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Fleury AS, Zhuang H. Recurrent Metastatic Ewing Sarcoma Involving Only in the Muscles of Extremities Shown on FDG PET/CT. Clin Nucl Med 2024; 49:589-591. [PMID: 38537215 DOI: 10.1097/rlu.0000000000005202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Ewing sarcoma is the second most common osseous malignancy in pediatric patient. Metastasis is common due to its aggressive nature, with 25% of patients with metastasis at diagnosis, commonly to the lungs, bone, or bone marrow. Muscle metastasis is uncommon. We report FDG PET/CT findings of multifocal muscle metastases of recurrent Ewing sarcoma in the extremities without lung and bone involvement in a 6-year-old boy.
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Affiliation(s)
- Anilawan S Fleury
- From the Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Chan HY, Chan WY, Lin JWS. Cardiac and Intramuscular Metastases Following Nephroureterectomy for Metachronous Urothelial Carcinoma. Am J Case Rep 2024; 25:e942864. [PMID: 38650318 PMCID: PMC11056213 DOI: 10.12659/ajcr.942864] [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] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/13/2024] [Accepted: 02/28/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND We present a case of metachronous cardiac and intramuscular metastases in a patient with a known history of radical nephroureterectomy for upper-tract urothelial carcinoma (UTUC). CASE REPORT A 58-year-old man had a history of metachronous renal pelvis urothelial carcinoma with prior left radical nephroureterectomy. He was also diagnosed with malignancy-associated deep vein thrombosis (DVT) and was on rivaroxaban. He presented at an oncology follow-up consult with shortness of breath and right scapular lump. CT scan revealed a soft-tissue mass at the surgical bed suspicious for local recurrence, as well as intracardiac hypodensities and intramuscular nodules in the right latissimus dorsi and right adductor muscles. The intracardiac hypodensities were located in the left atrial appendage and inter-atrial septum. Given that the patient had a history of DVT and in a pro-thrombotic state, differentials for the intracardiac densities included intracardiac thrombi or metastases. The intramuscular hypodensities were rim-enhancing. Given that the patient was on rivaroxaban, differentials included hematomas or metastases. As there was no overlying bruising and the lesions remained unchanged in size clinically, they were treated as metastases. The patient was treated with clexane but re-presented with worsening of shortness of breath and palpitations. CT scan showed increased size of intracardiac lesions, suggesting no response to anticoagulation, and therefore were likely metastatic in nature. He completed a 2-year course of IV pembrolizumab and was in complete remission. CONCLUSIONS Our case highlights the importance of this clinically challenging scenario when patients with known malignancy and on anticoagulation present with cardiac or musculoskeletal symptoms. Though these patients are at risk of thrombus and haematoma, cardiac and intramuscular metastasis should be considered, as the prognosis is guarded.
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Zhu G, Sun W, Liu Y, Wang H, Ye S. Skeletal muscle metastasis from a gastrointestinal stromal tumor: A case report. Medicine (Baltimore) 2021; 100:e27011. [PMID: 34449472 PMCID: PMC8389935 DOI: 10.1097/md.0000000000027011] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Common sites for metastasis are the liver and peritoneum, whereas skeletal muscle metastases are rare. PATIENT CONCERNS A 59-year-old man with skeletal muscle metastasis was diagnosed during a period of adjuvant imatinib therapy following the recurrence of GIST of the small intestine. DIAGNOSIS The patient was diagnosed with skeletal muscle metastasis of GIST based on immunohistochemistry and molecular pathology analysis results. INTERVENTION Extensive resection of the left thigh tumor was performed. The patient underwent whole-exome sequencing of tissue examination. The results suggest that resistance to imatinib may have been developed, and the patient was therefore administered sunitinib instead. OUTCOMES Complete remission was observed following sunitinib therapy. LESSONS In cases of skeletal muscle metastasis diagnosed during a period of adjuvant imatinib therapy following the recurrence of a GIST of the small intestine, whole exome sequencing may be used to discover more gene variations.
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Affiliation(s)
- Guangsheng Zhu
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China
| | - Wenjia Sun
- Department of Pathology, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China
| | - Yujun Liu
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China
| | - Huabin Wang
- Department of Bone and Soft Tissue Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China
| | - Shengwei Ye
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China
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Lin YC, Huang SH, She BC, Huang CY. Isolated rectus abdominis muscle recurrence of endometrial cancer. Taiwan J Obstet Gynecol 2021; 60:181-182. [PMID: 33494999 DOI: 10.1016/j.tjog.2020.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yun-Chieh Lin
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Shih-Hung Huang
- Department of Pathology, Cathay General Hospital, Taipei, Taiwan
| | - Bo-Ching She
- Department of Obstetrics and Gynecology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
| | - Chia-Yen Huang
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, Hsinchuang, New Taipei City, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
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Cao C, Fu Z, Liu Y, Zhou A, Wang J, Shou J. A Muscle-Invasive Bladder Cancer Patient With High Tumor Mutational Burden and RB1 Mutation Achieved Bladder Preservation Following Chemotherapy Combined With Immunotherapy: A Case Report. Front Immunol 2021; 12:684879. [PMID: 34177933 PMCID: PMC8222973 DOI: 10.3389/fimmu.2021.684879] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Neoadjuvant chemotherapy followed by radical cystectomy is the standard of care for patients diagnosed with muscle-invasive bladder cancer (MIBC). However, urinary diversion following radical cystectomy significantly reduces patient quality of life. In addition, patients who significantly respond to neoadjuvant chemotherapy have a strong will to preserve the bladder. Bladder-sparing therapy has become a research focus worldwide. Although the bladder-sparing regimen, referred to as trimodality therapy (TMT), has been accepted, the efficacy of immunotherapy combined with chemotherapy for bladder preservation in patients with MIBC has not yet been published. We describe the case of a 50-year-old male presented intermittent macrohematuria and was diagnosed with bladder urothelial carcinoma by diagnostic transurethral resection of bladder tumor (TURBt) with clinical stage IIIA (cT3bN0M0). A complete response was achieved after four courses of neoadjuvant chemotherapy combined with pembrolizumab. Then, we performed a second TURBt plus randomized biopsy by cystoscopy. The pathology indicated no tumor in the bladder. Adjuvant chemoradiotherapy and immunotherapy were subsequently performed. Imaging examinations, cystoscopy and urine tumor DNA (utDNA) levels were used for surveillance after treatment. Finally, the patient achieved bladder preservation and had remained cancer-free for 19 months at the last follow-up on February 20, 2021. This is the first published case study to describe neoadjuvant chemotherapy plus pembrolizumab followed by concurrent chemoradiotherapy as a novel bladder-sparing regimen and successfully achieved a promising outcome.
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Affiliation(s)
- Chuanzhen Cao
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhichao Fu
- Research Institute, GloriousMed Clinical Laboratory (Shanghai) Co., Ltd., Shanghai, China
| | - Yueping Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Aiping Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianfei Wang
- Research Institute, GloriousMed Clinical Laboratory (Shanghai) Co., Ltd., Shanghai, China
| | - Jianzhong Shou
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Billi T, Karadima V, Tyrnenopoulou P, Apostolopoulou EP, Brellou GD, Diakakis N. Surgical excision of a malignant metastatic melanoma located in a skeletal muscle of the lateral thorax of a horse. Vet Med Sci 2021; 7:297-302. [PMID: 32991055 PMCID: PMC8025616 DOI: 10.1002/vms3.366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/22/2020] [Accepted: 09/09/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND A 20-year-old grey Warmblood gelding that had history of dermal melanomatosis. OBJECTIVE To report surgical treatment of a 6-cm large malignant metastatic melanoma located in the cutaneous trunci muscle of the left lateral thorax of a horse. METHODS A 20-year-old grey Warmblood gelding was referred for evaluation of a large, rapidly growing, thoracic mass. Clinical examination revealed an ovoid, firm, non-painful, movable mass, approximately 6 cm in diameter, located in the cutaneous trunci muscle of the left lateral thorax. Multiple melanocytic nodules were also found at the perianal region and ventral tail. Rectal examination, ultrasonography and endoscopy of the respiratory tract revealed no melanomas internally. Haematological and biochemical values were within normal limits. Surgical excision of both the thoracic mass and perianal nodules was the treatment of choice. Histopathology of the distant thoracic mass confirmed the diagnosis of malignant metastatic melanoma secondary to the perineal lesions that were confirmed as dermal melanomatosis. RESULTS The horse recovered uneventfully. Up until 3 years post surgery there was no tumour regrowth at the excision sites. CONCLUSION Surgical excision of the metastatic melanoma was performed and considered successful, with no gross evidence of tumour reoccurrence. Despite the fact that surgical excision is considered a treatment option regarding equine dermal melanomatosis, there is no previously published study proposing surgical removal of distant malignant metastatic melanocytic masses. This is the first report of a successful surgical excision of a large (6 cm) metastatic melanocytic tumour from the skeletal muscle of the lateral thorax of a horse.
