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Hu J, Xia B, Yuan X, Chen H, Ou F, Huang L, Xu L, Feng X. Neuroblastoma with superficial soft tissue mass as the first symptom: case reports with atypical ultrasonic image and literature review. Braz J Med Biol Res 2023; 56:e12975. [PMID: 38088674 PMCID: PMC10712279 DOI: 10.1590/1414-431x2023e12975] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Neuroblastoma is one of the most common tumors in children. Cases where an isolated soft-tissue metastasis mass is the initial symptom are rare, with only four such cases reported to date. We describe the imaging findings of ten cases of neuroblastoma patients in our hospital with superficial soft tissue mass (SSTM) as the primary symptom. The main ultrasound finding of SSTM was hypoechoic masses or scattered speck-like hyperechoic masses. However, when this type of SSTM is caused by soft tissue metastasis, the location is often atypical, and ultrasound findings are difficult to distinguish from other benign diseases. Therefore, this research should remind clinicians to recognize atypical presentations of this common childhood malignant tumor. Radiologists should also consider the possibility of neuroblastoma when finding this type of SSTM with atypical ultrasound features.
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Affiliation(s)
- Jiale Hu
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
- China Medical University, Shenyang, Liaoning, China
| | - Bei Xia
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Xiuli Yuan
- China Medical University, Shenyang, Liaoning, China
- Department of Hematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Haixing Chen
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Fuxiang Ou
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Longlong Huang
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Lei Xu
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
- China Medical University, Shenyang, Liaoning, China
| | - Xia Feng
- Department of Ultrasound, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
- China Medical University, Shenyang, Liaoning, China
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Ye Q, Hu T, Sun Z, Xu P, Wang C, Sun Y, Yan W. Surgical resection of soft tissue metastasis in cancers: A single-center study of 77 cases over a 7-year period. Cancer Med 2023; 12:22081-22090. [PMID: 38083869 PMCID: PMC10757142 DOI: 10.1002/cam4.6808] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/31/2023] Open
Abstract
INTRODUCTION Soft tissue metastasis (STM) of cancers, encompassing skeletal muscle and subcutaneous tissue metastasis, is less common due to unique homeostatic conditions. With longer life expectancy and the advent of new imaging modalities, clinical physicians will increasingly encounter and manage such cases. This study retrospectively reviewed cases of STM in visceral cancers who underwent surgery at Fudan University Shanghai Cancer Center over a 7-year period. METHODS Data were collected through a comprehensive review of medical records, including demographic variables, primary tumor characteristics, surgical data, tumor pathology, and outcomes. Survival analysis was performed using Kaplan-Meier curves. RESULTS The study included 77 cases with a median follow-up period of 854 days. The most common primary tumor sites were the lung (11) and breast (10). The abdominal wall was the most frequent site of metastasis. The combination of visceral metastasis, age over 52 years, and a history of primary tumor correlates with a poorer prognosis. Surgical-related metastases are associated with a higher degree of differentiation. Additionally, we have identified a better prognosis for patients with cancer of unknown primary (CUP) exhibiting potential resectable soft tissue metastases. CONCLUSION The combination of visceral metastasis, age over 52 years, and a history of primary tumor suggest a poorer prognosis. While no significant impact on survival was observed for patients with lymph node metastasis. Surgical-related metastases are associated with a higher degree of differentiation. CUP patients with potentially resectable soft tissue metastases should be considered for surgical intervention.
