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Abstract
The relapses of rectal cancer are most frequently localized in the pelvis, liver, and pelvic and para-aortic lymph nodes and lungs, whereas the vagina is an unusual site. We present here a 60-year-old woman presenting with lower abdominal discomfort 23 months after radical resection of rectal adenocarcinoma. An isolated, solitary, hypermetabolic mass in the right part of the vagina was detected by F-FDG PET/CT. Ultimately, the vaginal neoplasm was proved to be adenocarcinoma of rectal origin based on its shared histologic features and compatible immunostaining profile.
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Turan T, Aykan B, Koc S, Boran N, Tulunay G, Karacay O, Erdogan Z, Kose F. Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites. TUMORI JOURNAL 2019; 92:491-5. [PMID: 17260489 DOI: 10.1177/030089160609200605] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.
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Affiliation(s)
- Taner Turan
- Gynecologic Oncology Division, Ankara Etlik Maternity and Women's Health Teaching Hospital, Ankara, Turkey.
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54
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Tian W, Zhou Y, Wu M, Yao Y, Deng Y. Ovarian metastasis from breast cancer: a comprehensive review. Clin Transl Oncol 2018; 21:819-827. [DOI: 10.1007/s12094-018-02007-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022]
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55
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56
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57
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Briki R, Cherif O, Bannour B, Hidar S, Boughizane S, Khairi H. Uncommon metastases of invasive lobular breast cancer to the endometrium: a report of two cases and review of the literature. Pan Afr Med J 2018; 30:268. [PMID: 30637053 PMCID: PMC6317397 DOI: 10.11604/pamj.2018.30.268.16208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/03/2018] [Indexed: 11/11/2022] Open
Abstract
Although it is known that breast cancer can metastasize to many organ sites, metastasis to the uterus is uncommon and usually occurs during widespread metastatic disease. Lobular carcinoma is not the most common histological subtypes of breast carcinoma, but it is the most frequent histologic type that causes gastrointestinal, gynecological and peritoneal metastases. The main symptoms of the uterine metastasis depend on the anatomic involvement site. Abnormal uterine bleeding is by far the most important symptom.We highlight the importance of the follow up of patient with breast cancer. A rapid endometrial sampling for confirmation of the diagnosis, should be performed when the routine gynecological follow-up revealed any abnormality. We report two original observations of endometrium metastases of invasive lobular carcinoma of the breast which we detected during follow-up.
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Affiliation(s)
- Raja Briki
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
| | - Ons Cherif
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
| | - Badra Bannour
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
| | - Samir Hidar
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
| | - Sassi Boughizane
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
| | - Hedi Khairi
- Department of Gynecology and Obstetrics, Farhat Hached's University Hospital, Sousse, Tunisia
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58
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Thouvenot A, Bizet Y, Baccar LS, Lamuraglia M. Primary breast cancer relapse as metastasis to the cervix uteri: A case report. Mol Clin Oncol 2018; 9:96-97. [PMID: 29896404 DOI: 10.3892/mco.2018.1627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/14/2018] [Indexed: 11/05/2022] Open
Abstract
Metastasis of non-gynaecological tumours to the cervix is a rare event, and metastasis from breast cancer is even rarer, with only a limited number of such cases reported in the literature to date. We herein report the case of an 86-year-old female patient who had undergone mastectomy and axillary lymphadenectomy for invasive ductal cell breast carcinoma 2 years prior, followed by adjuvant hormonal therapy with letrozole. During hospitalization for anemia associated with an inflammatory syndrome and abdominal pain with menorrhagia, an abdominal ultrasound examination revealed a suspicious uterine mass with irregular contours and abnormal vascularization with associated increase of the blood level of cancer antigen 15-3 to 34 kU/l. The histological and immunohistochemical analysis of a cervical biopsy sample discover a secondary lesion metastatic from the primary ductal cell breast carcinoma. The metastatic tissue was hormone-negative, which was compatible with disease progression during hormonal therapy. Considering the multiple metastasis, comorbidities, unfavourable performance status and the quick deterioration of the patient's clinical condition, only best supportive care was administered.
