A report on Metastasis

Illustration showing hematogenous metastasis
Cut surface of a liver showing multiple paler metastatic nodules originating from pancreatic cancer
Lymph node with almost complete replacement by metastatic melanoma. The brown pigment is focal deposition of melanin
Main sites of metastases for some common cancer types. Primary cancers are denoted by "...cancer" and their main metastasis sites are denoted by "...metastases".
Pulmonary metastases shown on Chest X-Ray
Cut surface of a humerus sawn lengthwise, showing a large cancerous metastasis (the whitish tumor between the head and the shaft of the bone)
Micrograph of thyroid cancer (papillary thyroid carcinoma) in a lymph node of the neck. H&E stain
CT image of multiple liver metastases
CT image of a lung metastasis
Metastasis proven by liver biopsy (tumor (adenocarcinoma)—lower two-thirds of image). H&E stain.
Metastatic cancer in the lungs
Metastases from the lungs to the brain
Metastases from the lungs to the pancreas

Pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor.

- Metastasis
Illustration showing hematogenous metastasis

51 related topics with Alpha

Overall
A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

Cancer

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A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Symptoms of cancer metastasis depend on the location of the tumor.
The GHS Hazard pictogram for carcinogenic substances
Share of cancer deaths attributed to tobacco in 2016.
The incidence of lung cancer is highly correlated with smoking.
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Chest X-ray showing lung cancer in the left lung
Three measures of global cancer mortality from 1990 to 2017
Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
University of Florida Cancer Hospital
CancerTreeMammal
An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
An invasive colorectal carcinoma (top center) in a colectomy specimen
A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
A large invasive ductal carcinoma in a mastectomy specimen

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

3D Medical Illustration depicting the TNM Stages in breast cancer

Cancer staging

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Process of determining the extent to which a cancer has developed by growing and spreading.

Process of determining the extent to which a cancer has developed by growing and spreading.

3D Medical Illustration depicting the TNM Stages in breast cancer
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The stage generally takes into account the size of a tumor, whether it has invaded adjacent organs, how many regional (nearby) lymph nodes it has spread to (if any), and whether it has appeared in more distant locations (metastasized).

A chest X-ray showing a tumor in the lung (marked by arrow)

Lung cancer

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Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

A chest X-ray showing a tumor in the lung (marked by arrow)
Relationship between cigarette consumption per person (blue) and male lung cancer rates (dark yellow) in the US over the century
Risk of death from lung cancer is strongly correlated with smoking.
CT scan showing a cancerous tumor in the left lung
Primary pulmonary sarcoma in an asymptomatic 72-year-old male
Pie chart showing incidences of NSCLCs as compared to SCLCs shown at right, with fractions of smokers versus nonsmokers shown for each type
Cross section of a human lung: The white area in the upper lobe is cancer; the black areas are discoloration due to smoking.
Pneumonectomy specimen containing a squamous-cell carcinoma, seen as a white area near the bronchi
Brachytherapy (internal radiotherapy) for lung cancer given via the airway
Monoclonal antibodies used in the treatment of NSCLC and their mechanism of action https://doi.org/10.3390/ph13110373
The main treatment arms of phase 3 clinical trials providing immunotherapy in the first line for patients with NSCLC https://doi.org/10.3390/ph13110373
Overall survival in NSCLC patients treated with protocols incorporating immunotherapy in the first line for advanced or metastatic disease. Nasser NJ, Gorenberg M, Agbarya A. Pharmaceuticals 2020, 13(11), 373;
Lung cancer, incidence, mortality, and survival, England 1971–2011
Stage IA and IB lung cancer
Stage IIA lung cancer
Stage IIB lung cancer
One option for stage IIB lung cancer, with T2b; but if tumor is within 2 cm of the carina, this is stage 3
Stage IIIA lung cancer
Stage IIIA lung cancer, if there is one feature from the list on each side
Stage IIIA lung cancer
Stage IIIB lung cancer
Stage IIIB lung cancer
Stage IV lung cancer
Trachea, bronchus, and lung cancers deaths per million persons in 2012 0–78–1213–3233–5354–8182–125126–286287–398399–527528–889

In time, this uncontrolled growth can metastasize (spreading beyond the lung) either by direct extension, by entering the lymphatic circulation, or via hematogenous, bloodborne spread – into nearby tissue or other, more distant parts of the body.

Malignant tumor (right) spreads uncontrollably and invades the surrounding tissues; benign tumor (left) remains self-contained from neighbouring tissue

Malignancy

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Tendency of a medical condition to become progressively worse.