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Affiliation(s)
- Theodora Billi
- Faculty of Health SciencesEquine UnitSchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Vasiliki Karadima
- Faculty of Health SciencesEquine UnitSchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Panagiota Tyrnenopoulou
- Faculty of Health SciencesEquine UnitSchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Emmanouela P. Apostolopoulou
- Faculty of Health SciencesLaboratory of PathologySchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Georgia D. Brellou
- Faculty of Health SciencesLaboratory of PathologySchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Nikolaos Diakakis
- Faculty of Health SciencesEquine UnitSchool of Veterinary MedicineAristotle University of ThessalonikiThessalonikiGreece
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Kikuchi K, Nakamura R, Segawa T, Oikawa H, Ariga H. Modified Glasgow prognostic score can predict survival of muscle invasive bladder cancer patients after radiotherapy. J Radiat Res 2020; 61:616-621. [PMID: 32567660 PMCID: PMC7336815 DOI: 10.1093/jrr/rraa039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/07/2020] [Indexed: 06/11/2023]
Abstract
In patients with various cancers, modified Glasgow prognostic score (mGPS) before treatment has predicted prognoses after antitumor therapy. This study aimed to assess whether pretreatment mGPS also has predictive value in patients with muscle-invasive bladder cancer (MIBC) after radiotherapy. A retrospective review accumulated 98 consecutive MIBC patients treated with definitive 3D-conformal radiotherapy from January 2011 to December 2016 in a single center. It included cT2-4bN0-3M0 patients with a median age of 79 years (range: 49 to 95 years). Radiotherapy was delivered at 60-66 Gy for bladder cancer. Patients were categorized in terms of their pretreatment serum albumin and C-reactive protein (CRP) values as mGPS_0, mGPS_1, and mGPS_2. Among them, cumulative overall survival (OS) rates were compared by Kaplan-Meier plots with log-rank tests. The number of patients with mGPS_0, mGPS_1, and mGPS_2 were 40, 40, and 18, respectively. The median follow-up time for all patients was 19 months (range: 2-73 months). The 2-year OS rate for all patients was 75.7%. The 2-year OS rates for mGPS_0, mGPS_1, and mGPS_2 were 85.1%, 71.3%, and 60.9%, respectively. Kaplan-Meier curves revealed a significantly higher cumulative OS rate for mGPS_0 compared with mGPS_1 and mGPS_2 (P = 0.003). Using multivariate Cox regression analysis, mGPS_0 and good performance status were associated with favorable OS rates, of which mGPS_0 was more significant (Hazard ratio 2.74, 95% CI 1.30-5.57, P = 0.008). Modified Glasgow prognostic score may be a novel biomarker that can predict survival in patients with MIBC after radiotherapy.
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Affiliation(s)
- Koyo Kikuchi
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Ryuji Nakamura
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Takafumi Segawa
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Hirobumi Oikawa
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Hisanori Ariga
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
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Omokawa N, Mabuchi S, Iwai K, Kawahara N, Kawaguchi R, Sugimoto S, Ohbayashi C, Honoki K, Nagai A, Kobayashi H. Skeletal muscle metastasis as a first site of recurrence of cervical cancer: A case report and review of the literature. Medicine (Baltimore) 2020; 99:e20056. [PMID: 32384470 PMCID: PMC7220549 DOI: 10.1097/md.0000000000020056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
RATIONALE Cervical cancer primarily spreads through direct invasion or via local lymphatics, and hematogenous metastasis is infrequent. Previous reports have shown that lung, liver, and bone are the organs most frequently affected by hematogenous metastasis of cervical cancer, while skeletal muscle is very rarely involved. PATIENT CONCERNS A 75-year-old Japanese woman presented with a painful muscular mass in her right lower abdomen. Five years ago, she was treated for her International Federation of Gynecology and Obstetrics stage IB2 cervical adenocarcinoma with radical surgery plus adjuvant chemotherapy. DIAGNOSES The patient was diagnosed with isolated oblique muscle metastasis from cervical adenocarcinoma as a first site of recurrence. INTERVENTIONS The patient was treated with salvage surgery consisting of partial resection of the oblique muscle and ilium. The tumor was completely excised with an adequate surgical margin by a partial resection of the oblique muscle and ilium OUTCOMES:: The patient is currently free of disease at 10 months after the development of recurrent disease. LESSONS We describe a rare case of isolated oblique muscle metastasis as a first site of recurrence of the International Federation of Gynecology and Obstetrics stage IB2 cervical adenocarcinoma, which was successfully treated with surgery. Although skeletal muscle metastasis is rare, this condition should be considered during the follow-up period, especially when patients complain of muscular pain with insidious progression. The present case and our literature review highlighted the possibility that loco-regional treatment may be curative for selected recurrent cervical cancer developed in skeletal muscles.
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Affiliation(s)
| | | | - Kana Iwai
- Department of Obstetrics and Gynecology
| | | | | | | | | | - Kanya Honoki
- Department of Orthopedics, Nara Medical University, Kashihara city, Nara
| | - Akira Nagai
- Department of Obstetrics and Gynecology, Osaka Habikino Medical Center, Osaka, Japan
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Mandelli GE, Missale F, Bresciani D, Benerini Gatta L, Scapini P, Caveggion E, Roca E, Bugatti M, Monti M, Cristinelli L, Belotti S, Simeone C, Calza S, Melocchi L, Vermi W. Tumor Infiltrating Neutrophils Are Enriched in Basal-Type Urothelial Bladder Cancer. Cells 2020; 9:cells9020291. [PMID: 31991796 PMCID: PMC7072276 DOI: 10.3390/cells9020291] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Urothelial bladder cancers (UBCs) are distinct in two main molecular subtypes, namely basal and luminal type. Subtypes are also diverse in term of immune contexture, providing a rationale for patient selection to immunotherapy. Methods: By digital microscopy analysis of a muscle-invasive BC (MIBC) cohort, we explored the density and clinical significance of CD66b+ tumor-associated-neutrophils (TAN) and CD3+ T cells. Bioinformatics analysis of UBC datasets and gene expression analysis of UBC cell lines were additionally performed. Results: Basal type BC contained a significantly higher density of CD66b+ TAN compared to the luminal type. This finding was validated on TCGA, GSE32894 and GSE124305 datasets by computing a neutrophil signature. Of note, basal-type MIBC display a significantly higher level of chemokines (CKs) attracting neutrophils. Moreover, pro-inflammatory stimuli significantly up-regulate CXCL1, CXCL2 and CXCL8 in 5637 and RT4 UBC cell lines and induce neutrophil chemotaxis. In term of survival, a high density of T cells and TAN was significantly associated to a better outcome, with TAN density showing a more limited statistical power and following a non-linear predicting model. Conclusions: TAN are recruited in basal type MIBC by pro-inflammatory CKs. This finding establishes a groundwork for a better understanding of the UBC immunity and its relevance.
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Affiliation(s)
- Giulio Eugenio Mandelli
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
| | - Francesco Missale
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
- IRCCS Ospedale Policlinico San Martino, 16121 Genova, Italy
- Department of Otorhinolaryngology, Head and Neck Surgery—University of Genoa, 16121 Genova, Italy
| | - Debora Bresciani
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
| | - Luisa Benerini Gatta
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25100 Brescia, Italy; (E.R.); (L.C.); (S.B.); (C.S.)
| | - Patrizia Scapini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy; (P.S.); (E.C.)
| | - Elena Caveggion
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy; (P.S.); (E.C.)
| | - Elisa Roca
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25100 Brescia, Italy; (E.R.); (L.C.); (S.B.); (C.S.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
| | - Mattia Bugatti
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
| | - Matilde Monti
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
| | - Luca Cristinelli
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25100 Brescia, Italy; (E.R.); (L.C.); (S.B.); (C.S.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
| | - Sandra Belotti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25100 Brescia, Italy; (E.R.); (L.C.); (S.B.); (C.S.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
| | - Claudio Simeone
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25100 Brescia, Italy; (E.R.); (L.C.); (S.B.); (C.S.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
| | - Stefano Calza
- Unit of Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, 25125 Brescia, Italy;
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Laura Melocchi
- Department of Pathology, Fondazione Poliambulanza, 25100 Brescia, Italy;
| | - William Vermi
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, 25125 Brescia, Italy; (G.E.M.); (F.M.); (D.B.); (L.B.G.); (M.B.); (M.M.)
- ASST Spedali Civili di Brescia, 25100 Brescia, Italy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63130, USA
- Correspondence: ; Tel.: +39-030-399-8425
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Kitagawa K, Shigemura K, Sung SY, Chen KC, Huang CC, Chiang YT, Liu MC, Huang TW, Yamamichi F, Shirakawa T, Fujisawa M. Possible correlation of sonic hedgehog signaling with epithelial-mesenchymal transition in muscle-invasive bladder cancer progression. J Cancer Res Clin Oncol 2019; 145:2261-2271. [PMID: 31367836 DOI: 10.1007/s00432-019-02987-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/24/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the role of sonic hedgehog (Shh) signaling and epithelial-mesenchymal transition (EMT) in bladder cancer progression and invasion. METHODS We cultured three bladder cancer cell lines, muscle-invasive T24 and 5637, and non-muscle-invasive KK47, in the presence of a recombinant-Shh (r-Shh) protein or cyclopamine, a Shh signaling inhibitor, to investigate proliferation and expression of EMT markers. Wound-healing assays and transwell assay were performed to evaluate cell invasion and migration. Mice were then inoculated with bladder cancer cells and treated with cyclopamine. Mouse tumor samples were stained for Shh signaling and EMT markers. RESULTS R-Shh protein enhanced cell proliferation, whereas cyclopamine significantly suppressed cell proliferation, especially in invasive cancer (5637 and T24) (p < 0.05). R-Shh protein promoted EMT, suppressed E-cadherin and enhanced N-cadherin and vimentin and Gli1, an Shh downstream molecule, while cyclopamine blocked EMT, especially in 5637 and T24. Cyclopamine also inhibited cell invasion and migration in vitro. In the animal study, intraperitoneal injection of cyclopamine significantly suppressed tumor growth in 5637 and T24 in mice (p = 0.01 and p = 0.004, respectively) and slightly suppressing KK47 tumor growth (p = 0.298). Significant cyclopamine-induced suppression of Gli1 in 5637 and T24 mouse tumors (both p = 0.03) was seen, suggesting that muscle-invasive bladder cancer may be more dependent on Shh signaling than non-muscle-invasive bladder cancer. CONCLUSIONS Shh signaling and EMT were especially enhanced in muscle-invasive bladder cancer progression and invasion, and suppressed by the inhibition of Shh signaling.
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Affiliation(s)
- Koichi Kitagawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Katsumi Shigemura
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.
