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Kennedy K, Leahy M, Laing ME. Penile melanoma diagnosis aided by in vivo confocal microscopy. JAAD Case Rep 2024; 44:30-33. [PMID: 38292567 PMCID: PMC10824698 DOI: 10.1016/j.jdcr.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Kaija Kennedy
- Mater Misericordiae University Hospital, University College Dublin
| | - Marion Leahy
- University Hospital Galway, National University of Ireland Galway
| | - Mary E. Laing
- University Hospital Galway, National University of Ireland Galway
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2
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Yamamoto M, Mizuuchi Y, Tamura K, Sada M, Nagayoshi K, Nakata K, Ohuchida K, Oda Y, Nakamura M. Nonmass-forming type anorectal cancer with pagetoid spread: A report of two cases. Asian J Endosc Surg 2023; 16:747-752. [PMID: 37332069 DOI: 10.1111/ases.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/03/2023] [Indexed: 06/20/2023]
Abstract
Pagetoid spread (PS) of anorectal cancer is relatively rare and associated with poor prognosis. While a primary tumorous lesion is usually obvious in most PS cases, we experienced two cases of nonmass-forming type anorectal cancer with PS. It remains challenging to decide strategies. In both cases, histological findings of a perianal skin biopsy showed proliferation of atypical cells that were positive for cytokeratin (CK) 7, CK20, and caudal type homeobox 2 and negative for Gross cystic disease fluid protein 15, suggesting PS. Abdominoperineal resection (APR) with extensive anal skin resection was performed in both patients. The pathological diagnosis in each was nonmass-forming type anorectal cancer with PS. Neither has experienced recurrence in postoperative courses. Even nonmass-forming type anorectal cancer with PS could have high malignant potentials. APR with lymph nodes dissection and wide skin excision and regular surveillance might be necessary.
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Affiliation(s)
- Masahiro Yamamoto
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Mizuuchi
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Sada
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kinuko Nagayoshi
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenoki Ohuchida
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Koufopoulos N, Ieronimaki AI, Zacharatou A, Gouloumis AR, Leventakou D, Boutas I, Dimas DT, Kontogeorgi A, Sitara K, Khaldi L, Zanelli M, Palicelli A. A Case of Prostatic Signet-Ring Cell-like Carcinoma with Pagetoid Spread and Intraductal Carcinoma and Long-Term Survival: PD-L1 and Mismatch Repair System Proteins (MMR) Immunohistochemical Evaluation with Systematic Literature Review. J Pers Med 2023; 13:1016. [PMID: 37374005 DOI: 10.3390/jpm13061016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Prostatic adenocarcinoma (PA) is the second most common malignancy in men globally. Signet-ring cell-like adenocarcinoma (SRCC) is a very rare PA subtype, with around 200 cases reported in the English literature. Histologically, the tumor cells show a vacuole compressing the nucleus to the periphery. Pagetoid spread in acini and ducts is usually related to metastases from urothelial or colorectal carcinomas, less commonly associated with intraductal carcinoma (IC); histologically, the tumor cells grow between the acinar secretory and basal cell layers. To our knowledge, we report the first prostatic SRCC (Gleason score 10, stage pT3b) associated with IC and pagetoid spread to prostatic acini and seminal vesicles. To our systematic literature review (PRISMA guidelines), it is the first tested case for both PD-L1 (<1% of positive tumor cells, clone 22C3) and mismatch repair system proteins (MMR) (MLH1+/MSH2+/PMS2+/MSH6+). We found no SRCC previously tested for MMR, while only four previous cases showed high expression of another PD-L1 clone (28-8). Finally, we discussed the differential diagnoses of prostatic SRCC.
