Definitions

neoplasm

neoplasm

[nee-uh-plaz-uhm]
neoplasm or tumor, tissue composed of cells that grow in an abnormal way. Normal tissue is growth-limited, i.e., cell reproduction is equal to cell death. Feedback controls limit cell division after a certain number of cells have developed, allowing for tissue repair but not expansion. Tumor cells are less responsive to these restraints and can proliferate to the point where they disrupt tissue architecture, distort the flow of nutrients, and otherwise do damage.

Tumors may be benign or malignant. Benign tumors remain localized as a discrete mass. They may differ appreciably from normal tissue in structure and excessive growth of cells, but are rarely fatal. However, even benign tumors may grow large enough to interfere with normal function. Some benign uterine tumors, which can weigh as much as 50 lb (22.7 kg), displace adjacent organs, causing digestive and reproductive disorders. Benign tumors are usually treated by complete surgical removal. Cells of malignant tumors, i.e., cancers, have characteristics that differ from normal cells in other ways beside cell proliferation. For example, they may be deficient in some specialized functions of the tissues where they originate. Malignant cells are invasive, i.e., they infiltrate surrounding normal tissue; later, malignant cells metastasize, i.e., spread via blood and the lymph system to other sites.

Both benign and malignant tumors are classified according to the type of tissue in which they are found. For example, fibromas are neoplasms of fibrous connective tissue, and melanomas are abnormal growths of pigment (melanin) cells. Malignant tumors originating from epithelial tissue, e.g., in skin, bronchi, and stomach, are termed carcinomas. Malignancies of epithelial glandular tissue such as are found in the breast, prostate, and colon, are known as adenocarcinomas. Malignant growths of connective tissue, e.g., muscle, cartilage, lymph tissue, and bone, are called sarcomas. Lymphomas and leukemias are malignancies arising among the white blood cells. A system has been devised to classify malignant tissue according to the degree of malignancy, from grade 1, barely malignant, to grade 4, highly malignant. In practice it is not always possible to determine the degree of malignancy, and it may be difficult even to determine whether particular tumor tissue is benign or malignant.

or neoplasm

Mass of abnormal tissue that arises from normal cells, has no useful function, and tends to grow. Cell abnormalities may include increased size or number or loss of characteristics that differentiate their tissue of origin. Cells in malignant tumours (see cancer) have a distorted size, shape, and/or structure. Less differentiated cells tend to grow faster. Malignant tumours invade tissues locally and spread (metastasize) in blood or lymph: the stronger the tendency to metastasize, the more malignant the tumour. Tumours may not cause pain until they press on or invade nerves. Both benign and malignant tumours can press on nearby structures, block vessels, or produce excess hormones, all of which can cause death. Benign tumours remain as a solid mass that can be removed by surgery if accessible; they can consist of various tissues and may become malignant; malignant tumours, though they may remain quiescent for a time, never become benign.

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Malignant tumour of the uterus. Cancers affecting the lining of the uterus (endometrium) are the most common cancers of the female reproductive tract. Risk factors include absence of pregnancy, early age of first menstruation (before age 12), late onset of menopause (after age 52), obesity, diabetes, and estrogen replacement therapy. Additional risk factors are a personal history of breast or ovarian cancer, age (over age 40), and a family history of uterine cancer. Whites are more likely to develop uterine cancer than are blacks. The major symptom is vaginal bleeding or discharge. Treatment may begin with simple or radical hysterectomy. Some uterine cancers are treated in part by hormonal therapy, radiation therapy, or chemotherapy.

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Malignant tumour of the testis, or testicle. Although relatively rare, testicular cancer is the most common malignancy for men between the ages of 20 and 34. It typically affects men between 15 and 39 years old. A developmental abnormality of males in which one or both testes fail to descend into the scrotum about the time of birth increases the risk of developing the cancer later in life. The most notable symptom of testicular cancer is the formation of a painless lump in either testis. Treatment usually consists of the surgical removal of the cancerous testis, followed by radiation therapy or chemotherapy if the cancer has metastasized.

