Malignant capsule

Cupissol, D., Bressolle, F., Adenis, L., Carmichael, J., and Romain, D., Evaluation of the bioequivalence of tablet and capsule formulations of granisetron in patients undergoing cytotoxic chemotherapy for malignant disease, /. Pharm. Sci., 82, 1281,1993. 

What treatment options are now available to Mrs CR and what are the goals of therapy for her with regard to (a) chemotherapy, (b) management of malignant hypercalcaemia/bone metastases, and (c) management of liver capsule pain ... 

Bile-duct adenomas are rare. Usually, they are solitary and < 2 cm in size. This type of adenoma is more often detected in men than in women (3 1) and it occurs in patients mainly over the age of 50. It is nearly always localized beneath the liver capsule. This adenoma has the form of a firm, whitish node and consists of bile-duct proliferations. It contains biliary acini and tubules which are lined with a layer of cuboid epithelium within loose fibrous, partially hyaline stroma. There is evidence of mononuclear inflammatory cells and, occasionally, lymph follicles. It is discussed that such biliary adenomas are peribiliary gland hamartomas. (162) There are no clinical or biochemical abnormalities, nor is there any tendency towards malignant degeneration. (161,163)... 

A malignant tumour grows rapidly and continuously, and even when it has impoverished its host and source of nutrition, it still retains the potentiality for further proliferation. Besides, malignant tumours invade and destroy neighbouring tissues and possess no effective capsule, a malignant tumour readilty ulcerate and tend sooner or later to disseminate and form metastases. 

IC Stage lA or IB with ascites (or with tumor on surface). Capsule ruptured, peritoneal washings positive for malignant cells... 

Carcinomas of the parathyroid are rare. Only 1-4% of all cases of hyperparathyroidism are associated with the development of a carcinoma. The criteria for malignancy in cancer of the parathyroid are invasion, recurrence, and metastasis. Metastases are most common in the local lymph nodes, and the tumor, instead of being easy to decapsulate, strongly adheres to the surrounding tissue. Without clear-cut invasion of the capsule of the parathyroid or the development of metastasis, carcinomas may be difficult to diagnose. 

Histologically, islet tumors are formed from chords of islet cells. The benign tumors are well encapsulated. The appearance of the individual cells in the malignant tumor is not very different from that in the benign tumor, but there is no fibrous capsule in the former. In contrast, surrounding tissues are invaded, and metastasis may develop. Occasionally, benign or malignant tumors of the islet cells may appear in ectopic pancreatic formation. 

One of the most common forms of cancer in males is prostate cancer. In addition to surgery and chemotherapy, one treatment option is to place 40 or more titanium capsules, or seeds, in the malignant area. Each seed, which is the size of a grain of rice, contains radioactive iodine-125, palladium-103, or cesium-131, which decays by gamma emission. The radiation from the seeds destroys the cancer by interfering with the reproduction of cancer cells with minimal damage to adjacent normal tissues. Ninety percent (90%) of the radioisotopes decay within a few months because they have short half-hves. 

Retraction of the overlying capsule probably due to lesion-related fibrosis is demonstrated in several cases, although this finding has been seen with other malignant liver tumors (Soyer et al. 1994). 

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