- Department of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Shian-Ying Sung
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan
| | - Kuan-Chou Chen
- Department of Urology, Taipei Medical University-Shuang Ho Hospital, 291, Zhongzheng Rd, Zhonghe District, Taipei, 23561, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, College of Medicine, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan
| | - Yi-Te Chiang
- Department of Urology, Taipei Medical University-Shuang Ho Hospital, 291, Zhongzheng Rd, Zhonghe District, Taipei, 23561, Taiwan
| | - Ming-Che Liu
- Department of Urology, Taipei Medical University-Shuang Ho Hospital, 291, Zhongzheng Rd, Zhonghe District, Taipei, 23561, Taiwan
| | - Tzu-Wen Huang
- Department of Microbiology and Immunology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan
| | - Fukashi Yamamichi
- Department of Urology, Hyogo Prefectural Amagasaki Hospital (Current name: Hyogo Prefectural Amagasaki General Medical Center), 2-17-77, Higashi-Namba-cho, Amagasaki, 660-8550, Japan
| | - Toshiro Shirakawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
- Department of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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11
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Abstract
In this paper, we describe a case of a 73-year old female with late skeletal muscle metastases from a clear-type renal cell carcinoma 8 years after total nephrectomy. The metastases were located in the right femoral quadriceps, in the sartorius muscle and adductor magnus muscle. A full clinical work-up was performed with blood examinations, radiological and pathological assessment. A complete surgical resection with a wide margin was performed for all lesions, and the final pathological report deposed for metastatic renal carcinoma clear-type cells. In this case report, we discuss the crucial rule of accurate radiological and pathological assessment and aggressive surgical management.
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Affiliation(s)
- Antonio Manzelli
- General Surgery Division, Department of Surgery, University of Rome Tor Vergata, Tor Vergata University Hospital, Rome, Italy.
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12
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Hsu KF, Chen CY, Chu TS, Liu HH, Chang CK, Wu CJ, Lin CT, Wang CH, Tzeng YS, Dai NT, Chen SG. Scalp melanoma with rectus abdominis metastasis: A rare case report. Medicine (Baltimore) 2019; 98:e16395. [PMID: 31305447 PMCID: PMC6641839 DOI: 10.1097/md.0000000000016395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE The main cause of death in melanoma patients is widespread metastases as it can metastasize to almost every organ. However, melanoma skeletal muscle metastases (MSMM) are exceptional, and only a few cases of MSMM to the rectus abdominis muscles have been previously described. And our case maybe the first reported case in Asia region. PATIENT CONCERNS A 45-year-old man with history of right scalp melanoma, pT3aN0M0, stage IIA status post wide excision with 2 cm safe margin and right neck lymph node dissection at 5 years before. He had an almost 5 years disease-free period but presented to our clinic due to intermittent abdominal sharp pain for 1 to 2 months, with a palpable soft tissue mass over his right abdomen. Metastatic melanoma to rectus abdominis muscles was highly suspected. INTERVENTIONS The patient subsequently underwent radical en-block extraperitoneal 15 cm segmental resection of the right rectus abdominis muscle including tumor mass. The resected tumor was a black-gray colored solid mass, and the final histologic study showed a metastasis of melanoma. OUTCOMES Postoperative course of the patient was uneventful, and the right abdominal pain was improved. The patient was referred for further target therapy, but passed away half a year later due to multiple metastasis. LESSONS Scalp melanoma with isolated rectus muscle metastasis is extremely rare especially for a young aged patient who had an almost 5-year disease-free period. Surgery is a potentially curative therapy for patients with isolated metastatic melanoma. The goal is negative resection margins, in order to avoid local recurrences. Radical compartmental surgery should be considered for selected stage IV melanoma patients with sole rectus abdominis MSMM, whose disease could be amenable to complete resection, in preliminary procedure to prolong disease-free survival time. For oligometastatic disease, surgical resection is sometimes useful in carefully selected patients after systemic therapy; also, it could be performed as symptomatic treatment.
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13
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Ciurea AI, Boca I, Rogojan L, Ciule LD, Ciortea CA. Pectoralis muscle metastases from breast cancer in a young patient detected by automated breast ultrasound. Med Ultrason 2019; 21:200-203. [PMID: 31063527 DOI: 10.11152/mu-1769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Metastases to the skeletal muscle from breast cancer represent an unusual and rare condition. We present the case of a 27-year-old female with left breast cancer (IDC NST G3) who underwent neoadjuvant chemotherapy followed by conservativesurgery (sectorectomy and lymphadenectomy) and radiation therapy. Two months after the end of radiotherapy she presented with a 2 mm skin lesion and she was referred for a screening ultrasound. The screening automated breast ultrasound (ABUS) revealed local recurrence and pectoralis metastases, lesions evaluated also by magnetic resonance imaging. The diagnosis was confirmed by the ultrasound-guided biopsy.
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Affiliation(s)
- Anca Ileana Ciurea
- Radiology Department, "Iuliu Hațieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Ioana Boca
- Radiology Department, County Clinical Emergency Hospital of Cluj-Napoca, Romania.
| | - Liliana Rogojan
- Pathology Department, County Clinical Emergency Hospital of Cluj-Napoca, Romania.
| | - Larisa Dorina Ciule
- Oncology Department, County Clinical Emergency Hospital of Cluj-Napoca, Romania.
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14
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Suzuki T, Furusawa H, Watanabe Y, Sakashita H, Fujii S, Tasaka Y, Shimada S, Majima H, Kawahara T, Katayanagi S, Ejima M, Nukui Y, Shirai T, Masuo M, Tateishi T, Fujie T, Tamaoka M, Taguchi T, Tomii S, Miyazak Y. [A Case of Pulmonary Enteric Adenocarcinoma with Soleus Muscle Metastasis]. Gan To Kagaku Ryoho 2019; 46:267-270. [PMID: 30914531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Pulmonary enteric adenocarcinoma is a unique pulmonary adenocarcinoma subtype and has histopathological findings that are similar to those of colorectal adenocarcinoma. A man in his 50s visited our hospital because of discomfort in his right lower leg for the last 9 months. Imaging studies revealed a mass in his right soleus muscle, and needle biopsy was performed. Histological findings revealed adenocarcinoma, and immunohistochemical staining showed that the tumor cells were positive for CK20 and CDX-2. The tumor was first suspected to be metastasis of gastrointestinal malignant tumors. FDG-PET/CT showed increased FDG uptake in the right soleus muscle mass and presented with increased FDG uptake in a right upper lobe mass and right mediastinum lymphadenopathy. There were no findings in other organs. Scraping cytology of a transbronchial biopsy indicated adenocarcinoma. Upper and lower gastrointestinal endoscopy showed no findings of malignancy. He was finally diagnosed with pulmonary enteric adenocarcinoma(cT3N2M1b, Stage ⅣA). Treatment with cisplatin(CDDP), pemetrexed( PEM), and bevacizumab(BEV) was initiated. After 4 courses of the regimen, the tumor was partially reduced, and the patient showed stable disease(SD).
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Affiliation(s)
- Takafumi Suzuki
- Dept. of Respiratory Medicine, Tokyo Medical and Dental University
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15
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Sindoni A, Gobitti C, Sulfaro S, Giacomarra V, Borsatti E. Unusual presentation of recurrent papillary thyroid microcarcinoma with neck muscles and skin dissemination [corrected]. Hormones (Athens) 2018; 17:589-591. [PMID: 30415409 DOI: 10.1007/s42000-018-0075-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/24/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Alessandro Sindoni
- Nuclear Medicine Unit, CRO Aviano National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Pordenone, Italy
| | - Carlo Gobitti
- Radiotherapy Unit, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Sandro Sulfaro
- Pathology Unit, "Santa Maria Degli Angeli" Hospital, Pordenone, Italy
| | - Vittorio Giacomarra
- Otorhinolaryngology Unit, "Santa Maria Degli Angeli" Hospital, Pordenone, Italy
| | - Eugenio Borsatti
- Nuclear Medicine Unit, CRO Aviano National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Pordenone, Italy.
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16
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Nedjadi T, Salem N, Khayyat D, Al-Sayyad A, Al-Ammari A, Al-Maghrabi J. Sonic Hedgehog Expression is Associated with Lymph Node Invasion in Urothelial Bladder Cancer. Pathol Oncol Res 2018; 25:1067-1073. [PMID: 30361899 PMCID: PMC6614154 DOI: 10.1007/s12253-018-0477-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 10/04/2018] [Indexed: 02/07/2023]
Abstract
Bladder cancer (BC) is a deadly disease characterized by high recurrence rates and frequent progression to an aggressive phenotype. Dysregulation of various signaling pathways have been implicated in BC tumorigenesis, however, the clinical relevance of sonic hedgehog pathway (Shh) remains under investigated. The aim of the current study was to analyze the prognostic value of Shh expression in patients with bladder carcinoma. Immunohistochemical expression of Shh was performed using tissue microarray with 128 specimens from bladder cancer patients. Kaplan-meier survival was analysed and correlation between Shh protein expression and patients' clinicopathological parameters wasexamined using Fisher's exact test. The immuno-staining results revealed that Shh protein exhibits cytoplasmic localization and is expressed in 49% of the analyzed bladder cancer cohort. Our data indicated that high Shh expression significantly correlated with increased lymph node metastasis (p = 0.02), however no association was reported between Shh expression and other clinicopatholigical parameters. High expression of sonic hedgehog was associated with lymph node invasion which may indicate that Shh might play an important role in progression and metastasis of bladder cancer.
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Affiliation(s)
- Taoufik Nedjadi
- King Abdullah International Medical Research Centre,, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Jeddah, Kingdom of Saudi Arabia.
| | - Nada Salem
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dareen Khayyat
- King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Al-Sayyad
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adel Al-Ammari
- Department of Urology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Jaudah Al-Maghrabi
- Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia
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17
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Park EJ, Plumb A, Powers R, Vidal P, Psutka S. Epithelioid angiomyolipoma metastasis to the rectus abdominis. Can J Urol 2018; 25:9527-9529. [PMID: 30281012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 37-year-old female presented with abdominal pain. An abdominal computed tomography scan demonstrated a 10 cm x 13 cm left renal mass. An open adrenal-sparing radical nephrectomy was performed. The pathological diagnosis was epithelioid angiomyolipoma. Five-year surveillance did not demonstrate recurrence of disease. However, a 1.8 cm x 2.5 cm mass on the rectus abdominis muscle was identified after 5 years. Biopsy of the mass demonstrated histologic findings consistent with the primary tumor. Herein, we report a case of metastatic renal epithelioid angiomyolipoma to the rectus abdominis muscle more than 5 years after resection of primary renal tumor.