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Affiliation(s)
- Aude Thouvenot
- Geriatric Unit, AP-HP, Louis Mourier Hospital, 92700 Colombes, France
| | - Yasmine Bizet
- Geriatric Unit, AP-HP, Louis Mourier Hospital, 92700 Colombes, France
| | - Laurent S Baccar
- Radiology Department, AP-HP, Louis Mourier Hospital, 92700 Colombes, France
| | - Michele Lamuraglia
- Oncology Unit, AP-HP - Hospital Beaujon, 92110 Clichy, France.,Biomedical Imaging Laboratory (LIB), AP-HP - Hospital Beaujon, University of Sorbonne, CNRS, INSERM, 75006 Paris, France
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Rahmani M, Nili F, Tabibian E. Endometrial Metastasis from Ductal Breast Carcinoma: A Case Report with Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:494-499. [PMID: 29700276 PMCID: PMC5944400 DOI: 10.12659/ajcr.907638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patient: Female, 51 Final Diagnosis: Endometrial metastasis from ductal breast carcinonoma Symptoms: Abnormal uterine bleeding • menorrhagia Medication: — Clinical Procedure: Dilatation and curettage (D&C) • tissue diagnosis of the endometrium Specialty: Obstetrics and Gynecology
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Affiliation(s)
- Maryam Rahmani
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Nili
- Department of Pathology, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Elnaz Tabibian
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
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La Fianza A, Alberici E, Pistorio A, Generoso P. Differential Diagnosis of Krukenberg Tumors Using Multivariate Analysis. TUMORI JOURNAL 2018; 88:284-7. [PMID: 12400978 DOI: 10.1177/030089160208800408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background Krukenberg tumors are ovarian metastases from a gastroenteric malignancy in 90% of cases. At present, diagnostic imaging techniques (US, CT, MRI) do not provide any reliable diagnostic criteria to differentiate these metastases from ovarian primaries. We tried to use multivariate analysis to distinguish malignant ovarian primaries from Krukenberg tumors based on their differential natural history. Patients and Methods We retrospectively compared the CT findings of Krukenberg tumors (47 patients, 79 masses, only from gastroenteric malignancy) with CT findings of primary epithelial ovarian cancers (46 patients, 67 masses). We compared the same independent variables in the two groups: age, morphology, margins, carcinomatosis, bilateral versus unilateral involvement, ascites, lymph node involvement, metastases on the basis of multivariate analysis. Results According to the best fitted model, clear-cut margins (OR: 3.75; 95% Cl: 1.14-9.72) and the presence of carcinomatosis (OR: 4.21; 95% Cl: 1.51-11.72) were the strongest predictors of a diagnosis of Krukenberg tumor. In contrast, the presence of ascites was more likely to be a protective factor (OR: 0.22; 95% Cl: 0.08-0.62). Conclusions We can try to make a differential diagnosis between a metastatic lesion from the gastroenteric tract and a primary adnexal lesion based on the multivariate statistical analysis of intraperitoneal spread of the different types of cancer rather than on morphologic findings at CT.
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Affiliation(s)
- Alfredo La Fianza
- Department of Radiology, University of Pavia, IRCCS Policlinico S Matteo, Italy.
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61
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Olesinski T. Surgical treatment of gastric carcinoma with ovarian metastases. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2018. [DOI: 10.1515/cipms-2017-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Ovarian metastases from extragenital neoplasms are rare. The prevalent sites of the primary tumors were the breast, colorectum and the stomach. The Krukenberg tumor (KT) is defined as a gastrointestinal cancer which metastasized to the ovaries. Metastasis to the ovary may appear at the time of diagnosis of the primary tumor (synchronous) or during observation (metachronous). Common clinical presentations are abdominal distention, pain, palpable mass, bloating, ascites or pain during sexual intercourse. Diagnosis can be made by ultrasound examinations, CT or EMR scans, laparotomy and/or a biopsy of the ovary. The current standard treatment for patients with metastatic gastric cancer is systemic chemotherapy, however, treatment strategy for KTs from gastric cancer has not been clearly established and surgical treatment is considered mainly for metachronous tumors. The prognosis of patients with ovarian metastasis of gastric cancer origin is poorer compared with that of other primary tumors. Although the results of cytoreductive surgery – especially in combination with modern chemotherapy – seems to be promising, the optimal therapeutic strategies for such patients requires further prospective studies.