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Affiliation(s)
- Qingrong Ye
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Tu Hu
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Zhengwang Sun
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Peihang Xu
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Chunmeng Wang
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Yangbai Sun
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
| | - Wangjun Yan
- Department of Musculoskeletal SurgeryFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College of Fudan UniversityShanghaiChina
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3
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Aydos U, Ateş SG, Kurukahvecioğlu O, Akdemir ÜÖ, Uyar Göçün P, Atay LÖ. Relationship Between Metabolic Activity, Cellularity, Histopathological Features of Primary Tumors and Distant Metastatic Potential in Breast Cancer. Mol Imaging Radionucl Ther 2023; 32:195-205. [PMID: 37870280 PMCID: PMC10600550 DOI: 10.4274/mirt.galenos.2022.60024] [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: 11/15/2022] [Accepted: 12/18/2022] [Indexed: 10/24/2023] Open
Abstract
Objectives The aim of this study was to evaluate the relationship between the types of distant metastatic spread, histopathological features, and imaging features of primary tumor on positron emission tomography/magnetic resonance imaging (PET/MRI) for primary staging in newly diagnosed breast invasive ductal carcinoma (IDC) patients. Methods Data from 289 female patients were retrospectively evaluated. Maximum standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and minimum apparent diffusion coefficient (ADCmin) values of primary tumors were obtained from PET/MRI. The patients were grouped as non-metastatic, oligometastatic (1-5 metastatic lesions) and multimetastatic (>5 metastatic lesions) disease according to the number of distant metastases, and divided into two groups as isolated bone metastasis (IBM) and mixed/soft tissue metastasis (M-SM) groups according to the sites of metastatic spread. Results Metabolic parameters had higher values and ADCmin had lower values in the multimetastatic and oligometastatic groups than in the non-metastatic group. MTV was the only parameter that showed significant difference between the multimetastatic and oligometastatic groups. MTV and TLG were significantly higher in the M-SM group than in the IBM group. 18F-fluorodeoxyglucose PET parameters had significantly higher values in grade 3, hormone receptor negative, human epidermal growth factor receptor 2 positive, triple negative, and highly proliferative (Ki-67 ≥14%) tumors. The prediction models that included imaging parameters to predict the presence of distant metastasis had higher discriminatory powers than the prediction models that included only histopathological parameters. Conclusion Primary tumors with higher metabolic-glycolytic activity and higher cellularity were more aggressive and had higher metastatic potential in breast IDC. Compared with histopathological parameters alone, the combination of imaging parameters and histopathological features of primary tumors may help to better understand tumor biology and behavior.
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Affiliation(s)
- Uğuray Aydos
- Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Türkiye
| | - Seda Gülbahar Ateş
- University of Health Sciences Türkiye, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Türkiye
| | | | - Ümit Özgür Akdemir
- Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Türkiye
| | - Pınar Uyar Göçün
- Gazi University Faculty of Medicine, Department of Medical Pathology, Ankara, Türkiye
| | - Lütfiye Özlem Atay
- Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Türkiye
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4
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Nienhaus A, Rajakulendran R, Bernad E. Cutaneous Metastasis of Endometrial Cancer and Long-Term Survival: A Scoping Review and Our Experience. Diagnostics (Basel) 2023; 13:2603. [PMID: 37568966 PMCID: PMC10417626 DOI: 10.3390/diagnostics13152603] [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: 06/20/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cutaneous and soft tissue metastases of endometrial cancer are rare. This review aims to examine the prevalence of cutaneous metastasis, the diagnosis and treatment options, and the impact of cutaneous metastasis of endometrial cancer on overall survival. We also present a particular case with a long-term overall survival. MATERIALS AND METHODS A systematic literature search was conducted on PubMed and PubMed Central using the following keywords: endometrial carcinoma metastasis, cutaneous metastasis, and five-year overall survival. RESULTS We identified 326 results and checked their titles for eligibility. There were eight studies included. We also presented a case of a 51-year-old woman with cutaneous metastasis and a large soft tissue metastasis with a prolonged overall survival of about 13 years after the appearance of the first cutaneous metastasis. CONCLUSIONS This paper highlights the importance of skin evaluations in patients diagnosed with endometrial cancer. Healthcare providers must consider the possibility of cutaneous metastasis localization in patients with endometrial cancer to assign the correct stage and apply the appropriate treatment to increase long-term survival.