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Malignant tumour of the stomach. The main risk factors include a diet high in salted, smoked, or pickled foods; Helicobacter pylori infection; tobacco and alcohol use; age (over age 60); and a family history of stomach cancer. Males develop stomach cancer at approximately twice the rate of females. Symptoms may be abdominal pain or swelling, unexplained weight loss, vomiting, and poor digestion. Surgery is the only method for treating stomach cancer, although radiation therapy or chemotherapy may be used in conjunction with surgery or to relieve symptoms.

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Malignant tumour of the skin, including some of the most common human cancers. Though recognizable at an early stage, it has a significant death rate. Light-skinned people have the highest risk but can reduce it by limiting exposure to sunlight and to ionizing radiation. The most common types arise in the epidermis (outer skin layer) and have become more frequent with the thinning of the atmosphere's ozone layer. The most serious form is melanoma, which is frequently fatal if not treated early with surgery. Cancers arising from the dermis are rare; the best-known is Kaposi sarcoma.

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Malignant tumour of the prostate gland. Prostate cancer commonly occurs in men over age 50. Symptoms include frequent or painful urination, blood in the urine, sexual dysfunction, swollen lymph nodes in the groin, and pain in the pelvis, hips, back, or ribs. The likelihood of developing prostate cancer doubles if there is a family history. Treatment may include surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of two or more of these approaches.

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Malignant tumour of the pancreas. Risk factors include smoking, a diet high in fat, exposure to certain industrial products, and diseases such as diabetes and chronic pancreatitis. Pancreatic cancer is more common in men. Symptoms often do not appear until pancreatic cancer is advanced; they include abdominal pain, unexplained weight loss, and difficulty digesting fatty foods. Surgery, radiation therapy, chemotherapy, or some combination of these may be used to treat the disease.

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Malignant tumour of the ovaries. Risk factors include early age of first menstruation (before age 12), late onset of menopause (after age 52), absence of pregnancy, presence of specific genetic mutations, use of fertility drugs, and personal history of breast cancer. Symptoms such as abdominal swelling, pelvic pressure or pain, and unusual vaginal bleeding often do not appear until ovarian cancer is advanced. Surgery, sometimes followed by chemotherapy or radiation therapy, is an effective treatment for most ovarian cancers.

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Malignant tumour of the lung. Four major types (squamous-cell carcinoma, adenocarcinoma, large-cell carcinoma, and small-cell carcinoma) have roughly equal prevalence. Most cases are due to long-term cigarette smoking. Heavy smoking and starting smoking earlier in life increase the risk. Passive inhalation (“secondhand smoke”) is linked to lung cancer in nonsmokers. Other risk factors include exposure to radon or asbestos. Symptoms, including coughing (sometimes with blood), chest pain, and shortness of breath, seldom appear until lung cancer is advanced, when treatment with surgery, chemotherapy, and radiation or some combination of the three is less effective. Most patients die within a year of diagnosis.

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Malignant tumour of the larynx. The larynx is affected by both benign and malignant tumours. Squamous-cell carcinoma, the most common laryngeal malignancy, is associated with smoking and alcohol consumption; it is more common in men. Prolonged hoarseness without pain is the major symptom and should always be investigated. Radiation therapy or surgery may be used to treat tumours.

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Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat. Many of the symptoms are associated with abnormal digestion and elimination. Colorectal cancer is treated by surgery, chemotherapy, or radiation therapy.

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Uncontrolled multiplication of abnormal cells. Cancerous cells and tissues have abnormal growth rates, shapes, sizes, and functioning. Cancer may progress in stages from a localized tumour (confined to the site of origin) to direct extension (spread into nearby tissue or lymph nodes) and metastasis (spread to more distant sites via the blood or lymphatic system). This malignant growth pattern distinguishes cancerous tumours from benign ones. Cancer is also classified by grade, the extent to which cell characteristics remain specific to their tissue of origin. Both stage and grade affect the chances of survival. Genetic factors and immune status affect susceptibility. Triggers include hormones, viruses, smoking, diet, and radiation. Cancer can begin in almost any tissue, including blood (see leukemia) and lymph (see lymphoma). When it metastasizes, it remains a cancer of its tissue of origin. Early diagnosis and treatment increase the chance of cure. Treatment may include chemotherapy, surgery, and radiation therapy. Seealso bladder cancer; breast cancer; carcinogen; colorectal cancer; Kaposi sarcoma; laryngeal cancer; lung cancer; ovarian cancer; pancreatic cancer; prostate cancer; skin cancer; stomach cancer; uterine cancer.

