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Xu T, Wei C, Zou X, Lu B, Wang Z. Case Report: Long-Term Survival With Anlotinib in a Patient With Advanced Undifferentiated Large-Cell Lung Cancer and Rare Tonsillar Metastasis. Front Oncol 2021; 11:680818. [PMID: 34249723 PMCID: PMC8264298 DOI: 10.3389/fonc.2021.680818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
Undifferentiated large-cell lung cancer is a rare type of non-small cell lung cancer (NSCLC) with a poor prognosis. It is insensitive to chemotherapy and easily develops drug resistance. Analysis of the Surveillance, Epidemiology, and End Results (SEER) database showed that patients with stage IV undifferentiated large-cell lung cancer had a median overall survival (OS) of only 4 months and that those who received chemotherapy had a median OS of only 5 months longer than those who did not. For the first time, we report a case of advanced large-cell undifferentiated lung cancer with rare tonsil metastasis. The patient developed resistance after 3 months of platinum-based systemic chemotherapy and local treatment. Antiangiogenic therapy has been continuously progressing and has shown certain efficacy in treating many malignant tumors, such as lung cancer. However, there are no relevant studies or case reports on antiangiogenic therapy in the treatment of undifferentiated large-cell lung cancer. Anlotinib, an orally delivered small-molecule antiangiogenic tyrosine kinase inhibitor (TKI), was administered to this patient after chemotherapy resistance occurred, and the outcome was assessed as continued stable disease (SD). As of the last follow-up evaluation, the progression-free survival (PFS) of the patient was 21.5 months, and the OS was 27.5 months. Retrospective immunohistochemical analysis showed that the patient was positive for one of the targets of anlotinib (PDGFR). In general, the findings in this case suggest that anlotinib may be an option with good efficacy for patients with large-cell undifferentiated lung cancer after chemotherapy resistance that may have good efficacy and also suggest that PDGFR may be the target underlying this effect.
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Affiliation(s)
- Tianwei Xu
- Cancer Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chenchen Wei
- Cancer Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoteng Zou
- Cancer Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Binbin Lu
- Cancer Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhaoxia Wang
- Cancer Medical Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Chen CC, Lee CT, Chang SL, Tsai MC. A case of palatine tonsillar metastasis of lung adenocarcinoma: A CARE-compliant article. Medicine (Baltimore) 2019; 98:e15763. [PMID: 31145296 PMCID: PMC6709259 DOI: 10.1097/md.0000000000015763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Palatine tonsil is an extremely rare site for metastatic disease, accounting for 0.8% of malignant tonsillar neoplasms. To the best of our knowledge, this is the first report of metastatic adenocarcinoma in the tonsil treated with wide excision and targeted therapy, with no local recurrence 6 months postoperatively. PATIENT CONCERNS A 75-year-old man presented hemoptysis and mild productive cough for 2 weeks. DIAGNOSES Palatine tonsil metastasis from lung adenocarcinoma, pT2bN0M1b, stage IVA, was confirmed. INTERVENTIONS Wide excision of primary lung tumor and metastatic tonsil carcinoma has been performed, and the patient was undergoing targeted therapy with the epidermal growth factor receptor inhibitor afatinib. OUTCOMES There was no local recurrence in the oropharynx 6 months postoperatively. LESSONS We aim at highlighting the importance of a thorough evaluation for suspicion of tonsillar enlargement, which might be a sign of a primary malignancy elsewhere.
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Affiliation(s)
- Chia-Chun Chen
- Department of Otorhinolaryngology, Chi Mei Medical Center
| | - Chin-Tse Lee
- Department of Otorhinolaryngology, Chi Mei Medical Center
| | - Shih-Lun Chang
- Department of Otorhinolaryngology, Chi Mei Medical Center
- Department of Optometry, Chung Hwa University of Medical Technology
| | - Meng-Chen Tsai
- Pathology Center, Chi Mei Medical Center, Tainan, Taiwan
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Abstract
RATIONALE Tongue metastasis from lung cancer is extremely rare, and the prognosis of these patients is rather poor. PATIENT CONCERS A 56-year-old man was found a 4-cm cavity lesion in the left upper lobe, which was initially misdiagnosed as tuberculosis. DIAGNOSES A case of lung squamous cell carcinoma that metastasized to the base of a patient's tongue. INTERVATIONS We send the biopsy of the lung and the tongue lesions for gene sequencing. OUTCOMES He received systemic chemotherapy, but continued to have pain at the base of his tongue and died 7 months later. LESSONS From sequencing data, mutations in KRAS proto-oncogene, GTPase (KRAS), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), and tumor protein p53 (TP53) were found in the tumor biopsy of the patient. All of these were indicators of poor prognosis.
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Affiliation(s)
| | - Zhenli Hu
- Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yipin Han
- Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
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Valle L, Thomas J, Kim C, Szabo E, Brown GT, Citrin D, Rajan A. Hepatoid adenocarcinoma of the lung metastasizing to the tonsil. Mol Clin Oncol 2017; 6:705-707. [PMID: 28529745 DOI: 10.3892/mco.2017.1215] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/13/2017] [Indexed: 12/30/2022] Open
Abstract
Hepatoid adenocarcinoma (HAC) is a rare tumor that typically originates in gastrointestinal tissue, such as the stomach, but can also occasionally originate in the lung. The majority of HACs express α-fetoprotein (AFP) on tumor cells, and serum AFP can be used as a marker of response to treatment or disease progression. HAC has a poor prognosis, although early diagnosis and aggressive treatment can result in long-term survival. To the best of our knowledge, this is the first reported case of HAC metastasizing to the tonsil. Irradiation using intensity-modulated radiation therapy (IMRT) to 30 Gray (Gy) achieved a significant, and durable tumor response. IMRT can be considered for local control of HAC at other metastatic sites of disease.
