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Makino K, Tsutsumi S, Takaki Y, Nonaka S, Okura H, Ishii H. Late orbital metastasis from colon cancer complicated by multiple tumors in the breast, lung, liver, and spine. Radiol Case Rep 2021; 17:5-12. [PMID: 34760033 PMCID: PMC8567180 DOI: 10.1016/j.radcr.2021.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 11/27/2022] Open
Abstract
A 69-year-old woman sustained progressive proptosis for 2 months. The patient had undergone surgery for resection of colon cancer 10 years prior, which was considered to have been completely cured 5 years prior. She was also aware of a hard mass in her left breast, but it had been left untreated. Furthermore, she experienced back pain for a month. Blood examination revealed an elevated level of serum carcinoembryonic antigen, at 17.4 ng/mL (< 5). Computed tomography (CT) revealed a tumor occupying the superolateral part of the right orbit, with intratumoral calcifications and destructive changes in the lateral orbital wall. On magnetic resonance imaging, it appeared as a heterogeneously enhancing, extraconal tumor, 44 mm × 31 mm in maximal dimension, extending into the middle fossa and the adjacent subcutaneous region. Fluorodeoxyglucose positron emission tomography/CT revealed abnormal accumulation in the left breast, T12 vertebra, liver, and lung, in addition to the orbital tumor. The patient underwent total tumor resection through a lateral orbitotomy. Histological examination of the tumor was highly suggestive of a metastatic colon cancer. Late metastasis should be assumed as a differential diagnosis that can be determined only through histological verification.
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Affiliation(s)
- Kensaku Makino
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Yuki Takaki
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Senshu Nonaka
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hidehiro Okura
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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Udare A, Sable N, Kumar R, Thakur M, Juvekar S. Solitary osseous metastasis of rectal carcinoma masquerading as osteogenic sarcoma on post-chemotherapy imaging: a case report. Korean J Radiol 2015; 16:175-9. [PMID: 25598687 PMCID: PMC4296267 DOI: 10.3348/kjr.2015.16.1.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 10/28/2014] [Indexed: 11/30/2022] Open
Abstract
Solitary metastases from colorectal carcinoma in the absence of hepatic or pulmonary metastases are rare. These can have a diverse imaging appearance, particularly after chemotherapy. It is important identify patients with solitary skeletal metastases, as they have a better prognosis than those with multiple skeletal or visceral metastases. We describe an unusual case of a solitary metastasis to the femur in a case of colon carcinoma that went undiagnosed and later presented with imaging features of osteogenic sarcoma.
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Affiliation(s)
- Amar Udare
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai 400012, India
| | - Nilesh Sable
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai 400012, India
| | - Rajiv Kumar
- Department of Pathology, Tata Memorial Hospital, Mumbai 400012, India
| | - Meenakshi Thakur
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai 400012, India
| | - Shashikant Juvekar
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai 400012, India
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Şahin E, Elboğa U, Yetişyiğit T, Kalender E. Mediastinal Ectopic Parathyroid Adenoma in a Patient Followed for Colon Cancer and Chronic Renal Failure: A Challenging Case. J Med Imaging Radiat Sci 2014; 45:335-338. [DOI: 10.1016/j.jmir.2014.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/24/2014] [Accepted: 02/24/2014] [Indexed: 10/25/2022]
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Padhi P, Mackey C. Spine and scapular pain: an unusual presentation of colon adenocarcinoma. BMJ Case Rep 2013; 2013:bcr-2013-010239. [PMID: 23861273 DOI: 10.1136/bcr-2013-010239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We are presenting an elderly Caucasian woman who was admitted to our hospital for severe lower back pain and scapular pain for 8 days. She had a history of spinal stenosis and we believed this was the aetiology of her pain. However, her pain was not subsiding and hence an MRI spine was performed. It revealed spinal stenosis and abnormal signal in the lower thoracic and lumbar vertebrae. Hence a bone biopsy was performed that came back as metastatic adenocarcinoma. She underwent a bone scan and revealed diffuse disease in thoracic, lumbar, sacral spine as well as third and 10th ribs. Her CT chest/abdomen/pelvis revealed no primary tumour. A mass was detected on her colonscopy, and pathology revealed adenocarcinoma. She underwent palliative radiation and one cycle of chemotherapy. She was discharged to home hospice care. It is very rare to have osseous metastases as the only manifestation of colon cancer.
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Affiliation(s)
- Parikshit Padhi
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
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Gharwan H, Yarlagadda L, Duffy A. Acrometastasis as the Initial Presentation of a KRAS-Positive Colon Cancer. Case Rep Oncol 2012; 5:404-8. [PMID: 23525126 PMCID: PMC3409512 DOI: 10.1159/000340011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The propensity of colon cancer to metastasize to bones is very low compared to prostate, breast or lung cancer. The reason for this is not yet understood, although an explanation for the osteotropism of certain primaries has been offered by the ‘seed and soil’ concept, suggesting that the bone microenvironment provides a favorable ‘soil’ for metastasis and proliferation of some tumor cells (‘seeds’) [1]. Here, we report an unusual case of colon cancer with metastasis to the finger at initial presentation, and exophytic sclerotic lesions to other bones. The incidence of metastases to fingers/toes (acrometastases) is reported to be only 0.1%, even after including involvement of primary sites other than the colon. The etiology and characteristics of acrometastases are reviewed in this case report.
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Affiliation(s)
- Helen Gharwan
- Department of Internal Medicine, Johns Hopkins University/Sinai Hospital of Baltimore, Md., USA
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Abstract
This article discusses general principles of medical management of bone metastases, including diagnosis and follow-up; management of specific symptoms; options for systemic treatment, including bisphosphonates; specific details about each cancer type; and future directions in therapy.
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Affiliation(s)
- Margaret K Yu
- Division of Medical Oncology, Department of Internal Medicine, University of Utah School of Medicine, 2000 Circle of Hope, Room 3344, Salt Lake City, UT 84112, USA.
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