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Malignant tumour in a breast, usually in women after menopause. Risk factors include family history of breast cancer, prolonged menstruation, late first pregnancy (after age 30), obesity, alcohol use, and some benign tumours. Most breast cancers are adenocarcinomas. Any lump in the breast needs investigation because it may be cancer. Treatment may begin with radical or modified mastectomy or lumpectomy (in which only the tumour is removed), followed by radiation therapy, chemotherapy, or removal of the ovaries or adrenal glands.

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Malignant tumour of the bladder. The most significant risk factor associated with bladder cancer is smoking. Exposure to chemicals called arylamines, which are used in the leather, rubber, printing, and textiles industries, is another risk factor. Most bladder cancers are diagnosed after the age of 60; men are affected more than women. Symptoms include blood in the urine, difficulty urinating, excessive urination, or, more rarely, painful urination. Bladder cancer can be treated with surgery, radiation therapy, or chemotherapy.

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Parallel of latitude approximately 23°27' north of the terrestrial Equator. It is the northern boundary of the tropics and marks the northernmost latitude at which the Sun can be seen directly overhead at noon.

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(Latin: “Crab”) In astronomy, the constellation lying between Leo and Gemini; in astrology, the fourth sign of the zodiac, governing approximately the period June 22–July 22. It is represented as a crab (or crayfish), a reference to the crab in Greek mythology that pinched Heracles while he was fighting the Lernaean hydra. Heracles crushed the crab, but his enemy Hera rewarded it by placing it in the sky as a constellation.

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Neoplasia (new growth in Greek) is the abnormal proliferation of cells, resulting in a structure known as a neoplasm. The growth of this clone of cells exceeds, and is uncoordinated with, that of the normal tissues around it. It usually causes a lump or tumor. Neoplasms may be benign, pre-malignant or malignant.

In modern medicine, the term tumor is synonymous with a neoplasm that has formed a lump. In the past, the term tumor was used differently. Some neoplasms do not cause a lump.

Types

A neoplasm can be benign, potentially malignant (pre-cancer), or malignant (cancer).

  • Benign neoplasms include uterine fibroids and melanocytic nevi (skin moles). They do not transform into cancer.
  • Potentially malignant neoplasms include carcinoma in situ. They do not invade and destroy but, given enough time, will transform into a cancer.
  • Malignant neoplasms are commonly called cancer. They invade and destroy the surrounding tissue, may form metastases and eventually kill the host.

Difficulty of definition

Because neoplasia includes very different diseases, it is difficult to find a definition that describe them all. The definition of the British oncologist R.A. Willis is widely cited: A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimulus which evoked the change.

This definition is criticized because some neoplasms, such as nevi, are not progressive.

Clonality

Neoplastic tumors often contain more than one type of cell, but their initiation and continued growth is usually dependent on a single population of neoplastic cells. These cells are presumed to be clonal - that is, they are descended from a single progenitor cell.

Sometimes, the neoplastic cells all carry the same genetic or epigenetic anomaly which becomes evidence for clonality. For lymphoid neoplasms, e.g. lymphoma and leukemia, clonality is proven by the amplification of a single rearrangement of their immunoglobulin gene (for B cell lesions) or T-cell receptor gene (for T cell lesions). The demonstration of clonality is now considered to be necessary to identify a lymphoid cell proliferation as neoplastic.

It is tempting to define neoplasms as clonal cellular proliferations but the demonstration of clonality is not always possible. Therefore, clonality is not required in the definition of neoplasia.

Neoplasia vs tumor

Tumor (Latin for swelling) originally meant all forms of swelling, neoplastic or not. In current English however, both common and Medical, tumor is now considered synonymous with Neoplasm. Note that some neoplasms do not form a tumor. They include leukemia and most forms of carcinoma in situ.

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