Diagnostic utility of the combined use of HNF4A and GATA3 in distinction between primary and metastatic breast and gastric carcinomas

A case of multiple bone metastases during the course of non-invasive bladder and prostate cancer

INTRODUCTION

Secondary bladder tumor is rare. We report a case of a bladder tumor initially thought to be a recurrence of non-muscle invasive bladder cancer that was ultimately identified as metastasis from gastric cancer treated 16 years prior.

CASE PRESENTATION

A 75-year-old male with a history of gastric, prostate, and recurrent non-muscle invasive bladder cancer was diagnosed to have multiple bone metastases. Open bone biopsy and cancer gene panel testing identified the primary origin of the metastases as gastric cancer. Retrospective evaluation revealed that what was initially suspected as recurrent bladder tumors were actually metastases from the gastric cancer.

CONCLUSION

In cases of metastases with an unknown primary origin, detailed evaluation, including biopsy of the metastatic lesion and genomic testing, is recommended.

Hepatocyte nuclear factor 4 a (HNF4α): A perspective in cancer

HNF4α, a transcription factor, plays a vital role in regulating functional genes and biological processes. Its alternative splicing leads to various transcript variants encoding different isoforms. The spotlight has shifted towards the extensive discussion on tumors interplayed withHNF4α abnormalities. Aberrant HNF4α expression has emerged as sentinel markers of epigenetic shifts, casting reverberations upon downstream target genes and intricate signaling pathways, most notably with cancer. This review provides a comprehensive overview of HNF4α's involvement in tumor progression and metastasis, elucidating its role and underlying mechanisms.

The role of hepatocyte nuclear factor 4α (HNF4α) in tumorigenesis

Hepatocyte Nuclear Factor 4 Alpha (HNF4α) is a master transcription factor mainly expressed in the liver, kidney, intestine and endocrine pancreas. It regulates multiple target genes involved in embryonic development and metabolism. HNF4α-related diseases include non-alcoholic fatty liver disease (NAFLD), obesity, hypertension, hyperlipidemia, metabolic syndrome and diabetes mellitus. Recently, HNF4α has been emerging as a key player in a variety of cancers. In this review, we summarized the role and mechanism of HNF4α in different types of cancers, especially in liver and colorectal cancer, aiming to provide additional guidance for intervention of these diseases.