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Affiliation(s)
- Alexandra Nienhaus
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square, No. 2, 300041 Timisoara, Romania;
- Department of Obstetrics and Gynaecology ‘Augusta Krankenanstalt’ Bochum, Bergstr. 26, 44807 Bochum, Germany;
| | - Rahavie Rajakulendran
- Department of Obstetrics and Gynaecology ‘Augusta Krankenanstalt’ Bochum, Bergstr. 26, 44807 Bochum, Germany;
| | - Elena Bernad
- Department of Obstetrics and Gynecology, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynecology, “Pius Brinzeu” County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Jiang T, Zheng H, Dong K, Guanghua W, Zhou S, Li C, Dong M, Fu J. The value of PET/CT for the diagnosis and evaluation of immunotherapy in occult primary renal cell carcinoma: a case report. J Int Med Res 2023; 51:3000605231162443. [PMID: 37032598 PMCID: PMC10107980 DOI: 10.1177/03000605231162443] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Abstract
Skin and soft tissue diffusion metastasis (also known as occult cancer) is rare in renal cell carcinoma (RCC). Here, we report an extremely rare case of a 67-year-old male patient with occult primary RCC who developed metastases to the gums, skin, and diffuse soft tissue. The primary renal lesion was missed by computed tomography (CT), ultrasound, and 18F-fluorodeoxyglucose positron emission tomography (PET)/CT, and the diagnosis was confirmed by biopsy of gums and subcutaneous nodules. Subsequent enhanced CT revealed a lesion in the left kidney. The patient had progression-free survival of 16 months after treatment with axitinib and pembrolizumab. Pseudoprogression and tumor heterogeneity pose major challenges in the evaluation of immunotherapy. PET/CT is indispensable especially for cases with multiple metastases, widespread distribution of lesions, and major heterogeneity. In this case, the total lesion glycolysis was calculated by PET/CT and was used to evaluate systemic tumor load before and after immunotherapy, which was calculated as the product of the metabolic tumor volume and the mean standardized uptake value of the target lesion, which increased the accuracy of assessing diffuse lesions. Total lesion glycolysis can be used as a new method to quantitatively evaluate the efficacy of immunotherapy.
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Affiliation(s)
- Ting Jiang
- Department of Nuclear Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Hongjuan Zheng
- Department of Medicine Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Ke Dong
- Department of Nuclear Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Wen Guanghua
- Department of Nuclear Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Shishi Zhou
- Department of Medicine Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Chenghui Li
- Department of Medicine Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
| | - Mengjie Dong
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jianfei Fu
- Department of Medicine Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China
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Zhang W, Cai YY, Wang XL, Wang XX, Li Y, Han GY, Chu YJ, Zhang YX, Hao FR. Bone Metastases of Glioblastoma: A Case Report and Review of the Literature. Front Oncol 2021; 11:705455. [PMID: 34646764 PMCID: PMC8504694 DOI: 10.3389/fonc.2021.705455] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/05/2021] [Accepted: 09/02/2021] [Indexed: 01/05/2023] Open
Abstract
Background Glioblastoma (GBM) is the most common primary intracranial tumor and originates from the small pool of adult neural stem and progenitor cells (NSPCs). According to the World Health Organization (WHO) classification of brain tumors, gliomas are classified into grades I–IV, and GBM is defined as the highest grade (IV). GBM can be disseminated by cerebrospinal fluid (CSF), but extracranial metastasis is rare. Additionally, the pathway and mechanism involved remain unclear. Case Presentation We report a rare case of left temporal lobe GBM with multiple bone metastases and soft tissue metastasis. This 49-year-old right-handed man who was diagnosed with GBM underwent surgery on May 9, 2017, followed by radiochemotherapy in June 2017. On August 13, 2019, local relapse was found. Then, the patient received a second surgery but not radiochemotherapy. In November 2019, the patient was reported to be suffering from low back pain for nearly 1 month. On December 6, 2019, magnetic resonance imaging (MRI) of the thoracolumbar vertebrae and abdominal computed tomography (CT) confirmed metastases on the ninth posterior rib on the right, the third anterior rib on the left, and the T7 and T10 vertebrae and their appendages. CT-guided rib space-occupying puncture biopsy was performed, and GBM was identified by pathology. Conclusion We should pay attention to extracranial metastasis of GBM. Timely detection and early treatment improve overall quality of patients’ life. The extracranial metastasis in this patient may have occurred through the spinal nerve root or intercostal nerve. Further clinical observations are required to clarify the pathway and mechanism involved.