Tendency of a medical condition to become progressively worse.

Malignant tumor (right) spreads uncontrollably and invades the surrounding tissues; benign tumor (left) remains self-contained from neighbouring tissue

Malignancy in cancers is characterized by anaplasia, invasiveness, and metastasis.

Normal epidermis and dermis with intradermal nevus, 10x-cropped

Benign tumor

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Normal epidermis and dermis with intradermal nevus, 10x-cropped
Endoscopic image of sigmoid colon of a patient with familial adenomatous polyposis.
Benign (L) vs Malignant tumor (R).
Diagram showing two epithelial tumors. The upper tumor is a benign tumor that is non-invasive. Benign tumors are usually round in shape and encapsulated by fibrous connective tissue. The lower picture depicts a malignant tumor. It is irregularly shaped, vascular, and it is invasive, crossing the basement membrane.

A benign tumor is a mass of cells (tumor) that lacks the ability either to invade neighboring tissue or metastasize (spread throughout the body).

3D rendered CT scan of bone metastases of the hip bone, in a 60 year old woman with parotid gland cancer. Large lesions are seen on the ilium on the more distant side. Involvement of the vertebral column has caused a compression fracture.

Bone metastasis

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3D rendered CT scan of bone metastases of the hip bone, in a 60 year old woman with parotid gland cancer. Large lesions are seen on the ilium on the more distant side. Involvement of the vertebral column has caused a compression fracture.
3D rendered CT scan of bone metastases of the hip bone, in a 60 year old woman with parotid gland cancer. Large lesions are seen on the ilium on the more distant side. Involvement of the vertebral column has caused a compression fracture.
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Main sites of metastases for some common cancer types, with lung and breast routes to bones shown at shoulder level. Prostate cancer, the third major source, is not shown because of female model. Primary cancers are denoted by "...cancer" and their main metastasis sites are denoted by "...metastases".
CT scan in the coronal plane of bone metastases of the hip bone, in a 60-year-old woman with parotid gland cancer. The more affected side is very irregular and sclerotic (visible as brighter in this presentation).

Bone metastases, or osseous metastatic disease, is a category of cancer metastases that results from primary tumor invasion to bone.

Cancers and tumors are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.

Carcinogenesis

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Formation of a cancer, whereby normal cells are transformed into cancer cells.

Formation of a cancer, whereby normal cells are transformed into cancer cells.

Cancers and tumors are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Longitudinally opened freshly resected colon segment showing a cancer and four polyps. Plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.
Tissue can be organized in a continuous spectrum from normal to cancer.
Many tumor suppressor genes effect signal transduction pathways that regulate apoptosis, also known as "programmed cell death".
Multiple mutations in cancer cells

Other mutations enable the tumor to grow new blood vessels to provide more nutrients, or to metastasize, spreading to other parts of the body.

Radiation therapy of the pelvis, using a Varian Clinac iX linear accelerator. Lasers and a mould under the legs are used to determine exact position.

Radiation therapy

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Therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator.

Therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator.

Radiation therapy of the pelvis, using a Varian Clinac iX linear accelerator. Lasers and a mould under the legs are used to determine exact position.
Radiation therapy for a patient with a diffuse intrinsic pontine glioma, with radiation dose color-coded.
Histopathology of radiation cystitis, including atypical stromal cells (“radiation fibroblasts”).
The beam's eye view of the radiotherapy portal on the hand's surface with the lead shield cut-out placed in the machine's gantry
A teletherapy radiation capsule composed of the following:
Varian TrueBeam Linear Accelerator, used for delivering IMRT
A SAVI brachytherapy device
X-ray treatment of tuberculosis in 1910. Before the 1920s, the hazards of radiation were not understood, and it was used to treat a wide range of diseases.

With the exception of oligometastatic disease, metastatic cancers are incurable with radiation therapy because it is not possible to treat the whole body.