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Affiliation(s)
- Edward J Park
- Division of Urology, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA
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18
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Boeri L, Soligo M, Frank I, Boorjian SA, Thompson RH, Tollefson M, Quevedo FJ, Cheville JC, Karnes RJ. Delaying Radical Cystectomy After Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer is Associated with Adverse Survival Outcomes. Eur Urol Oncol 2018; 2:390-396. [PMID: 31277775 DOI: 10.1016/j.euo.2018.09.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/03/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Delaying radical cystectomy (RC) after a diagnosis of muscle-invasive bladder cancer (MIBC) has been associated with adverse survival. However, data are lacking regarding the impact of RC delay in patients receiving neoadjuvant chemotherapy (NAC). OBJECTIVES To assess whether the time from last cycle of NAC to RC (time to cystectomy, TTC) is associated with survival among MIBC patients. DESIGN, SETTING, AND PARTICIPANTS The study cohort comprised 226 patients treated with NAC and RC between 1999 and 2015 for cT2-T4N0M0 bladder cancer. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Descriptive statistics were used to test the association between TTC and clinicopathologic variables. Overall mortality (OM) and cancer-specific mortality (CSM) were analyzed via Kaplan-Meier estimation according to TTC. We assessed factors associated with OM and CSM using multivariable Cox regression analyses. RESULTS AND LIMITATIONS The median TTC was 7.57wk (interquartile range 5.2-10.8). Patients with a Charlson comorbidity index (CCI) ≥1 had a longer TTC than those with a score of <1 (p=0.027). The group with TTC >10wk had significantly lower OM-free (p=0.003) and CSM-free rates (p<0.001) than the group with TTC ≤10wk. TTC was independently associated with higher risk of OM (p=0.027) and CSM (p=0.004) after accounting for age, gender, pathologic extravesical disease, and nodal status. CONCLUSIONS TTC of >10wk after NAC was associated with adverse survival among patients with MIBC. Patients with a higher CCI were more likely to have prolonged TTC. PATIENT SUMMARY The impact of delaying radical cystectomy in patients who have received neoadjuvant chemotherapy (NAC) is unknown. In this study we assessed whether prolonged time to cystectomy (TTC) after NAC affects survival outcomes in patients with muscle-invasive bladder cancer. We found that TTC of >10wk was associated with adverse overall survival and cancer-specific survival, and attempts should be made to shorten TTC after preoperative chemotherapy.
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Affiliation(s)
- Luca Boeri
- Department of Urology, Mayo Clinic, Rochester, MN, USA; Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Soligo
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Igor Frank
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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19
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Worst TS, Weis CA, Stöhr R, Bertz S, Eckstein M, Otto W, Breyer J, Hartmann A, Bolenz C, Wirtz RM, Erben P. CDKN2A as transcriptomic marker for muscle-invasive bladder cancer risk stratification and therapy decision-making. Sci Rep 2018; 8:14383. [PMID: 30258198 PMCID: PMC6158275 DOI: 10.1038/s41598-018-32569-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 09/10/2018] [Indexed: 12/22/2022] Open
Abstract
Deletions of the cell cycle control gene CDKN2A are described as progression markers of non-muscle invasive bladder cancer and to be associated with fibroblast growth factor 3 (FGFR3) mutations. The prognostic role of CDKN2A RNA expression in muscle invasive bladder cancer (MIBC) is under discussion. In 80 MIBC patients (m/f 60/20) who underwent radical cystectomy the expression of CDKN2A and FGFR3 was examined with qRT-PCR (test cohort). The MDA cohort (n = 57) and the TCGA cohort (n = 365) served for validation. The expression of drug target genes and TCGA molecular subtypes was correlated with CDKN2A expression. In the test cohort CDKN2Ahigh patients (n = 8; 10.0%) had a significantly shorter recurrence-free (p = 0.018) and disease-specific (p = 0.006) survival compared to the rest of the cohort. A similar stratification was seen in the validation cohorts (CDKN2Ahigh: n = 7, 12.3%, p = 0.001; n = 46, 12.6%, p = 0.011). In the TCGA cohort these patients had a comparably low expression of drug target genes. The expression of CDKN2A significantly differed among TGCA molecular subtypes. 71.7% of CDKN2Ahigh were TCGA basal squamous tumours but also show divergent molecular features compared to this group. In summary CDKN2A RNA expression-based risk stratification of MIBC allows the identification of a CDKN2Ahigh poor prognosis group with low expression of drug target genes.
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Affiliation(s)
- Thomas S Worst
- Department of Urology, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Cleo-Aron Weis
- Institute of Pathology, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Robert Stöhr
- Institute of Pathology, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Simone Bertz
- Institute of Pathology, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Markus Eckstein
- Institute of Pathology, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Wolfgang Otto
- Department of Urology, University of Regensburg, Landshuter Straße 65, 93053, Regensburg, Germany
| | - Johannes Breyer
- Department of Urology, University of Regensburg, Landshuter Straße 65, 93053, Regensburg, Germany
| | - Arndt Hartmann
- Institute of Pathology, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Christian Bolenz
- Department of Urology, University of Ulm, Prittwitzstraße 43, 89075, Ulm, Germany
| | - Ralph M Wirtz
- STRATIFYER Molecular Pathology GmbH, Werthmannstraße 1, 50935, Cologne, Germany
- Institute of Pathology at the St Elisabeth Hospital Köln-Hohenlind, Werthmannstraße 1, 50935, Cologne, Germany
| | - Philipp Erben
- Department of Urology, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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20
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Zheng J, Shen S, Jiang L, Yan L, Yang J, Li B, Wen T, Wang W, Xu M. Outcomes of anterior approach major hepatectomy with diaphragmatic resection for single huge right lobe HCC with diaphragmatic invasion. Medicine (Baltimore) 2018; 97:e12194. [PMID: 30200125 PMCID: PMC6133608 DOI: 10.1097/md.0000000000012194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 08/09/2018] [Indexed: 02/06/2023] Open
Abstract
The outcomes following anterior approach (AA) hepatectomy in huge hepatocellular carcinoma (HCC) patients with diaphragmatic invasion (DI) remain unclear. This study compared the outcomes of single huge right HCC patients with and without DI after AA hepatectomy. A total of 203 consecutive patients with single huge right lobe HCC who underwent AA major hepatectomy were included. They were divided into group PDI (n = 53) and group ADI (n = 150) according to the presence or the absence of DI. Their short- and long-term outcomes were compared, and a subgroup analysis was performed. There were no significant differences regarding postoperative complications and 90-day mortality between the 2 groups. The overall survival (OS) and recurrence-free survival (RFS) rates were similar between the 2 groups. The subgroup analysis also showed that patients with tumor resection en bloc with part of the diaphragm had similar OS and RFS rates as those who underwent diaphragmatic resection after hepatectomy. Tumor diameter ≥ 15 cm, serum AFP level ≥ 400 ng/mL, and tumor grade of G4 and microvascular invasion are independent predictors of poor prognosis. For the single huge right lobe HCC patients with DI, AA major hepatectomy combined with diaphragmatic resection could offer similar OS and RFS as those without diaphragmatic invasion.
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21
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Kim S, Lee AJ, Yeo MK, Na YG, Kim JY, Cho MJ, Kim JS, Jo EK, Kim JM. Clinicopathological Profiling of LC3B, an Autophagy Marker, and ESRRA (Estrogen-related Receptor-alpha) in Muscle-invasive Bladder Cancer. Anticancer Res 2018; 38:2429-2437. [PMID: 29599373 DOI: 10.21873/anticanres.12495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Microtubule-associated protein 1 light chain 3B (LC3B), an autophagy marker, has been used as a promising marker in various cancer types. However, the expression of LC3B in muscle-invasive bladder cancer (MIBC) and its prognostic significance have not been investigated. Recent studies pointed to the involvement of ESRRA in regulating autophagy via both transcriptional and post-translational control. In the current study, prognostic importance of LC3B and ESRRA in MIBC was investigated. PATIENTS AND METHODS We immunohistochemically studied the expression of LC3B and ESRRA in 56 MIBC samples. RESULTS LC3B was stained high in 16 patients (28.6%) and low or negative in 40 patients (71.4%). ESRRA expression was high for 20 patients (35.7%) and low for 36 patients (64.3%). Both LC3B (p=0.003) and ESRRA (p=0.026) expression correlated significantly with disease-free survival rates. Double-positive LC3B and ESRRA correlated with poor overall survival (p=0.007) and disease-free survival (p=0.001) in MIBC patients. CONCLUSION LC3B and ESRRA might be a useful prognostic factor in patients with MIBC. The co-expression of LC3B and ESRRA might be a prognostic and therapeutic target for patients with bladder cancer.
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Affiliation(s)
- Sup Kim
- Department of Pathology, Infection Control Convergence Research Center, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
- Department of Microbiology, Infection Control Convergence Research Center, Chungnam National University, Daejeon, Republic of Korea
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
- Department of Radiation Oncology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Adam Jaehyeok Lee
- Department of Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Min-Kyung Yeo
- Department of Pathology, Infection Control Convergence Research Center, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Yong Gil Na
- Department of Urology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Ji-Yeon Kim
- Department of Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Moon-June Cho
- Department of Radiation Oncology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jun-Sang Kim
- Department of Radiation Oncology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Eun-Kyeong Jo
- Department of Microbiology, Infection Control Convergence Research Center, Chungnam National University, Daejeon, Republic of Korea
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jin-Man Kim
- Department of Pathology, Infection Control Convergence Research Center, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
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22
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Loricera J, Hernández JL, García-Castaño A, Martínez-Rodríguez I, González-Gay MÁ, Blanco R. Subclinical aortitis after starting nivolumab in a patient with metastatic melanoma. A case of drug-associated aortitis? Clin Exp Rheumatol 2018; 36 Suppl 111:171. [PMID: 29799390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/11/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Javier Loricera
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain
| | - José Luis Hernández
- Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain
| | - Almudena García-Castaño
- Department of Oncology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain
| | - Isabel Martínez-Rodríguez
- Department of Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain
| | - Miguel Ángel González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
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23
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Spinelli M, Gillibrand R. Metastasis to gluteal muscle from high grade transitional cell carcinoma of bladder. Report of a case and review of literature. Pathologica 2018; 110:78-81. [PMID: 30259916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
High grade bladder malignancies have tendency to local and distant invasion. The most commonly involved sites are lymph nodes, lungs, bone and liver. Muscle metastases are generally rare and have been described in few cases of Genito-Urinary cancer. In this work we describe a rare case of high grade transitional cell carcinoma from bladder metastatising to the left gluteal muscle together with the review of the pertinent literature.
