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Guruvaiah Sridhara N, Guruvaiah Sridhara N, Li W, Ponnatapura J. A rare radiological presentation of pulmonary metastases from malignant melanoma. Radiol Case Rep 2023; 18:2653-2658. [PMID: 37287725 PMCID: PMC10241655 DOI: 10.1016/j.radcr.2023.04.060] [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: 04/14/2023] [Revised: 04/23/2023] [Accepted: 04/30/2023] [Indexed: 06/09/2023] Open
Abstract
Malignant melanoma is a highly aggressive cancer with metastatic potential to various locations such as the lymph nodes, lungs, liver, brain, and bone. After the lymph nodes, the lungs are the most common site of malignant melanoma metastases. Pulmonary metastases from malignant melanoma commonly presents as solitary or multiple solid nodules, sub-solid nodules or miliary opacities on CT chest. We present a case of pulmonary metastases from malignant melanoma in a 74-year-old man which presented unusually on CT chest as a combination of patterns like "crazy paving," upper lobe predominance with subpleural sparing, and centrilobular micronodules. Video-assisted thoracoscopic surgery, wedge resection and tissue analysis were performed, which confirmed the diagnosis of malignant melanoma metastases, and the patient further underwent PET-CT for staging and surveillance. Patients with pulmonary metastases from malignant melanoma can have atypical imaging findings, therefore radiologists should be aware of these unconventional presentations to avoid any misdiagnoses.
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Affiliation(s)
| | | | - Wengcheng Li
- Department of Pathology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Janardhana Ponnatapura
- Department of Radiology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
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2
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Soh EG, Rho JY, Jeong S, Kang SR, Choi KH. Primary Pulmonary Malignant Melanoma Presenting as Bilateral Multiple Subsolid Nodules: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:387-393. [PMID: 36237923 PMCID: PMC9514426 DOI: 10.3348/jksr.2021.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/09/2021] [Indexed: 11/15/2022]
Abstract
Primary pulmonary malignant melanoma is an extremely rare type of melanoma. The radiologic features of primary pulmonary malignant melanoma are nonspecific; however, it almost always presents as a well-demarcated round or lobulated solitary solid nodule or mass. Herein, we report the case of a 78-year-old male with primary pulmonary malignant melanoma that was mistaken for primary pulmonary adenocarcinoma with lepidic growth and was seen as bilateral multiple subsolid nodules on CT.
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Affiliation(s)
- Eun Gyu Soh
- Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Ji Young Rho
- Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Sooyeon Jeong
- Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Se Ri Kang
- Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Keum Ha Choi
- Department of Pathology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
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3
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Vessel co-option and resistance to anti-angiogenic therapy. Angiogenesis 2019; 23:55-74. [PMID: 31865479 DOI: 10.1007/s10456-019-09698-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/22/2019] [Indexed: 12/20/2022]
Abstract
Vessel co-option is a non-angiogenic mechanism of tumour vascularisation in which cancer cells utilise pre-existing blood vessels instead of inducing new blood vessel formation. Vessel co-option has been observed across a range of different tumour types, in both primary cancers and metastatic disease. Importantly, vessel co-option is now implicated as a major mechanism that mediates resistance to conventional anti-angiogenic drugs and this may help to explain the limited efficacy of this therapeutic approach in certain clinical settings. This includes the use of anti-angiogenic drugs to treat advanced-stage/metastatic disease, treatment in the adjuvant setting and the treatment of primary disease. In this article, we review the available evidence linking vessel co-option with resistance to anti-angiogenic therapy in numerous tumour types, including breast, colorectal, lung and pancreatic cancer, glioblastoma, melanoma, hepatocellular carcinoma, and renal cell carcinoma. The finding that vessel co-option is a significant mechanism of resistance to anti-angiogenic therapy may have important implications for the future of anti-cancer therapy, including (a) predicting response to anti-angiogenic drugs, (b) the need to develop therapies that target both angiogenesis and vessel co-option in tumours, and (c) predicting the response to other therapeutic modalities, including immunotherapy.
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4
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Kuczynski EA, Vermeulen PB, Pezzella F, Kerbel RS, Reynolds AR. Vessel co-option in cancer. Nat Rev Clin Oncol 2019; 16:469-493. [PMID: 30816337 DOI: 10.1038/s41571-019-0181-9] [Citation(s) in RCA: 252] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
All solid tumours require a vascular supply in order to progress. Although the ability to induce angiogenesis (new blood vessel growth) has long been regarded as essential to this purpose, thus far, anti-angiogenic therapies have shown only modest efficacy in patients. Importantly, overshadowed by the literature on tumour angiogenesis is a long-standing, but continually emerging, body of research indicating that tumours can grow instead by hijacking pre-existing blood vessels of the surrounding nonmalignant tissue. This process, termed vessel co-option, is a frequently overlooked mechanism of tumour vascularization that can influence disease progression, metastasis and response to treatment. In this Review, we describe the evidence that tumours located at numerous anatomical sites can exploit vessel co-option. We also discuss the proposed molecular mechanisms involved and the multifaceted implications of vessel co-option for patient outcomes.
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Affiliation(s)
- Elizabeth A Kuczynski
- Bioscience, Oncology, IMED Biotech Unit, AstraZeneca, Cambridge, UK. .,Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
| | - Peter B Vermeulen
- HistoGeneX, Antwerp, Belgium.,Translational Cancer Research Unit, GZA Hospitals St Augustinus, University of Antwerp, Wilrijk-Antwerp, Belgium.,Tumour Biology Team, Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Francesco Pezzella
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Robert S Kerbel
- Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Andrew R Reynolds
- Tumour Biology Team, Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK. .,Oncology Translational Medicine Unit, IMED Biotech Unit, AstraZeneca, Cambridge, UK.