Patterns of cancer cell invasion: collective cell and individual cell migration. In collective cell migration, tumor cells exhibit high expression of E-cadherin and integrins. Epithelial-mesenchymal (EMT) and collective-amoeboid (CAT) transitions are a trigger between collective cell invasion and individual cell migration. EMT involves activation of transcription factors, such as TWIST1, Snail, Slug, ZEB1/2, a decrease in E-cadherin expression, and an increase in protease activity. During EMT, tumor cells acquire the mesenchymal phenotype, detach from the tumor mass, and migrate by the mesenchymal mechanism. In contrast, the partial EMT that is specific to the tumor invasive front means that tumor cells retain cell-cell adhesion but already possess migratory ability. This tumor cell phenotype was named the “epithelial-mesenchymal” phenotype. In CAT, which takes place when β1 integrins are down-regulated, tumor cells detach from the tumor mass and move by the amoeboid mechanism. Amoeboid migration involves a decrease in protease and integrin expression and changes in the activity of GTPases – inhibition of Rac1 and activation of RhoA. This movement type occurs in the loose/soft extracellular matrix. In contrast, mesenchymal migration is associated with the opposite phenotype and predominates in the dense/stiff matrix. These two movement types are highly plastic and can convert to each other, depending on the extracellular matrix type and intracellular regulation. Thereby, the mesenchymal-amoeboid (MAT) and amoeboid-mesenchymal (AMT) transitions are suggested.

Invasion (cancer)

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Direct extension and penetration by cancer cells into neighboring tissues.

Direct extension and penetration by cancer cells into neighboring tissues.

Patterns of cancer cell invasion: collective cell and individual cell migration. In collective cell migration, tumor cells exhibit high expression of E-cadherin and integrins. Epithelial-mesenchymal (EMT) and collective-amoeboid (CAT) transitions are a trigger between collective cell invasion and individual cell migration. EMT involves activation of transcription factors, such as TWIST1, Snail, Slug, ZEB1/2, a decrease in E-cadherin expression, and an increase in protease activity. During EMT, tumor cells acquire the mesenchymal phenotype, detach from the tumor mass, and migrate by the mesenchymal mechanism. In contrast, the partial EMT that is specific to the tumor invasive front means that tumor cells retain cell-cell adhesion but already possess migratory ability. This tumor cell phenotype was named the “epithelial-mesenchymal” phenotype. In CAT, which takes place when β1 integrins are down-regulated, tumor cells detach from the tumor mass and move by the amoeboid mechanism. Amoeboid migration involves a decrease in protease and integrin expression and changes in the activity of GTPases – inhibition of Rac1 and activation of RhoA. This movement type occurs in the loose/soft extracellular matrix. In contrast, mesenchymal migration is associated with the opposite phenotype and predominates in the dense/stiff matrix. These two movement types are highly plastic and can convert to each other, depending on the extracellular matrix type and intracellular regulation. Thereby, the mesenchymal-amoeboid (MAT) and amoeboid-mesenchymal (AMT) transitions are suggested.
Intratumoral morphological heterogeneity in invasive breast carcinoma. Diversity of invasive growth of breast cancer is shown, which can be classified into five main morphological structures: alveolar (Alv), trabecular (Trab), tubular (Tub), solid (Solid) structures, and discrete groups of tumor cells (Discr). Hematoxylin and eosin staining. Magnification of 200x.

It is generally distinguished from metastasis, which is the spread of cancer cells through the circulatory system or the lymphatic system to more distant locations.

Micrograph of a mucinous ovarian carcinoma stained by H&E.

Ovarian cancer

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Cancer that forms in or on an ovary.

Cancer that forms in or on an ovary.

Micrograph of a mucinous ovarian carcinoma stained by H&E.
Site of ovarian cancer
Women with ovarian or breast cancer in a pedigree chart of a family
A very large ovarian cancer as seen on CT
Micrograph of serous carcinoma, a type of ovarian cancer, diagnosed in peritoneal fluid
Ovarian cancers in women aged 20+, with area representing relative incidence and color representing five-year relative survival rate
A pathological specimen of ovarian carcinoma
Hobnail cells seen in a clear cell carcinoma sample
Ovarian adenocarcinoma deposit in the mesentery of the small bowel
Relative five-year survival of invasive epithelial ovarian cancer by stage
Ovarian tumors (including non-cancerous tumors) by incidence and risk of ovarian cancer.
Ovarian cancer cases diagnosed by age group in the US
Stage 1 ovarian cancer
Stage 2 ovarian cancer
Stage 3 ovarian cancer
Stage 4 ovarian cancer
Age-standardized death from ovarian cancer per 100,000 inhabitants in 2004 no data less than 0.6 0.6–1.2 1.2–1.8 1.8–2.4 2.4–3 3–3.6 3.6–4.2 4.2–4.8 4.8–5.4 5.4–6 6–7 more than 7

It results in abnormal cells that have the ability to invade or spread to other parts of the body.