Exophytic tumor

Exophytic tumors - Exophytic tumors can be challenging due to their complex vascular supply. Vascular tumors, especially HCC, can parasitize blood flow from many other sources, such as intercostal arteries, renal and adrenal arteries, as well as the splenic artery. A transcatheter CT angiogram can be performed with the catheter in the vessel of interest. Contrast is injected directly into the catheter while CT images of the liver are acquired, giving an extremely accurate view of contrast distribution [8J. If no extra-tumoral blood flow is seen, one can use this vessel to deliver Y microspheres. 

Fig. 8.6. Radiofrequency ablation of exophytic left renal cell carcinoma. Contrast-enhanced CT scan before treatment shows marked enhancement of solid exophytic tumor (arrow). CT done 6 months after ablation shows no contrast enhancement indicating favorable outcome...

Roughen or clear away the exophytic part of the tumor (debulking)... 

Cervical cancer arises in the transitional zone that marks the junction of the squamous epithelium of the external cervix with the columnar epithelium of the cervical canal. This zone is usually located on the portio in younger women, which is where cervical cancer usually occurs with exophytic growths. In contrast, older women with retraction of the transformation zone into the cervical canal typically develop cervical cancer with an endocervical growth pattern (Fig. 7.13). This growth type usually gives rise to the typical barrel-shaped configuration of the cervix as the tumor increases in size or an endocervical ulcer develops when there is necrosis. 

The clinical presentation of an invasive penile carcinoma is varied and may range from an area of induration or erythema to a non-healing ulcer or a warty exophytic growth. Phimosis may obscure the tumor, and not until there is a bloody or foul smelling discharge is the tumor diagnosed. 

Tumors of the large bowel in humans are of three types—adenocarcinoma, carcinoid, and squamous cell carcinoma. Of these, adenocarcinoma is the most common and can be either the fungating exophytic type or the flat infiltrative type. Opinions vary regarding the histogenesis of... 

Adenocarcinomas are the most common colonic primary tumors. The peak incidence is between 50 and 70 years of age. Approximately 90% arise from benign adenomatous polyps. Most carcinomas show an exophytic, polypous type of growth with frequent... 

Fig. 4.3a-c. Tumor locations suited or not suited for percutaneous RF ablation. Exophytic and cortical tumors (a) are best suited for renal RF ablation. Parenchymal tumor location with contact to the renal hilum (b) might be considered for RF ablation, whereas central tumor location (c) is typically considered a contraindication for RF ablation... 

The first case of percutaneous RF ablation prior to radical open nephrectomy of an exophytic RCC was reported by Zlotta et al. in 1997 (Zlotta et al. 1997). Histopathological evaluation of the operation specimen revealed stromal edema and pyknosis. The zones of ablation were correctly predicted from the needle deployment. No viable tumor cells were demonstrated in the percutaneously treated tumor. In 1999 the first case of RF ablation as sole treat-... 

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