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Affiliation(s)
- M Spinelli
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
| | - R Gillibrand
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
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24
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Pretell-Mazzini J, de Neyra JZS, Luengo-Alonso G, Shemesh S. Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature. Arch Orthop Trauma Surg 2017; 137:1477-1489. [PMID: 28852837 DOI: 10.1007/s00402-017-2782-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 05/13/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION There is scarce information in the literature dealing with the clinical presentation, management and oncologic outcomes of skeletal muscle metastases (SMM). We sought to perform a systematic review of the literature to investigate: (1) tumor characteristics of SMM, (2) therapeutic approach, and (3) oncological outcomes. METHODS A systematic review of the literature was performed using PubMed and EMBASE search engines. A total of 3231 references were reviewed and 49 studies were included. Demographic data, presentation characteristics, and oncological outcomes were recorded. Statistical analysis was performed using SPSS 22.0 software (IBM; Armonk, New York) and Comprehensive Meta-Analysis software version 3 (Biostat, Inc.), with p < 0.05 as statistically significant. RESULTS A total of 231 patients were included. These tumors presented more commonly on males 58.4% (135/231), with a mean age of 60.08 ± 10.6 years, and in the axial area 39.6% (88/222). The most common carcinoma type was lung 41.1% (95/231). Resection of a single metastases did not change survival significantly (p = 0.992). LRR was higher within the group of patients that underwent WLE compared with non-WLE [31.3% (23/74) vs. 8.7% (2/23), p ≤ 0.001]. Kaplan-Meier survival analysis for the entire cohort showed an estimate of 15.3 months [95% confidence interval (CI) 11.6-19; standard error (SE) 0.432], with lung carcinoma carrying the worst prognosis 6.7 months (95% CI 5.4-8.07; SE 0.68). Patients with a single SMM showed a worse estimate mean survival time compared to patients with multiple metastases limited to muscles [8.6 months (95% CI 4.7-12.5; SE 2.0) vs 25.4 months (95% CI 19.8-31.05; SE 2.8; p ≤ 0.001)]. CONCLUSIONS Overall survival is poor and is driven mainly by the type of carcinoma. An Increased LRR might be present due to the systemic nature of the condition, and degree of control of the primary carcinoma.
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Affiliation(s)
- Juan Pretell-Mazzini
- Division of Musculoskeletal Oncology, Department of Orthopedics, Miller School of Medicine, University of Miami, 1400 NW 12th Avenue East Building, 4th Floor Suite 4036, Miami, FL, 33136, USA.
| | - Jaime Zorrilla S de Neyra
- PGY-4 Orthopedic Surgery, Department of Orthopaedic Surgery, 12 Octubre University Hospital, Madrid, Spain
| | - Gonzalo Luengo-Alonso
- PGY-3 Orthopedic Surgery, Department of Orthopaedic Surgery, 12 Octubre University Hospital, Madrid, Spain
| | - Shai Shemesh
- Division of Musculoskeletal Oncology, Department of Orthopedics, University of Miami, Miami, USA
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Kiyohara Y, Yoshikawa S, Otsuka M, Kondou R, Iizuka A, Nonomura C, Ohshima K, Urakami K, Kusuhara M, Nagashima T, Sugino T, Yamaguchi K, Akiyama Y. Melanoma patient response to nivolumab treatment for metastatic lung lesions: Multi-OMICS analysis in Project HOPE. J Dermatol 2017; 44:1156-1159. [PMID: 28452169 DOI: 10.1111/1346-8138.13879] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
Abstract
A 70-year-old woman was diagnosed with a malignant melanoma of the occipital skin which was resected; however, multiple lung metastases were detected. Nivolumab therapy was initiated and partial response was obtained. However, the patient was diagnosed with grade 2 interstitial pneumonitis. Prednisolone administration was initiated and the interstitial pneumonitis shadow disappeared. However, then a right rib metastasis was noticed and given radiation therapy. After progressive disease was obtained, the metastatic lesion was resected, and no relapse occurred until skeletal muscle metastasis was found. According to whole-exome sequencing and gene expression profiling, the rib and skeletal muscle metastatic lesions showed an upregulated expression of programmed death-ligand 1 mRNA and a high single-nucleotide variant (SNV) number. The current melanoma case is representative of a patient who responded to nivolumab therapy, and showed typical immunological markers for responders such as high PD-L1 expression and high SNV.
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MESH Headings
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antineoplastic Agents/therapeutic use
- B7-H1 Antigen/genetics
- B7-H1 Antigen/metabolism
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Bone Neoplasms/genetics
- Bone Neoplasms/secondary
- Bone Neoplasms/therapy
- Female
- Gene Expression Profiling/methods
- Glucocorticoids/therapeutic use
- Humans
- Lung/pathology
- Lung Diseases, Interstitial/diagnostic imaging
- Lung Diseases, Interstitial/drug therapy
- Lung Diseases, Interstitial/immunology
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Lung Neoplasms/secondary
- Melanoma/drug therapy
- Melanoma/pathology
- Muscle Neoplasms/genetics
- Muscle Neoplasms/secondary
- Muscle, Skeletal/pathology
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Nivolumab
- Polymorphism, Single Nucleotide
- Prednisolone/therapeutic use
- Programmed Cell Death 1 Receptor/antagonists & inhibitors
- Ribs/diagnostic imaging
- Ribs/pathology
- Sequence Analysis, DNA
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- Treatment Outcome
- Exome Sequencing
- Melanoma, Cutaneous Malignant
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Affiliation(s)
- Yoshio Kiyohara
- Division of Dermatology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Shusuke Yoshikawa
- Division of Dermatology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masaki Otsuka
- Division of Dermatology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Ryota Kondou
- Immunotherapy Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Akira Iizuka
- Immunotherapy Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Chizu Nonomura
- Immunotherapy Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Keiichi Ohshima
- Medical Genetics Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Kenichi Urakami
- Cancer Diagnostics Research Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masatoshi Kusuhara
- Regional Resources Division, Shizuoka Cancer Center Research Institute, Shizuoka, Japan
| | | | - Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Ken Yamaguchi
- Office of the President, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Yasuto Akiyama
- Immunotherapy Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan
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Greaves GH, Livingston K, Liu GT, Shindler KS, Volpe NJ, Pistilli M, Mehta S, Tamhankar MA. Orbital ultrasonography in the diagnosis of neoplastic extraocular muscle enlargement. Orbit 2017; 36:317-321. [PMID: 28704144 DOI: 10.1080/01676830.2017.1337173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 05/28/2017] [Indexed: 06/07/2023]
Abstract
Neoplastic infiltration of the extraocular muscle (EOM) is a rare condition which can pose a diagnostic dilemma due to its rarity and overlapping ultrasonographic features with orbital myositis. The ultrasonographic features of neoplastic enlargement of EOM have not been systematically studied and previously have been described in only a few case reports. Orbital ultrasonography, in conjunction with the pattern of ocular misalignment, was assessed for its potential role in identifying patients with neoplastic EOM enlargement. Retrospective chart review of patients with neoplasm and myositis. The clinical features of 8 patients with neoplastic infiltration of the EOM were compared to 15 patients with myositis. In the neoplastic group the width of the EOM was (10.5 mm) almost twice the normal width of the muscle with myositis (p < 0.001). All the muscles in the neoplastic category were low to medium reflective. Paretic deviation was seen in 4/8(50%), purely restrictive in 2/8 (25%) and combined pattern in 2/8 (25%) were noted. In the myositis group the average EOM enlargement was 5.8 mm and all muscles showed low reflectivity. Although ultrasonographic features overlapped between the 2 groups paretic deviations were more common in the neoplastic group versus the myositis group (50% versus 7%). Neoplastic muscle enlargement tends to be larger with paretic deviations of ocular motility seen clinically. These findings in a patient with EOM enlargement should raise the suspicion of neoplasm as the etiology and further work up should be considered.
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Affiliation(s)
- Giovanni H Greaves
- a Department of Ophthalmology , Northwell Health , Great Neck , New York , USA
| | - Kym Livingston
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
| | - Grant T Liu
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
- c Department of Neurology , University of Pennsylvania , Philadelphia , Pennsylvania , USA
| | - Kenneth S Shindler
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
- c Department of Neurology , University of Pennsylvania , Philadelphia , Pennsylvania , USA
| | - Nicholas J Volpe
- d Department of Ophthalmology , Feinberg School of Medicine , Chicago , Illinois , USA
| | - Maxwell Pistilli
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
| | - Sonul Mehta
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
| | - Madhura A Tamhankar
- b Department of Ophthalmology , Scheie Eye Institute , Philadelphia , Pennsylvania , USA
- c Department of Neurology , University of Pennsylvania , Philadelphia , Pennsylvania , USA
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Affiliation(s)
- Helena Temido
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Filipe Vilão
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Francisco Parente
- Serviço de Medicina Interna A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
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Khettab M, Barrascout E, Lamuraglia M. Sternocleidomastoid muscle metastasis of breast cancer: case report. EUR J GYNAECOL ONCOL 2017; 38:113-114. [PMID: 29767876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The authors report a case of 84-year-old women, with dysphagia to liquids and solid foods, and with infiltration of right stemocleidomastoid muscle that compressed the upper third of the esophagus to the thoracic hull. The biopsy of sternocleidomastoid muscle permitted the diagnosis of metastatic breast cancer relapse after 22 years.