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Affiliation(s)
- Tomasz Olesinski
- Maria Sklodowska-Curie Institute – Oncology Center , W. K. Roentgena 5, 02-781 Warsaw , Poland
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62
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Tang TY, Wang TY. A vulvar mass as the first presentation in colorectal carcinoma: An unusual site of metastasis masquerading a primary cancer. Taiwan J Obstet Gynecol 2018; 57:157-160. [PMID: 29458890 DOI: 10.1016/j.tjog.2017.12.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To demonstrate a case with a vulvar metastasis masquerading a primary vulvar malignancy. The clinical and histological features, mechanism, and impact to the prognosis are discussed. CASE REPORT A 58-year-old woman presented to gynecologist for abnormal vaginal discharge. A vulvar nodule was noticed during physical examination. Biopsy showed adenocarcinoma (ADC) and she was referred for further survey under the impression of Bartholin duct ADC. Later she was further found to also have a colorectal tumor with liver metastasis and subsequently received surgery under the suspicion of a double primary cancer involving the colon and vulva. The pathology revealed colorectal ADC with both hepatic and vulvar metastasis. CONCLUSION Secondary tumor in female genital tract is unusual and vulvar metastasis is the rarest kind. The clinical manifestation may be perplexing especially if a patient is presented with a nonspecific gynecological symptom such as abnormal vaginal discharge without any past history.
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Affiliation(s)
- Tzu-Yin Tang
- Department of Pathology, MacKay Medical College, MacKay Memorial Hospital, No.45, Minsheng Rd., Tamsui District, 25160, New Taipei City, Taiwan.
| | - Tao-Yeuan Wang
- Department of Pathology, MacKay Medical College, MacKay Memorial Hospital, No.45, Minsheng Rd., Tamsui District, 25160, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan.
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63
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Reynolds L, Kenny S, Crozier-Shaw G, Connolly C, Joyce WP. Uterine colorectal metastatic disease: a rare occurrence. ANZ J Surg 2018; 89:963-964. [PMID: 29415367 DOI: 10.1111/ans.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Reynolds
- Department of Surgery, Galway Clinic, Doughiska, Ireland
| | - Sarah Kenny
- Department of Surgery, Galway Clinic, Doughiska, Ireland
| | | | | | - William P Joyce
- Department of Surgery, Galway Clinic, Doughiska, Ireland.,Royal College of Surgeons Ireland, Dublin, Ireland
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Abstract
Mucinous tumours involving the ovary may be benign, borderline, or malignant. Malignant tumours may be primary or metastatic. Differentiation between primary and metastatic involvement of the ovary is critical for optimal patient management. Even among skilled pathologists, this distinction can be problematic, as can the distinction between borderline ovarian tumour of intestinal type and well-differentiated invasive primary mucinous ovarian carcinoma. Primary invasive mucinous ovarian carcinoma and mucinous carcinoma metastatic to the ovary do have distinct patterns of macroscopic and microscopic involvement which will reveal the correct diagnosis in many cases. There are also well-recognized patterns of immunohistochemical staining that can further assist in this differentiation. As a result of the application of these histopathological techniques, the incidence of primary invasive mucinous epithelial carcinoma has fallen over recent years from ∼12% to ∼3%. However, even in recent multicentre clinical trials such as GOG 182, expert pathological review suggests that ∼60% of tumours originally classified as primary invasive mucinous carcinomas were in fact metastatic tumours to the ovary. Review of outcome data for patients with mucinous carcinoma entered into multicentre trials suggests that this subtype of disease has a particularly poor prognosis in comparison with other subtypes of ovarian carcinoma. Historically, patients with mucinous epithelial ovarian carcinoma (mEOC) have been treated in the same way as other subtypes of ovarian carcinoma. While there is undoubtedly a response rate to platinum-based chemotherapy, retrospective reviews of individual centre experience suggest that this is substantially lower than for high-grade papillary serous carcinoma and in the order of only 30%-40%. The mEOC trial was established to investigate the possibility that the combination of capecitabine and oxaliplatin (chemotherapy drugs more commonly used in colorectal carcinoma) may be superior to conventional carboplatin and paclitaxel chemotherapy. In a 2 × 2 factorial design, there was also a randomization to bevacizumab. Unfortunately, this trial closed early, 5 years after initiation having recruited just 50 of a proposed 322 patients. mEOC is now characterized as a type I tumour with an identifiable stepwise progression from a premalignant lesion, through non-invasive, to invasive malignancy. Molecular characterization of mEOC reveals it to be distinct from other subtypes of the disease with a KRAS mutation occurring in 40%-50% of patients. Other gene abnormalities including HER2 amplification in ∼19% also occur. This raises the possibility of the use of targeted molecular therapies which with molecular analysis of individual patient tumours could form the basis of a future clinical trial. It is, however, clear that if trials are to be conducted in this rare subtype of disease, they will need to be truly international in nature and carefully designed, possibly using an adaptive stepwise approach and will require an appropriate level of funding with a realistic assessment of likely recruitment. Associated translational research will clearly be essential.
