Characteristics and Pattern of Direct Tumor Spreading

  • H. E. Kaiser
Chapter
Part of the Cancer Growth and Progression book series (CAGP, volume 7)

Abstract

Malignant neoplastic spread can occur in form of infiltration into the surrounding tissues, even before metastasis appears; the malignant spread may appear in form of metastasis; or malignant neoplastic spread may be by direct extension. In reality, these three modes of tumor progression are in most cases interwoven into each other. Direct spread of neoplasms has been determined as a mode of distribution from malignant tumors. But also venous deposits, as of leiomyoma, can grow independently in veins after the original connections with the primary uterine tumor have been severed. The literature contains approximately 50 cases, three of which extended from the pelvic veins into the right atrium (81). Direct extension is one of the mechanisms of cancer dissemination, either spontaneous or iatrogenic (10). Early stages, and those after settlement in the soil tissue during direct extension, follow along lines of least tissue resistance (11). Our challenge lies in the opportunity to obtain better insight into the mechanisms of direct tumor spreading and metastatic neoplastic spreading, to use this knowledge to curtail tumor spreading (17). Direct tumor spread is also a malignant process, more localized, and strongly influenced by the topography of structures surrounding the primary neoplasm. The direct tumor spread can be considered as tumor-specific, following a specific topographic path. This pattern depends much more on the topographic location of the primary tumor than is the case in distant, metastatic spread. Again, in contrast to metastasis, the potency of direct spreading diminishes as the distance from the primary tumor increases. Direct spreading is more vigorous around the primary tumor, as opposed to metastasis, where distant dissemination exhibits strong aggressiveness. A continued connection with the primary tumor and diminishing aggressiveness in proportion to increasing distance from the primary tumor may be viewed as typical characteristic of direct tumor spreading. Such direct infiltration of neoplasms may take place via (1) tissue spaces; (2) lymph vessels; (3) blood vessels, veins and arteries; (4) nerve pathways; (5) the coelomic cavity; (6) spaces associated with the distribution of fasciae and aponeuroses; (7) cerebrospinal spaces; and (8) epithelial cavities.

Keywords

Pulmonary Vein Basal Cell Carcinoma Renal Pelvis Adenoid Cystic Carcinoma Direct Extension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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© Kluwer Academic Publishers 1989

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  • H. E. Kaiser

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