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Albulescu DM, Ionovici N, Moldovan HR, Demetrian AD, Bălă VS, Constantin C, Bumbea AM, Pănuş C, Albu VC. Muscle metastases from cervical carcinoma - case report. Rom J Morphol Embryol 2017; 58:545-551. [PMID: 28730241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Muscular metastases are rarely found in medical practice, and the reported cases in literature are not numerous. The diagnosis of these lesions involves an interdisciplinary collaboration. We present a case of secondary determination in the psoas muscle, with a starting point of cervical squamous carcinoma. In establishing the diagnosis, there contributed the clinical, imagistic and magnetic resonance evaluation and computed tomography (CT), the histopathological diagnosis being determined after the CT-guided biopsy puncture.
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Affiliation(s)
- Dana Maria Albulescu
- Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania;
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Dirlik Serim B, Vatankulu B, Halaç M, Dikici S, Kantarcı F, Sönmezoğlu K. Metastatic epithelioid sarcoma revealed with 18F-FDG PET/CT imaging. Nuklearmedizin 2016; 55:N62-N63. [PMID: 27922155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/13/2016] [Indexed: 06/06/2023]
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31
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Narayan V, Mamtani R, Keefe S, Guzzo T, Malkowicz SB, Vaughn DJ. Cisplatin, Gemcitabine, and Lapatinib as Neoadjuvant Therapy for Muscle-Invasive Bladder Cancer. Cancer Res Treat 2016; 48:1084-91. [PMID: 26639198 PMCID: PMC4946374 DOI: 10.4143/crt.2015.405] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 11/09/2015] [Indexed: 01/19/2023] Open
Abstract
PURPOSE We sought to investigate the safety and efficacy of gemcitabine, cisplatin, and lapatinib (GCL) as neoadjuvant therapy in patients with muscle-invasive bladder cancer (MIBC) planned for radical cystectomy. MATERIALS AND METHODS Four cycles of GCL were administered as neoadjuvant therapy for patients with MIBC. Although initially designed as a phase II efficacy study with a primary endpoint of pathologic complete response at the time of radical cystectomy, the dose selected for investigation proved excessively toxic. A total of six patients were enrolled. RESULTS The initial four patients received gemcitabine 1,000 mg/m(2) intravenously on days 1 and 8 and cisplatin 70 mg/m(2) intravenously on day 1 of each 21-day treatment cycle. Lapatinib was administered as 1,000 mg orally daily starting one week prior to the initiation of cycle 1 of gemcitabine and cisplatin (GC) and continuing until the completion of cycle 4 of GC. These initial doses were poorly tolerated, and the final two enrolled patients received a reduced lapatinib dose of 750 mg orally daily. However, reduction of the lapatinib dose did not result in improved tolerance or drug-delivery, and the trial was terminated early due to excessive toxicity. Grade 3/4 toxicities included diarrhea (33%), nausea/vomiting (33%), and thrombocytopenia (33%). CONCLUSION The addition of lapatinib to GC as neoadjuvant therapy for MIBC was limited by excessive treatment-related toxicity. These findings highlight the importance of thorough dose-escalation investigation of combination therapies prior to evaluation in the neoadjuvant setting, as well as the limitations of determination of maximum tolerated dose for novel targeted combination regimens.
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Affiliation(s)
- Vivek Narayan
- Division of Medical Oncology, Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA, USA
| | - Ronac Mamtani
- Division of Medical Oncology, Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA, USA
| | - Stephen Keefe
- Division of Medical Oncology, Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA, USA
| | - Thomas Guzzo
- Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - S. Bruce Malkowicz
- Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Vaughn
- Division of Medical Oncology, Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA, USA
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Papanastasopoulos P, Annan B, Dalla Pria A, Bower M. HIV-related Kaposi's Sarcoma with Musculoskeletal Involvement in the Modern Antiretroviral Era. Anticancer Res 2016; 36:3465-3469. [PMID: 27354609] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/31/2016] [Indexed: 06/06/2023]
Abstract
AIM To describe the patterns of disease and clinical outcomes of MSK-KS in people living with HIV in the era of (combination anti-retroviral therapy cART). PATIENTS AND METHODS We reviewed our prospectively collected dataset of patients with HIV with biopsy-proven KS; 17 out of 1,489 seropositive patients were identified with subsequent evidence of MSK involvement by KS. We collected data with regards to clinicopathological parameters and radiological patterns of disease. RESULTS Fourteen patients (82.4%) had AIDS Clinical Trials Group T1 stage disease at presentation including four (23.5%) with non-nodal visceral disease. At the time of MSK-KS diagnosis, more than 80% of 14 patients had excellent HIV control. The median interval between initial KS to MSK-KS diagnosis was 3.3 years. Five-year overall survival rate from initial KS diagnosis was 76%, and 60% from MSK-KS diagnosis. The majority of patients were asymptomatic and MSK-KS involvement was demonstrated during imaging prompted by progression of their mucocutaneous KS. The majority of lesions were lytic with cortical involvement on cross-sectional imaging, whereas a soft-tissue component was commonly associated with long-bone involvement. CONCLUSION MSK-KS continues to be a rare entity in the modern era of cART, however patients appear to experience significantly improved survival.
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Affiliation(s)
| | - Bertrand Annan
- Department of Oncology, Chelsea & Westminster Hospital, London, U.K
| | | | - Mark Bower
- Department of Oncology, Chelsea & Westminster Hospital, London, U.K.
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Kassi ABF, Beuvon F, Costi R, Massault PP, Dousset B. [Parietal seeding of HCC after percutaneous radiofrequency thermal ablation]. Rev Med Brux 2016; 37:114-115. [PMID: 27487698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
We present the clinical findings, diagnosis and treatment of an 11-year old intact male Fox Terrier with a malignant Leydig cell tumor of the right testicle, which metastasized to the skeletal musculature of the left hind limb. The primary tumor and the metastasis were resected with narrow margins. The dog was treated with metronomic chemotherapy using thalidomid and dyclophosphamide. Local recurrence at the site of the metastasis and a pulmonary metastasis were present 30 months after surgery. The dog was euthanized.
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Meneses-Medina M, Ceja-Bojorge AC, Perochena-Gonzalez A, Urbina-Ramírez S, de Anda-Gonzalez J, Bourlon MT. Man With Recurring Chordoma and Progressive Disease Despite Radiotherapy and Radical Resection. Oncology (Williston Park) 2016; 30:180-186. [PMID: 26892155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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36
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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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37
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Li ZG, Lin ZC, Mu HY. Polysplenia Syndrome With Splenic and Skeletal Muscle Metastases From Thyroid Carcinoma Evaluated by FDG PET/CT: Case Report and Literature Review: A Care-Compliant Article. Medicine (Baltimore) 2016; 95:e2532. [PMID: 26825891 PMCID: PMC5291561 DOI: 10.1097/md.0000000000002532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Polysplenia syndrome (PSS) is a rare congenital abnormality. Metastases to spleen and skeletal muscle from differentiated thyroid cancer (DTC) are also extremely rare. Our case report aims to present an interesting case of PSS associated with splenic metastasis (SM) and skeletal muscle metastasis (SMM) from advanced papillary thyroid carcinoma which was evaluated on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). An 84-year-old Chinese man was admitted with the history of multiple enlarged masses in bilateral neck, right axillary, and inguinal areas for >2 months. The results of ultrasonography examination were highly suggestive of malignancy. The histological results of the following biopsy were consistent with papillary thyroid carcinoma with involvement of multiple regional lymph nodes. He was referred for an FDG PET/CT imaging to evaluate the situation. FDG PET/CT showed that an intense FDG-avid thyroid mass with widespread regional lymph node involvement and distant metastases in the body. Unexpected sites of metastases were detected in the spleens and skeletal muscles. Most interestingly, FDG PET/CT imaging also described the typical imaging findings of PSS including the 2 right-sided spleens, azygos and hemiazygos continuation of inferior vena cava (IVC), right-sided stomach, middle line liver, a short pancreas, preduodenal portal vein (PPV), and malrotation of gut. Whole body FDG PET/CT imaging can accurately evaluate the situation of DTC by detecting regional lymph node involvement, common and rare sites of distant metastases which are closely related to staging, management, and prognosis of this disease. Whole-body FDG PET/CT is also valuable in demonstrating the typical imaging features of PSS.
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Affiliation(s)
- Zu-Gui Li
- From the Department of Nuclear Medicine (Z-GL, Z-CL); and Department of Oncology (H-YM), Pingjin Hospital, Logistics University of Chinese People's Armed Police Force, Tianjin, People's Republic of China
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McGarry JG, Redmond M, Tuffy JB, Wilson L, Looby S. Metastatic pleomorphic adenoma to the supraspinatus muscle: a case report and review of a rare aggressive clinical entity. J Radiol Case Rep 2015; 9:1-8. [PMID: 26629288 DOI: 10.3941/jrcr.v9i10.2283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
We report a case of a 65-year-old female with a recurrent right parotid pleomorphic adenoma (PA) 24 years after initial surgical excision. Positron-emission tomography (PET) and computed tomography (CT) demonstrated an unusual suspicious FDG-avid erosive rim enhancing mass centered in the right supraspinatus muscle. Cytology from CT-guided aspiration of the mass was consistent with a histologically benign PA, and the patient was diagnosed with metastatic pleomorphic adenoma (MPA). The patient later developed diffuse pulmonary metastases and died within 3 months. MPA, although rare, is recognised as a potentially lethal malignant complication of recurrent or longstanding benign PA. As no biochemical or genetic parameters are predictive of malignant change, patients presenting with recurrent PA should be considered for screening for metastatic disease.