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Affiliation(s)
- Wei Zhang
- Clinical School, Weifang Medical University, Weifang, China
| | - Yuan-Yuan Cai
- Department of Radiation Oncology, Weifang People's Hospital, Weifang, China
| | - Xiao-Li Wang
- Department of Radiation Oncology, Weifang People's Hospital, Weifang, China
| | - Xiao-Xiao Wang
- Department of Radiation Oncology, Weifang People's Hospital, Weifang, China
| | - Yang Li
- Department of Radiation Oncology, Weifang People's Hospital, Weifang, China
| | - Gui-Yan Han
- Department of Pathology, Weifang People's Hospital, Weifang, China
| | - Yu-Jing Chu
- Department of Imaging, Weifang People's Hospital, Weifang, China
| | - Yun-Xiang Zhang
- Department of Pathology, Weifang People's Hospital, Weifang, China
| | - Fu-Rong Hao
- Department of Radiation Oncology, Weifang People's Hospital, Weifang, China.,Weifang Key Laboratory of Radiophysics and Oncological Radiobiology, Weifang, China
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7
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Lalchandani A, Shukla Y, Parwez MM. Carcinoma Lung Presenting with Skeletal Muscle Metastasis: Case Report with Review of Literature. Surg J (N Y) 2021; 7:e121-e123. [PMID: 34179461 PMCID: PMC8221840 DOI: 10.1055/s-0041-1731636] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
Lung cancers usually present very late with distant metastasis, thereby carrying a poor prognosis. Metastasis at unusual sites such as extremity musculature does create a diagnostic challenge. This leads to delay in diagnosis and treatment initiation and further worsens the prognosis of the patient. Not many cases have been reported as of now and no standard guidelines are available regarding clinical approach in such cases. We have presented one of such cases to emphasize on importance of early detection and differentiation of such lesions from primary soft tissue malignancies.
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Affiliation(s)
- Ankit Lalchandani
- Department of General Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Yogeshwar Shukla
- Department of Surgical Oncology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Mohammad Masoom Parwez
- Department of General Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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8
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Hashimoto K, Nishimura S, Akagi M. Lung Adenocarcinoma Presenting as a Soft Tissue Metastasis to the Shoulder: A Case Report. ACTA ACUST UNITED AC 2021; 57:181. [PMID: 33672554 DOI: 10.3390/medicina57020181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/14/2022]
Abstract
Background: Metastasis to soft tissue is rare, and the pathogenesis remains unclear. Soft tissue metastases (STMs) have varied presentations; existing reports are few. Herein, we report a case of STMs of the shoulder with a rich characterization. Case presentation: A 93-year-old man presented to our hospital with pain and swelling of the left shoulder for one week. Magnetic resonance imaging (MRI) showed a T1 low-intensity and T2 high-intensity mass. We suspected a primary sarcoma and performed a needle biopsy. However, on histopathological examination, the findings were suggestive of lung adenocarcinoma. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography also revealed FDG accumulation in the right lung, thus confirming the diagnosis. Conclusion: Oncologists should keep in mind that STMs of lung cancer may resemble soft-tissue sarcomas at the time of initial diagnosis.
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9
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Mooney CP, Gao K, Clark JR, Gupta R, Shannon K, Palme CE, Ebrahimi A, Ch'ng S, Low THH. Soft Tissue Metastases in Head and Neck Cutaneous Squamous Cell Carcinoma. Laryngoscope 2020; 131:E1209-E1213. [PMID: 32926433 DOI: 10.1002/lary.29064] [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: 03/11/2020] [Revised: 07/26/2020] [Accepted: 08/11/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Soft tissue metastases (STM) in head and neck cutaneous squamous cell carcinoma (HNcSCC) are non-nodal based metastases to the parotid and cervical soft tissues of the head and neck. This is a unique subgroup of regional metastases amongst patients with cSCC and have been shown to be associated with poor prognosis. Detailed studies of this subgroup are lacking in the literature. A retrospective cohort analysis was performed to characterize the prognostic significance of STM in HNcSCC based on individual clinicopathological features. METHODS Patients with HNcSCC with STM were identified from the Sydney Head and Neck Cancer Institute database. Clinicopathological characteristics were extracted from the histopathological reports. Recurrence and follow-up data were analyzed to determine disease-free and overall survival using the Kaplan-Meier method and Cox proportional hazards models. RESULTS After excluding all patients with lymph node metastasis with no STM, there were 200 patients identified (161 parotid, 32 cervical, and seven with concurrent parotid and cervical STM) with a 5-year overall survival of 36%. In univariable analysis, age of patients, size of the deposits, location of the deposits, and patients that were not offered adjuvant radiotherapy have worse overall survival. However, on multivariable analysis, age and the number of STM deposits were independent factors that predict for worse survival. CONCLUSION The presence of STM in patients with HNcSCC is associated with poor prognosis. Increasing number of STM deposits, as well as involved margin of the regional excision, negatively impacted on the overall prognosis. LEVEL OF EVIDENCE Level III - retrospective cohort study. Laryngoscope, 131:E1209-E1213, 2021.