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Affiliation(s)
- Nektarios Koufopoulos
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Argyro-Ioanna Ieronimaki
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Andriani Zacharatou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Alina Roxana Gouloumis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Danai Leventakou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Ioannis Boutas
- Breast Unit, Rea Maternity Hospital, P. Faliro, 17564 Athens, Greece
| | - Dionysios T Dimas
- Breast Unit, Athens Medical Center, Psychiko Clinic, 11525 Athens, Greece
| | - Adamantia Kontogeorgi
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Kyparissia Sitara
- Department of Internal Medicine, "Elpis" General Hospital of Athens, 11522 Athens, Greece
| | - Lubna Khaldi
- Pathology Department "Saint Savvas" Anti-Cancer Hospital, 10447 Athens, Greece
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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Kosano M, Kiniwa Y, Mikoshiba A, Iwaya M, Okuyama R. Clinical features of pagetoid spread: Analysis of perianal lesions associated with anal canal adenocarcinoma and perianal primary extramammary Paget disease. J Dermatol 2023; 50:546-550. [PMID: 36794662 DOI: 10.1111/1346-8138.16744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/06/2023] [Accepted: 01/26/2023] [Indexed: 02/17/2023]
Abstract
Secondary extramammary Paget disease (s-EMPD) represents anal canal and rectal, bladder, and gynecological cancers, which horizontally extend within the epidermis of the anal and vulvar skin. It is necessary to distinguish this condition from primary extramammary Paget disease (p-EMPD), which occurs primarily in genital and perianal areas. This study aimed to investigate the clinical and histopathological features of these two conditions in the perianal skin and to identify useful features for differentiation. We retrospectively analyzed 16 patients who visited Shinshu University Hospital from 2009 to 2022 and presented with perianal skin lesions and suspected EMPD. Six patients had p-EMPD and 10 had s-EMPD derived from anal canal adenocarcinoma. Regarding clinical features, nine of 10 (90%) of the s-EMPD cases had symmetric skin lesions, whereas all of the p-EMPD cases had asymmetrical lesions (p = 0.0004). Furthermore, assessment of symmetry around the anus showed that s-EMPD had a significantly smaller coefficient of variation than p-EMPD (0.35 and 0.62, respectively; p = 0.048), suggesting that s-EMPD was more symmetric around the anus. The frequency of raised lesions, such as foci or nodules, was nine of 10 (90%) for s-EMPD and one of six (16%) for p-EMPD (p = 0.003). Well-defined tumor borders on the lateral margins were identified in s-EMPD (5/10, 50%); however, they were not identified in p-EMPD (0/6, 0%). The borders tended to be clearer in s-EMPD; however, the difference was not significant (p = 0.078). Based on these findings, we recommend consideration of s-EMPD when anal skin lesions are symmetrical, well-defined, or raised.
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Affiliation(s)
- Megumi Kosano
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Asuka Mikoshiba
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Mai Iwaya
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
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Nishikawa T, Ushiku T, Emoto S, Murono K, Kaneko M, Sonoda H, Sasaki K, Shuno Y, Tanaka T, Hata K, Kawai K, Nozawa H, Ishihara S. Anal canal adenocarcinoma with pagetoid spread and inguinal lymph node metastasis treated with preoperative chemoradiotherapy: A case report. Mol Clin Oncol 2020; 12:529-532. [PMID: 32337034 DOI: 10.3892/mco.2020.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 02/06/2020] [Indexed: 12/13/2022] Open
Abstract
Perianal Paget's disease is a rare condition, which is not usually accompanied by cancer. Here, a case of anal canal carcinoma with pagetoid spread and inguinal lymph node metastasis, which exhibited a significant response to preoperative chemoradiotherapy (CRT), is presented. A 58-year-old woman was admitted to The University of Tokyo Hospital with a complaint of discomfort around the anus. Physical examination revealed an erythematous inflamed skin lesion in the perianal region and a tumor of 15 mm in diameter detected on palpation in the left inguinal region, which was diagnosed as metastatic adenocarcinoma by excisional biopsy. Colonoscopy revealed moderately differentiated adenocarcinoma of 15 mm in diameter in the anal canal. Skin biopsy of the perianal region revealed an infiltration of pagetoid cells, which were positive for cytokeratin 7, and negative for cytokeratin 20 and gross cystic disease fluid protein 15. Based on these results, the patient was diagnosed as having anal canal adenocarcinoma with pagetoid spread. The patient received preoperative CRT including the bilateral inguinal region. After CRT, robotic-assisted laparoscopic abdominoperineal resection was performed. The macroscopic findings of the surgical specimen confirmed the formation of a scar as a result of the preoperative CRT. Microscopic examination of the anal tumor revealed no residual carcinoma or lymph node metastasis. In conclusion, this case may suggest the potential applicability of preoperative CRT for the local control of anal canal carcinoma with pagetoid spread.