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5
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Borghesi A, Bercich L, Michelini S, Bertagna F, Scrimieri A, Maroldi R. Pulmonary metastases from malignant epithelioid schwannoma of the arm presenting as fast-growing subsolid nodules: Report of an unusual case. Eur J Radiol Open 2019; 6:307-314. [PMID: 31692656 PMCID: PMC6804872 DOI: 10.1016/j.ejro.2019.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/01/2019] [Indexed: 01/15/2023] Open
Abstract
Subsolid pulmonary nodules (SSNs) may be the manifestation of benign and malignant conditions. Malignant SSNs usually correspond to the preinvasive or invasive lepidic growth of pulmonary adenocarcinomas. More rarely, malignant SSNs may be the manifestation of primitive pulmonary lymphomas or metastases from extrapulmonary malignancies. In the case of metastases from extrapulmonary malignancies, the SSNs exhibit more aggressive behavior with rapid growth in a short period of time. The present article describes the first case of pulmonary metastases presenting as fast-growing SSNs in a patient with malignant epithelioid schwannoma of the arm.
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Affiliation(s)
- Andrea Borghesi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Luisa Bercich
- Department of Pathology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Silvia Michelini
- Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alessandra Scrimieri
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
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6
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Borghesi A, Tironi A, Michelini S, Scrimieri A, Benetti D, Maroldi R. Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns. Eur J Radiol Open 2019; 6:287-290. [PMID: 31453271 PMCID: PMC6702405 DOI: 10.1016/j.ejro.2019.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022] Open
Abstract
Malignant melanoma is an aggressive cancer with a high metastatic potential. Among the multiple sites of metastatic disease, the lung is one of the most frequently involved sites. Typically, pulmonary metastases from malignant melanoma occur as solid nodules. Rarely, pulmonary involvement in metastatic melanoma occurs as subsolid nodules. The present article describes an unusual case of a patient with malignant melanoma that developed two synchronous pulmonary metastases with two different densities on CT images (one solid and the other subsolid) and different morphological patterns on histologic images. The radiologic-pathologic correlation of these two patterns of presentation was also reported.
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Affiliation(s)
- Andrea Borghesi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Tironi
- Department of Pathology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Silvia Michelini
- Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Alessandra Scrimieri
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Diego Benetti
- Thoracic Surgery Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
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7
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Dalpiaz G, Asioli S, Fanti S, Rea G, Marchiori E. Rapidly growing pulmonary ground-glass nodule caused by metastatic melanoma lacking uptake on 18F-FDG PET-CT. ACTA ACUST UNITED AC 2019; 44:171-172. [PMID: 29791543 PMCID: PMC6044662 DOI: 10.1590/s1806-37562017000000298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, Surgical Pathology Section, University of Bologna, Italy
| | - Stefano Fanti
- Department of Nuclear Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Gaetano Rea
- Department of Radiology, Monaldi Hospital, Naples, Italy
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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8
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Wagner DC, Balzer JO, Gohrbandt B, Kreft A. Two Growth Patterns in One Melanoma Lung Metastasis. Int J Surg Pathol 2018; 27:529-530. [PMID: 30449216 DOI: 10.1177/1066896918813452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Suda K. Intraoperative molecular imaging-a bright navigator for thoracic surgeons in the era of limited resection. Transl Lung Cancer Res 2018; 7:S232-S235. [PMID: 30393610 DOI: 10.21037/tlcr.2018.08.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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10
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Rapidly progressing lepidic pulmonary metastases from a treated poorly differentiated hepatocellular carcinoma demonstrating new pathologic features of cholangiocarcinoma: A potential diagnostic pitfall that may mimic pneumonia. Radiol Case Rep 2018; 13:336-342. [PMID: 29904468 PMCID: PMC6000012 DOI: 10.1016/j.radcr.2018.01.008] [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: 11/21/2017] [Accepted: 01/04/2018] [Indexed: 11/21/2022] Open
Abstract
Although the lung is a common site for metastatic disease from extrathoracic malignancies, a pattern of lepidic growth of these metastases is considered rare. A 67-year-old man with a history of partial hepatectomy for hepatocellular carcinoma (HCC) presented to our hospital with dyspnea and a nonproductive cough. Chest radiographs and computed tomography imaging demonstrated consolidation in the right upper lobe and an ipsilateral pleural effusion. Findings were initially suspected to be secondary to infection, given the radiographic appearance and the rapid development from a normal computed tomography 3 months previously. However, the patient did not have convincing clinical evidence of pneumonia, and after little change after antibiotic therapy, a thoracentesis and pleural biopsy were performed that were positive for malignancy. Although immunostaining and morphology closely resembled the patient's primary HCC, new pathologic features of cholangiocarcinoma were found. We herein report the first case of rapidly progressing lepidic pulmonary metastases from an HCC that dedifferentiated into a hepatocholangiocarcinoma.
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Furuya T, Tsunezuka H, Okada S, Kato D, Shimada J, Miyachi M, Iehara T, Hosoi H, Inoue M. Synchronous bilateral lung adenocarcinomas associated with vulvar rhabdomyosarcoma in a 15-year-old girl. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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