
*The progression to [disease name] usually involves the [molecular pathway].
*The pathophysiology of [disease/malignancy] depends on the histological subtype.
 
==Genetics==
[Disease name] is transmitted in [mode of genetic transmission] pattern.
 
OR
 
Genes involved in the pathogenesis of [disease name] include:
*[Gene1]
*[Gene2]
*[Gene3]
 
OR
 
The development of [disease name] is the result of multiple genetic mutations such as:
 
*[Mutation 1]
*[Mutation 2]
*[Mutation 3]
 
==Associated Conditions==
Conditions associated with [disease name] include:


*[Condition 1]
* It remains unknown whether cancers of unknown primaries are [[genetically]] or [[phenotypically]] distinct from [[metastasis]] with known origins.<ref name="pmid19262901">{{cite journal |vauthors=Varadhachary GR |title=Carcinoma of unknown primary origin |journal=Gastrointest Cancer Res |volume=1 |issue=6 |pages=229–35 |year=2007 |pmid=19262901 |pmc=2631214 |doi= |url=}}</ref>
*[Condition 2]
*[Condition 3]


==Gross Pathology==
== Genetics ==
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
The factors that keep the primary site of CUP hidden have not yet been identified.


==Microscopic Pathology==
Several studies noted consistency between metastatic cancer of unknown primary and metastases with known primary origins based on [[chromosomal abnormalities]] and overexpression of several [[genes]] including:
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*[[Bcl-2|Bcl2]]<ref name="pmid9677443">{{cite journal| author=Briasoulis E, Tsokos M, Fountzilas G, Bafaloukos D, Kosmidis P, Samantas E et al.| title=Bcl2 and p53 protein expression in metastatic carcinoma of unknown primary origin: biological and clinical implications. A Hellenic Co-operative Oncology Group study. | journal=Anticancer Res | year= 1998 | volume= 18 | issue= 3B | pages= 1907-14 | pmid=9677443 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9677443  }}</ref>
** Bcl-2 expression was seen in 65% of tumors
** It was found to be overexpressed in 40% of tumors
*[[p53]]<ref name="pmid9677443" />
** Expression of p53 was detected in 70.2% of tumors
** It was found to be overexpressed in 53% of tumors
*[[C-myc]]<ref name="pmid8669824" />
** 96% of the tumors studied showed positive immunoreactivity for c-myc
*[[Ras]]<ref name="pmid8669824">{{cite journal| author=Pavlidis N, Briassoulis E, Bai M, Fountzilas G, Agnantis N| title=Overexpression of C-myc, Ras and C-erbB-2 oncoproteins in carcinoma of unknown primary origin. | journal=Anticancer Res | year= 1995 | volume= 15 | issue= 6B | pages= 2563-7 | pmid=8669824 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8669824  }}</ref>
** 92% of the tumors studied showed positive immunoreactivity for Ras
*[[ErbB|C-erbB-2]]<ref name="pmid8669824" />
** 65% of the tumors studied showed positive immunoreactivity for c-erbB-2


*
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 15:55, 16 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Roukoz A. Karam, M.D.[2]

Overview

The exact pathogenesis of cancer of unknown primary origin is not fully understood. Several studies noted consistency between metastatic cancer of unknown primary and metastases with known primary origins based on chromosomal abnormalities and overexpression of several genes.


Pathophysiology

Pathogenesis

  • The exact pathogenesis of cancer of unknown primary origin is not fully understood.
  • Cancer of unknown primary, like other cancers, arises from one cell that has managed to escape regulation and produces a tumor at a certain site (the site of origin) and consequently metastasizes to other parts of the body.
  • It is thought that the site of origin of CUP remains unknown due to one or more of the following theories:[1]
    • Remaining small and undetectable clinically
    • Disappearing after metastasizing
    • Elimination by body's defense

Genetics

The factors that keep the primary site of CUP hidden have not yet been identified.

Several studies noted consistency between metastatic cancer of unknown primary and metastases with known primary origins based on chromosomal abnormalities and overexpression of several genes including:

  • Bcl2[2]
    • Bcl-2 expression was seen in 65% of tumors
    • It was found to be overexpressed in 40% of tumors
  • p53[2]
    • Expression of p53 was detected in 70.2% of tumors
    • It was found to be overexpressed in 53% of tumors
  • C-myc[3]
    • 96% of the tumors studied showed positive immunoreactivity for c-myc
  • Ras[3]
    • 92% of the tumors studied showed positive immunoreactivity for Ras
  • C-erbB-2[3]
    • 65% of the tumors studied showed positive immunoreactivity for c-erbB-2

References

  1. ↑ 1.0 1.1 Varadhachary GR (2007). "Carcinoma of unknown primary origin". Gastrointest Cancer Res. 1 (6): 229–35. PMC 2631214. PMID 19262901.
  2. ↑ 2.0 2.1 Briasoulis E, Tsokos M, Fountzilas G, Bafaloukos D, Kosmidis P, Samantas E; et al. (1998). "Bcl2 and p53 protein expression in metastatic carcinoma of unknown primary origin: biological and clinical implications. A Hellenic Co-operative Oncology Group study". Anticancer Res. 18 (3B): 1907–14. PMID 9677443.
  3. ↑ 3.0 3.1 3.2 Pavlidis N, Briassoulis E, Bai M, Fountzilas G, Agnantis N (1995). "Overexpression of C-myc, Ras and C-erbB-2 oncoproteins in carcinoma of unknown primary origin". Anticancer Res. 15 (6B): 2563–7. PMID 8669824.

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