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Affiliation(s)
| | - Maeve Redmond
- Department of Pathology, Beaumont Hospital, Dublin, Ireland
| | - John B Tuffy
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Lorraine Wilson
- Blackrock Clinic Nuclear Medicine PET CT centre, Blackrock, Co. Dublin, Ireland
| | - Seamus Looby
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
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Nagai T, Oshiro H, Sagawa Y, Sakamaki K, Terauchi F, Nagao T. Pathological Characterization of Ovarian Cancer Patients Who Underwent Debulking Surgery in Combination With Diaphragmatic Surgery: A Cross-Sectional Study. Medicine (Baltimore) 2015; 94:e2296. [PMID: 26683966 PMCID: PMC5058938 DOI: 10.1097/md.0000000000002296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Despite exhaustive efforts to detect early-stage ovarian cancers, greater than two-thirds of patients are diagnosed at an advanced stage. Although diaphragmatic metastasis is not rare in advanced ovarian cancer patients and often precludes optimal cytoreductive surgery, little is known about the mechanisms and predictive factors of metastasis to the diaphragm. Thus, as an initial step toward investigating such factors, the present study was conducted to characterize the pathological status of ovarian cancer patients who underwent debulking surgery in combination with diaphragmatic surgery. This is a retrospective and cross-sectional study of patients who underwent debulking surgery in combination with diaphragmatic surgery at our institution between January 2005 and July 2015. Clinicopathological data were reviewed by board-certified gynecologists, pathologists, and cytopathologists. The rates of various pathological findings were investigated and compared by Fisher exact test between 2 groups: 1 group that was pathologically positive for diaphragmatic metastasis (group A) and another group that was pathologically negative for diaphragmatic metastasis (group B). Forty-six patients were included: 41 patients pathologically positive and 5 pathologically negative for diaphragmatic metastasis. The rates of metastasis to the lymph node (95.8% vs 20%, P = 0.001) and metastasis to the peritoneum except for the diaphragm (97.6% vs 60.0%, P = 0.028) were significantly increased in group A compared with group B. However, no significant differences between the 2 groups were found for rates of histological subtypes (high-grade serous or non-high-grade serous), the presence of ascites, the presence of malignant ascites, exposure of cancer cells on the ovarian surface, blood vascular invasion in the primary lesion, and lymphovascular invasion in the primary lesion. Our study demonstrated that metastasis to the lymph node and nondiaphragmatic metastasis to the peritoneum are significantly associated with metastasis to the diaphragmatic peritoneum, indicating that these factors may be pathological predictors of diaphragmatic metastasis in patients with ovarian cancer. However, as the data available are not sufficient to demonstrate the predictive power of these factors, a further comprehensive, large-scale study should be performed.
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Affiliation(s)
- Takeshi Nagai
- From the Department of Anatomic Pathology (TN, HO, TN); Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo (YS, FT); Department of Biostatics and Epidemiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan (KS)
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Yi C, Liu Z, Chu Y, Li S, Liu L, Li J, Yu X. Ileocecal adenocarcinoma with overexpression of P53 protein metastasized to the thenar muscle: report of a rare case and review of literature. Int J Clin Exp Pathol 2015; 8:13546-13551. [PMID: 26722571 PMCID: PMC4680516] [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] [Received: 08/30/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
Metastatic malignancies of the hand are rare and metastases to the skeletal muscle from the gastrointestinal system are even much rare. Here we present a case of metastatic ileocecal adenocarcinoma to the thenar muscle, which is the first report of thenar muscle metastasis from ileocecal adenocarcinoma with P53 mutation. To date, only two other cases of thenar muscle metastasis have been documented, one is from squamous cell carcinoma of the lung and the other is from rectal carcinoma. The present 67-year-old Chinese man of poorly differentiated adenocarcinoma of the ileocecal region developed metastatic carcinoma in the right thenar eminence, which presented with swelling and pain. Magnetic resonance imaging of the right hand revealed a well-defined enhanced mass in the right thenar muscle. It was proved to be metastatic adenocarcinoma using core needle biopsy, which was supported to be gastrointestinal origination by positive immunoreaction with CDX2. Positive immunoreaction with P53 protein indicated the poor prognosis of the patient. Further systemic evaluation including computerized tomography scans revealed extensive metastases to liver, right kidney, right abdominal wall, left axillary and right subclavicular lymph nodes, and skin of the right thigh. Treatment was given with palliative systemic chemotherapy. After 8 cycles of chemotherapy, the swelling and pain of the right thenar were ameliorated, and the patient regained full use of his right hand and his quality of life was improved. The patient died of liver metastasis 9 months after the diagnosis of the right thenar metastasis. In conclusion, here we display a case of thenar skeletal muscle metastasis from P53 mutated ileocecal adenocarcinoma, who survived 9 months after diagnosis of the rare metastasis. If an oncological patient presents an intramuscular mass, muscle metastasis must be included in the differential diagnosis. Metastatic hand tumors generally indicate systemic spread, so the treatment is usually palliative and the prognosis is poor. The primary objective of treatment is improvement of the patient's quality of life.
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Affiliation(s)
- Cuihua Yi
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
| | - Zhiyan Liu
- Department of Pathology and Pathophysiology, School of Medicine, Shandong UniversityJinan 250012, PR China
| | - Yunxia Chu
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
| | - Shuguang Li
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
| | - Lian Liu
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
| | - Jisheng Li
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
| | - Xuejun Yu
- Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong UniversityJinan 250012, PR China
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Reynolds JK, Cofer JB. An Unusual Case of Metastatic Basal Cell Carcinoma from the Upper Extremity. Am Surg 2015; 81:e334-e335. [PMID: 26350650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Jessica K Reynolds
- Department of Surgery, University of Tennessee College of Medicine, Chattanooga, Tennessee, USA
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Portela RA, Choby GW, Manni A, Campbell D, Crist H, Goldenberg D. Unusual sites of metastasis of papillary thyroid cancer: Case series and review of the literature. Ear Nose Throat J 2015; 94:E43-E47. [PMID: 26322457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Papillary thyroid cancer (PTC) is the most common malignancy of the thyroid gland. It typically spreads via lymphatic extension. The rate of regional PTC metastasis to the neck is relatively high, while metastases outside the deep cervical chain are rare. Distant metastases are found in only 1% of patients with PTC at the time of surgery; the two most common sites are the lung and bone. We report 4 cases of PTC metastasis to unusual sites: (1) the occipital skull and internal jugular vein, (2) the parapharyngeal space, (3) the sternocleidomastoid muscle, and (4) the right atrium of the heart. It has been well documented that aggressive distant metastasis is a characteristic of PTC, and it is known to be an indicator of a poor prognosis. Some of our patients' sites of metastatic disease have not been previously reported. Patients in this series exhibited aggressive histologic findings, including columnar cell and follicular variants of papillary disease. In addition, all 4 patients demonstrated "PET-avid" disease with decreased iodine avidity.
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Baras AS, Gandhi N, Munari E, Faraj S, Shultz L, Marchionni L, Schoenberg M, Hahn N, Hoque M, Berman D, Bivalacqua TJ, Netto G. Identification and Validation of Protein Biomarkers of Response to Neoadjuvant Platinum Chemotherapy in Muscle Invasive Urothelial Carcinoma. PLoS One 2015; 10:e0131245. [PMID: 26230923 PMCID: PMC4521868 DOI: 10.1371/journal.pone.0131245] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/08/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The 5-year cancer specific survival (CSS) for patients with muscle invasive urothelial carcinoma of the bladder (MIBC) treated with cystectomy alone is approximately 50%. Platinum based neoadjuvant chemotherapy (NAC) plus cystectomy results in a marginal 5-10% increase in 5-year CSS in MIBC. Interestingly, responders to NAC (<ypT2) have a 5-year CSS of 90% which is in stark contrast to the 30-40% CSS for those whose MIBC is resistance to NAC. While the implementation of NAC for MIBC is increasing, it is still not widely utilized due to concerns related to delay of cystectomy, potential side-effects, and inability to predict effectiveness. Recently suggested molecular signatures of chemoresponsiveness, which could prove useful in this setting, would be of considerable utility but are yet to be translated into clinical practice. METHODS mRNA expression data from a prior report on a NAC-treated MIBC cohort were re-analyzed in conjunction with the antibody database of the Human Protein Atlas (HPA) to identify candidate protein based biomarkers detectable by immunohistochemistry (IHC). These candidate biomarkers were subsequently tested in tissue microarrays derived from an independent cohort of NAC naive MIBC biopsy specimens from whom the patients were treated with neoadjuvant gemcitabine cisplatin NAC and subsequent cystectomy. The clinical parameters that have been previously associated with NAC response were also examined in our cohort. RESULTS Our analyses of the available mRNA gene expression data in a discovery cohort (n = 33) and the HPA resulted in 8 candidate protein biomarkers. The combination of GDPD3 and SPRED1 resulted in a multivariate classification tree that was significantly associated with NAC response status (Goodman-Kruskal γ = 0.85 p<0.0001) in our independent NAC treated MIBC cohort. This model was independent of the clinical factors of age and clinical tumor stage, which have been previously associated with NAC response by our group. The combination of both these protein biomarkers detected by IHC in biopsy specimens along with the relevant clinical parameters resulted in a prediction model able to significantly stratify the likelihood of NAC resistance in our cohort (n = 37) into two well separated halves: low-26% n = 19 and high-89% n = 18, Fisher's exact p = 0.0002). CONCLUSION We illustrate the feasibility of translating a gene expression signature of NAC response from a discovery cohort into immunohistochemical markers readily applicable to MIBC biopsy specimens in our independent cohort. The results from this study are being characterized in additional validation cohorts. Additionally, we anticipate that emerging somatic mutations in MIBC will also be important for NAC response prediction. The relationship of the findings in this study to the current understanding of variant histologic subtypes of MIBC along with the evolving molecular subtypes of MIBC as it relates to NAC response remains to be fully characterized.