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Affiliation(s)
- Luca Valle
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - Joel Thomas
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - Chul Kim
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - Eva Szabo
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - G Thomas Brown
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - Deborah Citrin
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
| | - Arun Rajan
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1906, USA
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Irani S. Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prev Community Dent 2016; 6:393-401. [PMID: 27891304 PMCID: PMC5109852 DOI: 10.4103/2231-0762.192935] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/22/2016] [Indexed: 12/17/2022] Open
Abstract
The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.
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Affiliation(s)
- Soussan Irani
- Dental Research Center, Department of Oral Pathology, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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Unsal M, Kutlar G, Sullu Y, Yurtlu S. Tonsillar metastasis of small cell lung carcinoma. CLINICAL RESPIRATORY JOURNAL 2015; 10:681-683. [PMID: 25620524 DOI: 10.1111/crj.12275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 11/23/2014] [Accepted: 01/20/2015] [Indexed: 11/27/2022]
Abstract
Metastasis to palatine tonsils are rare, accounting from only 0.8% of all tonsillar tumors, so far only 100 cases reported in the English literature. Only a few cases have been reported for small cell and non-small cell lung cancer as a primary site. With a diagnosis of small cell lung cancer, a 68-year-old male patient relapsed after six cycles of chemotherapy in tonsilla palatina and cervical lymph nodes. Patients died 26 months after being diagnosed with lung cancer and 2 months after detection of tonsil metastasis. We present the current case report because of the rarity of metastasis to tonsil in lung cancer.
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Affiliation(s)
- Meftun Unsal
- Department of Chest, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey
| | - Gokhan Kutlar
- Department of Otolaryngology, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey.
| | - Yurdanur Sullu
- Department of Pathology, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey
| | - Sirin Yurtlu
- Department of Chest, Sinop State Hospital, Sinop, Turkey
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Chen XH, Bao YY, Zhou SH, Wang QY, Zhao K. Palatine Tonsillar Metastasis of Small-Cell Neuroendocrine Carcinoma from the Lung Detected by FDG-PET/CT After Tonsillectomy: A Case Report. IRANIAN JOURNAL OF RADIOLOGY 2013; 10:148-51. [PMID: 24348600 PMCID: PMC3857977 DOI: 10.5812/iranjradiol.9281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 02/20/2013] [Accepted: 04/08/2013] [Indexed: 11/16/2022]
Abstract
Metastasis from a malignant tumor to the palatine tonsils is rare, accounting for only 0.8% of all tonsillar tumors, with only 100 cases reported in the English-language literature. Various malignant lung carcinomas may metastasize to the tonsils. A few cases of tonsillar metastasis from neuroendocrine lung carcinoma have been reported. A 67-year-old female underwent a right tonsillectomy because of a sore throat and an enlarged right tonsil. The postoperative pathology showed right tonsillar small cell neuroendocrine carcinoma (SCNC). Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) demonstrated metabolic activity in the lower lobe of the right lung. In addition, hypermetabolic foci were noted in the lymph nodes of the right neck and mediastinum. A needle biopsy of the pulmonary mass showed SCNC. The patient received chemotherapy and died of multiple distant metastases after 6 months. This is the first report using PET/CT to evaluate tonsillar metastasis from lung SCNC.
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Affiliation(s)
- Xiao-Hong Chen
- Department of Otolaryngology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Otolaryngology, the Second Hospital of Jiaxing City 314000, Zhejiang, China
| | - Yang-Yang Bao
- Department of Otolaryngology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Corresponding author: Shui-Hong Zhou, Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Tel.: +86-13868060120, Fax: +86-57187236895, E-mail:
| | - Qin-Ying Wang
- Department of Otolaryngology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kui Zhao
- Center of PET, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Hassona Y, Hughes C, Prime SS. Metastatic tumours of the tongue. Oral Oncol 2011; 47:308-11. [PMID: 21354854 DOI: 10.1016/j.oraloncology.2011.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/27/2011] [Accepted: 01/30/2011] [Indexed: 11/16/2022]
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Sheng LM, Zhang LZ, Xu HM, Zhu Y. Ascending colon adenocarcinoma with tonsillar metastasis: A case report and review of the literature. World J Gastroenterol 2008; 14:7138-40. [PMID: 19084924 PMCID: PMC2776847 DOI: 10.3748/wjg.14.7138] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Metastatic palatine tonsil cancer is extremely rare, with nearly 100 such tumors reported in the English literature. The prognosis of metastatic palatine tonsil cancer is poor. A 53-year-old man presented with painless left palatine tonsillar swelling and a cervical mass following right hemicolectomy for an ascending colon adenocarcinoma. Physical examination showed an ulcerated mass located on the upper pole of the left palatine tonsil. A punch biopsy was taken for histological examination which showed a moderately-differentiated adenocarcinoma. The patient was treated with palliative radiotherapy and chemotherapy. He was still alive when we wrote this paper. Our case shows that immunohistochemical diagnosis of metastatic palatine tonsil cancer is essential.
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