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Affiliation(s)
- Takeshi Nishikawa
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Koji Murono
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Manabu Kaneko
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yasutaka Shuno
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan
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García-Rabasco A, Roselló-Añón A, De-Unamuno-Bustos B, Ferrer-Guillén B, Alegre De Miquel V. Juvenile melanocytic acral nevus: A comparative study between MANIAC and non-MANIAC nevus and its clinicopathological characteristics. J Cutan Pathol 2019; 46:898-904. [PMID: 31373032 DOI: 10.1111/cup.13553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Melanocytic acral nevi have a series of distinguishing features, including their location, patient age at onset, clinical progression, and histological findings. In particular, histopathological analysis often reveals a melanocytic acral nevus with intraepidermal ascent of cells (MANIAC nevus), which in some cases can be mistaken for atypia or malignancy. AIM This study describes the clinicopathological characteristics of acral nevi in patients under 18 years old and contrasts the clinical and histological features between MANIAC vs non-MANIAC nevi. METHODS This was a retrospective observational study, performed in our department in the decade between January 2007 and January 2017. We included patients younger than 18 years of age who were subjected to the removal of melanocytic acral nevi. RESULTS A total of 70 patients were studied. 54.2% (38/70) were females and 45.8% (32/70) were males. With regard to the type of nevus, 34 were compound, 27 were junctional, and 9 were predominantly intradermal lesions. We identified a total of 41 MANIAC nevi and 29 non-MANIAC nevi. Statistically significant differences between these two groups were identified in nevus size (larger in MANIAC) and the frequency of compound nevi (higher in the MANIAC group), but not in the remainder of the histological parameters studied.
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Affiliation(s)
- Ana García-Rabasco
- Department of Dermatology, Valencia University General Hospital, Valencia, Spain
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Grunes D, Kim MK, Chessin DB, Yaeger RD, Ward SC. Perianal Goblet Cell Carcinoid With Pagetoid Spread. Int J Surg Pathol 2019; 27:788-791. [PMID: 31079516 DOI: 10.1177/1066896919845478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present a case of perianal goblet cell carcinoid with pagetoid spread. Goblet cell carcinoid, also known as adenocarcinoid tumor, predominantly arises as a primary appendiceal tumor and contains nests of neuroendocrine and mucin-containing cells. When this tumor type is seen in other sites it usually represents a metastasis. We present the case of an 81-year-old woman with a perianal mass. Histologic and immunohistochemical examination following surgical excision showed a goblet cell carcinoid demonstrating pagetoid spread along the perianal squamous mucosa. There was no evidence of a primary appendiceal tumor by history or imaging studies. To our knowledge, this is the first report of a goblet cell carcinoid presenting in this manner. The patient died due to complications of metastatic disease 26 months after initial diagnosis.
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Affiliation(s)
- Dianne Grunes
- 1 Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - David B Chessin
- 1 Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rona D Yaeger
- 2 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen C Ward
- 1 Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Muinonen-Martin AJ, Insall RH. Melanomas' fatal attraction to lysophosphatidic acid trails: a new prognostic and therapeutic approach? Melanoma Manag 2015; 2:97-100. [PMID: 30190836 PMCID: PMC6094656 DOI: 10.2217/mmt.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Andrew J Muinonen-Martin
- Leeds Cancer Centre, Bexley Wing, St James’ University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - Robert H Insall
- CRUK Beatson Institute for Cancer Research, Glasgow, G61 1BD, UK
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Ogawa H, Tanaka Y, Koma YI, Hokka D, Tane S, Tauchi S, Uchino K, Yoshimura M, Maniwa Y. Pulmonary large cell neuroendocrine carcinoma exhibiting extensive pagetoid spread in the bronchial epithelium: A case report. Oncol Lett 2014; 8:2621-2623. [PMID: 25364438 PMCID: PMC4214490 DOI: 10.3892/ol.2014.2538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 07/01/2014] [Indexed: 01/15/2023] Open
Abstract
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive malignant tumor, which was proposed as a novel type of neuroendocrine tumor in 1991. Although it is categorized as a non-small cell lung carcinoma, the precise pathological condition is unknown due to its rare occurrence. The present study outlines the case of a patient presenting with an LCNEC that exhibited pagetoid spread from the region of the primary tumor to the bronchial epithelium (distance, >30 mm). The pagetoid spread was unconfirmed preoperatively, however, was identified by intraoperative rapid diagnosis. This caused us to suffer the perioperative decision of additional resection and resulted in an incomplete resection, as suture of the bronchus was not possible. Pagetoid spread, which is often apparent in the breast, presents as a rare pattern of infiltration of cancer cells when a massive carcinoma is identified beneath the intraepithelial spread. Although preoperative diagnosis of pagetoid spread is difficult due to its rarity and undefined clinical features, it is important for surgeons and pathologists treating lung cancer patients to be aware of potential pagetoid spread in the thoracic region.
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Affiliation(s)
- Hiroyuki Ogawa
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Yugo Tanaka
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Yu-Ichiro Koma
- Department of Pathology, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Daisuke Hokka
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Shunsuke Tauchi
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yoshimasa Maniwa
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
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Ishida M, Okabe H. Pagetoid spread of urothelial carcinoma in the epidermis surrounding a ureterocutaneostomy. J Cutan Pathol 2013; 40:775-6. [PMID: 23495973 DOI: 10.1111/cup.12136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 12/26/2012] [Accepted: 01/14/2013] [Indexed: 11/28/2022]
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