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Affiliation(s)
- Craig P Mooney
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Kan Gao
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
| | - Jonathan R Clark
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia
| | - Ruta Gupta
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, Australia
| | - Kerwin Shannon
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
| | - Carsten E Palme
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia
| | - Ardalan Ebrahimi
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sydney Ch'ng
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia
| | - Tsu-Hui Hubert Low
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia
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10
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Azhar A, Wilder E. A perianal subcutaneous metastasis as the presenting sign for lung cancer. Proc (Bayl Univ Med Cent) 2020; 34:133-134. [PMID: 33456175 DOI: 10.1080/08998280.2020.1798717] [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: 10/23/2022] Open
Abstract
Metastases to soft tissues are rarely reported in the initial presentation and diagnosis of lung cancer. We report a case of a 77-year-old white man who presented with a 9-day history of a painful, rapidly growing mass on his left buttock in the gluteal cleft. The deep dermal location of the neoplasm and the lack of epidermal involvement led to suspicion of a metastatic carcinoma. Imaging showed a lung lesion suspected to be a primary malignancy with distant liver and gastric fundus metastases. Lung pathology showed primarily adenocarcinoma with squamous differentiation, whereas the skin biopsy showed poorly differentiated squamous cell carcinoma. Clinically, we concluded the skin carcinoma was a metastasis of a primary lung adenocarcinoma with squamous differentiation. This case highlights the importance of appropriate preventative screening.
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Affiliation(s)
- Aaminah Azhar
- Texas A&M University College of Medicine, Bryan, Texas
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11
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Abstract
Distant soft tissue tumor metastasis isolated in the digit, presenting as a primary esophageal squamous cell carcinoma is considered extremely rare. Herein, we present a rare case of a 44-year-old male patient with squamous cell carcinoma of the esophagus associated with the clinical symptoms of progressive dysphagia and hoarseness in the course of 2 days. During the second course of chemotherapy, the patient sustained a fall with scald to his right ring finger, while the swelling in the right ring finger was soft, cystic and 2.0×1.8 cm in size. Then, phalangectomy was performed in his right ring finger and pathologic diagnosis was considered metastasis from the esophagus. Unfortunately, the patient succumbed to this disease within 2 months of diagnosis of metastasis. In conclusion, detection of soft tissue metastasis may have prognostic implications, providing more accessible biopsy sites and helping avoid invasive procedures.
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Affiliation(s)
- Yi Chen
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University.,Department of Oncology, Nanjing Pukou Central Hospital
| | - Weiwei Tang
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Hua Xiao
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinfei Chen
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University
| | - Huanyu Zhao
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University
| | - Junfeng Shi
- Department of Oncology, Nanjing First Hospital, Nanjing Medical University
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12
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Kataoka K, Osaka E, Shimizu T, Okamura Y, Yoshida Y, Tokuhashi Y. Lung squamous cell carcinoma with brachial soft tissue metastasis responsive to gefitinib: Report of a rare case. Thorac Cancer 2016; 7:676-680. [PMID: 27755795 PMCID: PMC5093176 DOI: 10.1111/1759-7714.12366] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 04/27/2016] [Indexed: 11/28/2022] Open
Abstract
Metastasis of lung cancer to soft tissue is rare and patient outcomes are generally poor. There are no reports describing soft tissue metastasis in lung squamous cell carcinoma (SCC), in which gefitinib treatment was effective not only for the primary tumor but also the metastatic lesion. A 61‐year‐old Asian woman presented to our facility with pain and a mass in the brachium. An additional tumor was identified in the lung. As we suspected soft tissue metastasis of lung cancer, an incisional biopsy was performed, yielding a diagnosis of SCC. The brachial tumor continued to grow and became exposed at the biopsy site when the incisional wound dehisced. Because the biopsied specimen was positive for an epidermal growth factor receptor (EGFR) gene mutation, we commenced gefitinib administration. This treatment resulted in the rapid shrinkage of both the brachial metastasis and the primary tumor, followed by healing of the wound. Therefore, tyrosine kinase inhibitors should be used for cases that present EGFR activating mutations independently from the presence of skin and soft tissue metastases.