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Affiliation(s)
- Alexander S. Baras
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- * E-mail: (AB); (GN)
| | - Nilay Gandhi
- Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Enrico Munari
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Sheila Faraj
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Luciana Shultz
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Luigi Marchionni
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Mark Schoenberg
- Department of Urology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Noah Hahn
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Mohammad Hoque
- Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - David Berman
- Department of Pathology, Queen's University, Kingston, Ontario, Canada
| | - Trinity J. Bivalacqua
- Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - George Netto
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Department of Urology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- * E-mail: (AB); (GN)
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Jin SS, Jeong HS, Noh HJ, Choi WH, Choi SH, Won KY, Kim DP, Park JC, Joung MK, Kim JG, Sul HJ, Lee SW. Gastrointestinal stromal tumor solitary distant recurrence in the left brachialis muscle. World J Gastroenterol 2015; 21:6404-6408. [PMID: 26034378 PMCID: PMC4445120 DOI: 10.3748/wjg.v21.i20.6404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/14/2015] [Accepted: 03/27/2015] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract that are most commonly found in the stomach. Although GISTs can spread to the liver and peritoneum, metastasis to the skeletal muscle is very rare and only four cases have previously been reported. These cases involved concurrent skeletal metastases of primary GISTs or liver metastases. Here, we report the first case of a distant recurrence in the brachialis muscle after complete remission of an extra-luminal gastric GIST following a wedge resection of the stomach, omental excision, and adjuvant imatinib therapy for one year. Ten months after therapy completion, the patient presented with swelling and tenderness in the left arm. Magnetic resonance imaging revealed a large mass in the brachialis muscle, which showed positivity for c-kit and CD34 upon pathologic examination. This is the first reported case of a solitary distant recurrence of a GIST in the muscle after complete remission had been achieved.
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Abstract
Metaplastic breast carcinoma (MBC) is a rare type of breast carcinoma. Recurrence presenting as chest wall invasion is common but rarely as metastasis to distal skeletal muscle in which most patients present with a painful mass. Herein, we report a rare case of 65-year-old woman, with MBC and recurrence presenting as distal multiple muscle metastasis. The patient received surgical excision for symptomatic relief. Unfortunately, she died 12 months postoperatively due to disease progression with multiple lung metastasis.In addition to radiotherapy and chemotherapy, surgical excision is an alternative option in selected patients such as those with painful, isolated, and easily approachable mass.
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Affiliation(s)
- Chung Hsiung Liu
- From the Department of Surgery (CHL); Department of Pathology (CC); Department of Pediatric Surgery (ES), National Cheng Kung University Hospital, Tainan; Endoscopic and Oncoplastic Breast Surgery Center (H-WL), Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua; and Department of Surgery (Y-LK), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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46
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Lee J, Lee SW, Han SY, Baek YH, Kim SY, Rhyou HI. Rapidly aggravated skeletal muscle metastases from an intrahepatic cholangiocarcinoma. World J Gastroenterol 2015; 21:1989-1993. [PMID: 25684968 PMCID: PMC4323479 DOI: 10.3748/wjg.v21.i6.1989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/11/2014] [Accepted: 10/15/2014] [Indexed: 02/06/2023] Open
Abstract
We present a rare case of intrahepatic cholangiocarcinoma (ICC) with multiple skeletal muscle metastases. The patient was a 55-year-old Asian woman presenting with abdominal pain; abdominal and pelvic computed tomography and magnetic resonance cholangiopancreatography revealed an unresectable ICC with hepatic metastasis and metastastatic lymphadenopathy in the porto-caval area. After 3 mo of treatment with palliative radiotherapy and chemotherapy, magnetic resonance imaging of the thoracolumbar spine detected right psoas muscle and paraspinous muscle metastases. We performed an ultrasound-guided percutaneous fine-needle biopsy that confirmed a similar pattern of poorly differentiated adenocarcinoma. The patient treated with palliative chemotherapy and achieved 10 mo of survival. Here we report the first case quickly spread to multiple sites of muscle even though the three-month treatment, compare to the other cases reported muscle metastases at diagnosis.
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47
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Tchatalbachev VV, Kirkpatrick DL, Duff DJ, Travis MD. Seeding of the rectus sheath with hepatocellular carcinoma after image guided percutaneous liver biopsy using coaxial biopsy needle system. J Radiol Case Rep 2015; 9:18-25. [PMID: 25926917 DOI: 10.3941/jrcr.v9i1.1887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Needle track seeding following image guided needle biopsy is a known but uncommon complication in the workup of hepatocellular carcinoma. We present the case of a 55 year-old male who was found to have a recurrent hepatocellular carcinoma in the rectus sheath five years following a CT guided biopsy with the biopsy needle passing through the anterior abdominal wall muscles.
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Affiliation(s)
| | | | - Deiter J Duff
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA
| | - Mark D Travis
- Department of Radiology, University of Missouri, Columbia, Missouri, USA
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Bhat A, Heinzel A, Mayer B, Perco P, Mühlberger I, Husi H, Merseburger AS, Zoidakis J, Vlahou A, Schanstra JP, Mischak H, Jankowski V. Protein interactome of muscle invasive bladder cancer. PLoS One 2015; 10:e0116404. [PMID: 25569276 PMCID: PMC4287622 DOI: 10.1371/journal.pone.0116404] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 12/09/2014] [Indexed: 12/31/2022] Open
Abstract
Muscle invasive bladder carcinoma is a complex, multifactorial disease caused by disruptions and alterations of several molecular pathways that result in heterogeneous phenotypes and variable disease outcome. Combining this disparate knowledge may offer insights for deciphering relevant molecular processes regarding targeted therapeutic approaches guided by molecular signatures allowing improved phenotype profiling. The aim of the study is to characterize muscle invasive bladder carcinoma on a molecular level by incorporating scientific literature screening and signatures from omics profiling. Public domain omics signatures together with molecular features associated with muscle invasive bladder cancer were derived from literature mining to provide 286 unique protein-coding genes. These were integrated in a protein-interaction network to obtain a molecular functional map of the phenotype. This feature map educated on three novel disease-associated pathways with plausible involvement in bladder cancer, namely Regulation of actin cytoskeleton, Neurotrophin signalling pathway and Endocytosis. Systematic integration approaches allow to study the molecular context of individual features reported as associated with a clinical phenotype and could potentially help to improve the molecular mechanistic description of the disorder.
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Affiliation(s)
- Akshay Bhat
- Charité-Universitätsmedizin Berlin, Med. Klinik IV, Berlin, Germany
- Mosaiques diagnostics GmbH, Hannover, Germany
| | | | - Bernd Mayer
- emergentec biodevelopment GmbH, Vienna, Austria
| | - Paul Perco
- emergentec biodevelopment GmbH, Vienna, Austria
| | | | - Holger Husi
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Axel S. Merseburger
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Jerome Zoidakis
- Biomedical Research Foundation Academy of Athens, Biotechnology Division, Athens, Greece
| | - Antonia Vlahou
- Biomedical Research Foundation Academy of Athens, Biotechnology Division, Athens, Greece
| | - Joost P. Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Cardiovascular and Metabolic Diseases, Toulouse, France
- Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Harald Mischak
- Mosaiques diagnostics GmbH, Hannover, Germany
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Vera Jankowski
- Institute for Molecular Cardiovascular Research (IMCAR), Aachen, Germany
- * E-mail:
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Oldani A, Gentilli S, Monni M, Bellora P, Grossi G, Casadio C, Garavoglia M. A typical behaviour of thymic carcinoma. Ann Ital Chir 2014; 85:S2239253X14023214. [PMID: 25425601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To describe the case of a thymic carcinoma with atypical clinical behavior that has arisen with a voluminous metastasis at the right hemidiaphragm while the primitive thymic neoplasm was initially occult. CASE REPORT A 42 years female patient came to clinical observation for a voluminous thoraco-abdominal mass located in right side, infiltrating the diaphragm. The patient was submitted to surgical excision of the mass; definitive histological examination: non-keratinizing spinocellular carcinoma suggestive for neoplasia on ectopic thymic tissue or metastasis from carcinoma of the thymus. Three 3 months after surgery MR and CT-scan restaging identified the presence of anterior mediastinal mass of about 3 cm of diameter, compatible with thymical origin; thymectomy was performed (histology: Lymphoepithelial thymoma). Eight months after the first surgical procedure a restaging by CT, MR and PET CT showed the presence of disease recurrence at the right diaphragmatic level. The patient underwent surgical exploration, with right thoracotomic approach: a metastasis in the hepatic segment VII was found and radically removed. Six months after liver metastasis resection, CT scan showed disease progression in mediastinum, with involvement of pericardium and aorta; the patient died for disease recurrence five months later, 22 months after the first surgical procedure. CONCLUSION Thymic neoplasms are the most common tumors of the mediastinum; a small percentage of these tumors are however extremely aggressive carcinomas. Rare but not exceptional findings are also cancers arising from ectopic thymic tissue.
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50
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Hong S, Li L, Liu X, Tu C. Neuroendocrine carcinoma of the larynx with subcutaneous and intramuscular metastases: a case report. Int J Clin Exp Pathol 2014; 7:8217-8222. [PMID: 25550875 PMCID: PMC4270572] [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] [Received: 09/24/2014] [Accepted: 11/08/2014] [Indexed: 06/04/2023]
Abstract
Neuroendocrine carcinomas have become increasingly recognized as more reports are emerging to describe these rare tumors. Primary sites include the lung, liver, throat, and other organs. Laryngeal neuroendocrine carcinomas are relatively rare, and the subtypes as well as the prognoses are quite different in most cases. Metastases to the liver, lungs and other parts are common. However, metastases to subcutaneous tissues or muscles have been rarely reported. We report a case of a neuroendocrine carcinoma of the larynx with subcutaneous and muscle metastases.
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Affiliation(s)
- Song Hong
- Department of Orthopaedic Surgery, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan, China
- Department of Orthopaedic Surgery, The Affiliated Hospital, Zunyi Medical College149 Dalian Road, Zunyi 563003, Guizhou, China
| | - Lin Li
- Department of Pathology, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan, China
| | - Xiwei Liu
- Department of Orthopaedic Surgery, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan, China
| | - Chongqi Tu
- Department of Orthopaedic Surgery, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan, China
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