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Affiliation(s)
- T J Perren
- Professor of Women's Cancers and Oncology, Leeds Institute of Cancer Medicine and Pathology, St James's Institute of Oncology, St James's University Hospital, Leeds, UK
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65
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Schmoeckel E, Kirchner T, Mayr D. SATB2 is a supportive marker for the differentiation of a primary mucinous tumor of the ovary and an ovarian metastasis of a low-grade appendiceal mucinous neoplasm (LAMN): A series of seven cases. Pathol Res Pract 2017; 214:426-430. [PMID: 29487003 DOI: 10.1016/j.prp.2017.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/07/2017] [Accepted: 12/11/2017] [Indexed: 11/19/2022]
Abstract
The differentiation between a primary mucinous ovarian neoplasm and an extra-ovarian metastasis in the ovary is often challenging in the histopathologic practice. Among various ovarian metastases from the gastro-intestinal tract the low-grade appendiceal mucinous neoplasm (LAMN) is an important differential diagnosis to consider particularly in case of pseudomyxoma peritonei. A newly recognized marker in the routine diagnostic of a mucinous neoplasm in the ovary is SATB2 (Special AT-rich sequence-binding protein 2). The expression of SATB2 is, within cells of epithelial lineages, mainly restricted to the lower gastro-intestinal tract, indicating colorectal or appendiceal cancer origin. We report seven cases of LAMN, which clinically became apparent due to ovarian metastases in context of pseudomyxoma peritonei or at least small foci of peritoneal tumor spread. An immunohistochemical marker-panel including SATB2, CDX2, CK20, CK7, PAX8, ER and PR revealed a strong expression of SATB2 in all seven cases. On the contrary SATB2-negativity could be demonstrated in the 40 cases of mucinous borderline tumors and primary mucinous carcinomas of the ovary. The histopathologic tentative diagnosis of an ovarian metastasis of LAMN could be confirmed in the findings of the Appendix in six of seven cases. This report supports SATB2 as an additional diagnostic marker for the diagnosis of an ovarian manifestation of LAMN.
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Affiliation(s)
- Elisa Schmoeckel
- Institute of Pathology, Faculty of Medicine, LMU Munich, Germany.
| | - Thomas Kirchner
- Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - Doris Mayr
- Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
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66
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Kammar PS, Engineer R, Patil PS, Ostwal V, Shylasree TS, Saklani AP. Ovarian Metastases of Colorectal Origin: Treatment Patterns and Factors Affecting Outcomes. Indian J Surg Oncol 2017; 8:519-526. [PMID: 29203984 PMCID: PMC5705507 DOI: 10.1007/s13193-017-0667-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/02/2017] [Indexed: 01/25/2023] Open
Abstract
The purpose of this study is to evaluate the patterns of treatment and factors affecting outcomes in ovarian metastases of colorectal origins treated at our institution and to assess the response of ovarian metastases to chemotherapy. Survival in R0 and R+ resections and patients receiving only chemotherapy is also analyzed. This is a retrospective study of 25 patients registered between January 2012 and December 2015. Patient's age, disease status, mode of presentation, disease spread, mode of treatment, response to chemotherapy, completeness of resection, histology, and outcomes were considered as variables for analysis. There were 21 synchronous presentations and 4 metachronous presentations. In synchronous presentations, only 2 had extra-abdominal disease. Of these patients, 15 underwent surgeries of various extents. The remaining 6 patients were treated with chemotherarpy initially. Only one of them could come up to surgery later. In R0 resections, disease recurred between 1 and 9 months (median 3.5 months). The recurrence was in peritoneum and ovaries. In operated cases, 12 of 15 patients received chemotherapy and 9 patients progressed on first line chemotherapy. In all 4 metachronous patients, the disease was in the peritoneum. No one underwent surgery for the recurrence due to the extensive nature of the disease. All received chemotherapy. Sixty-six percent ovarian metastases showed progression on chemotherapy. There was no significant difference in the median survival between patients treated with surgery plus chemotherapy (23 months) vs. those treated with chemotherapy alone (28 months). Age and presence of disease at other sites did not affect the outcomes. Non-signet ring cell histologies showed better outcomes compared to signet ring cell histology (p = 0.02). Synchronous presentation, R0 resections, and responsive disease showed better survival, however it was clinically not significant. Treatment of ovarian metastases of colorectal origins is varied but has consistently poor outcome. Non-signet histology was the only prognostic factor which showed better outcome. Survival was not different between patients treated with surgery+chemotherapy and chemotherapy alone but majority of ovarian metastases progressed on chemotherapy. Considering the poor response to chemotherapy and peritoneum being the most common site of disease, both in primary and recurrent setting, R0 resection should always be attempted after selecting the correct patients using PET scan, laparoscopy and standard exploratory protocols. Treatment should be tailored upon patient's status and disease burden with an aim to do complete cytoreduction whenever possible. CRS+HIPEC (cytoreductive surgery + hyperthermic intraperitoneal chemotherapy) can be considered on case to case basis as even R0 resections tend to recur.