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Affiliation(s)
- Kana Kataoka
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Eiji Osaka
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Tetsuo Shimizu
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuki Okamura
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuaki Tokuhashi
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
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13
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Arunachalam K. Refractory sciatica could be a sign of malignancy: A unique case presentation. R I Med J (2013) 2016; 99:25-27. [PMID: 26726859] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
t Renal cell carcinoma is one of the highly aggressive tumors and notorious for late presentations. It is associated with high morbidity and mortality. Renal cell carcinoma is known for rare metastatic sites. In clinical practice, it is often important not to anchor to a particular diagnosis but rather revisit and revaluate entire history and clinical examination. We describe a case of metastatic renal cell carcinoma that was initially treated as sciatica and later found to have advanced debilitating malignancy. Internal medicine physicians should be able to recognize one of the rare metastatic sites of renal cell carcinoma and understand the importance of imaging studies if patient has persisting sciatica symptoms without improvement.
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Affiliation(s)
- Karuppiah Arunachalam
- Department of Hospital Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
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Moreno-Ramírez D, Alés-Martínez M, Ferrándiz L. Fast-growing in-transit melanoma metastasis after intratumoral interleukin-2. Cancer Immunol Immunother 2014; 63:1229-30. [PMID: 25056817 PMCID: PMC11029765 DOI: 10.1007/s00262-014-1583-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/05/2014] [Indexed: 10/25/2022]
Affiliation(s)
- David Moreno-Ramírez
- Melanoma Clinic, Dermatology Unit, University Hospital Virgen Macarena, Avda. Dr. Fedriani s/n, 41009, Seville, Spain,
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Vallianou N, Gounari P, Skourtis A, Vourlakou C. Cervical mass as the presenting manifestation of hepatocellular carcinoma. Hippokratia 2014; 18:285-287. [PMID: 25694768 PMCID: PMC4309154] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Hepatocellular carcinoma is one of the most common cancers in the world due to its association with chronic hepatitis infections. Amongst the most usual metastasis of hepatocellular carcinoma are the lymph nodes, the lungs and the bones. Soft tissue metastases are extremely rare. CASE PRESENTATION Herein, we report the case of a 73-years-old male patient who presented with cervical and upper extremities muscle pain along with paresthesias and a palpable mass on the cervical region. CONCLUSION This unusual clinical manifestation along with the above-described rare presentations of hepatocellular carcinoma must be taken into account, especially among patients with chronic hepatitis infections. Hippokratia 2014; 18 (3): 285-287.
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Affiliation(s)
- Ng Vallianou
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - P Gounari
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - A Skourtis
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - C Vourlakou
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
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Kechagias A, Delis S, Dervenis C, Maniatis P, Papailiou J. Computed tomography-guided radiofrequency ablation for palliation of a painful supraclavicular soft-tissue metastasis invading the brachial plexus. Oncol Lett 2013; 6:1521-1523. [PMID: 24179552 PMCID: PMC3813792 DOI: 10.3892/ol.2013.1577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/12/2013] [Accepted: 08/23/2013] [Indexed: 11/24/2022] Open
Abstract
The present study describes a case of a painful supraclavicular soft-tissue metastasis of a skin melanoma invading the brachial plexus in a 38-year-old male. The patient was treated twice with radiofrequency ablation (RFA) under computed tomography (CT) guidance, which caused tumoral necrosis. The patient was originally referred with a 7-cm metastasis in the right supraclavicular fossa, which caused intractable pain and a degree of numbness. These symptoms were unresponsive to chemotherapy and radiotherapy and the pain was not controlled using narcotic analgesics. The lesion was treated with CT-guided RFA causing necrosis, relieving the pain and sparing the patient from using analgesics. The pain recurred 19 months thereafter and a CT scan revealed an 8-cm mass in the right supraclavicular space. The patient underwent repeat CT-guided RFA, which reduced the pain to a level that was controlled with minor oral analgesics. In conclusion, in this case of a painful supraclavicular soft-tissue metastasis invading the brachial plexus, which was intractable to chemotherapy and radiotherapy, RFA was feasible and offered substantial palliation of the symptoms, freedom from the use of narcotic analgesics and improvements to the quality of life.
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Affiliation(s)
- Aristotelis Kechagias
- First Department of Surgery, Konstantopouleion-Agia Olga General Hospital, Athens 142-33, Greece
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