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Affiliation(s)
- Praveen S. Kammar
- Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Marg, Parel, Mumbai, Maharashtra 400012 India
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India
| | - Prachi S. Patil
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Mumbai, India
| | - Vikas Ostwal
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - T. S. Shylasree
- Department of Gynaecologic Oncology, Tata Memorial Centre, Mumbai, India
| | - Avanish P. Saklani
- Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Marg, Parel, Mumbai, Maharashtra 400012 India
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Akhtar A, Ratra A, Puckett Y, Sheikh AB, Ronaghan CA. Synchronous Uterine Metastases from Breast Cancer: Case Study and Literature Review. Cureus 2017; 9:e1840. [PMID: 29344435 PMCID: PMC5766353 DOI: 10.7759/cureus.1840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Breast cancer rarely metastasizes to the uterus. Here, we report two breast cancer patients with synchronous metastases to the uterus. Case 1 highlights a 46-year-old female with invasive ductal carcinoma who presented with a breast mass and was found to have uterine enlargement on positron emission tomography (PET) scan. Biopsy revealed a metastatic 4 mm focus of breast cancer in the background of endometrial hyperplasia. Case 2 reports a 62-year-old postmenopausal female diagnosed with lobular carcinoma of the breast following an abnormal screening mammogram. A routine pap smear necessitated further workup, revealing simultaneous endometrial and cervical metastasis. Both patients did not have any gynecologic symptoms and presented a diagnostic challenge.
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Affiliation(s)
- Aisha Akhtar
- Department of Surgery, Texas Tech University Health Sciences Center
| | - Atul Ratra
- Internal Medicine, Texas Tech University Health Sciences Center
| | - Yana Puckett
- Department of Surgery, Texas Tech University Health Sciences Center
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Razia S, Nakayama K, Tsukao M, Nakamura K, Ishikawa M, Ishibashi T, Ishikawa N, Sanuki K, Yamashita H, Ono R, Hossain MM, Minamoto T, Kyo S. Metastasis of breast cancer to an endometrial polyp, the cervix and a leiomyoma: A case report and review of the literature. Oncol Lett 2017; 14:4585-4592. [PMID: 29085457 PMCID: PMC5649554 DOI: 10.3892/ol.2017.6822] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 07/13/2017] [Indexed: 11/26/2022] Open
Abstract
Haematogenous metastases of breast cancer tumors has previously been demonstrated to frequently occur at the sites of the lung, bones, liver and brain, however presence in the uterine remains a rare occurrence. Metastatic carcinoma of the uterus usually originates from other genital sites, most frequently from the ovaries. The current review presents the first reported case of lobular breast carcinoma metastasizing to an endometrial polyp, the cervix and a leiomyoma simultaneously. The patient (58 years, female) first presented with abnormal uterine bleeding. Invasive ductal carcinoma had previously been diagnosed in her right breast, with lobular and ductal cancer cells observed to be present in her lymph nodes. A hysteroscopic procedure to examine the postmenopausal bleeding revealed an endometrial polyp, which was subsequently resected. The morphology and immunohistochemical studies confirmed the diagnosis of metastasis of lobular breast carcinoma to an endometrial polyp. An 18F fludeoxyglucose positron emission tomography/computed tomography (PET-CT) scan performed following the diagnosis, revealed a slightly increased uptake in the myoma, which is often observed in benign uterine leiomyoma. The patient then underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial colectomy. Pathology results demonstrated that the uterine leiomyoma and cervix shared the same histopathological features as those presented by the primary lobular breast carcinoma. Although rare, breast tumors may metastasize to an endometrial polyp, cervix and leiomyoma concurrently in patients, therefore physicians may now consider the potential of the diagnosis of metastatic spread to the genital tract, in a patient with abnormal uterine bleeding and a history of lobular breast cancer. Gynecologists planning a laparoscopic hysterectomy for a patient with a history of lobular breast carcinoma may consider abdominal rather than laparoscopic hysterectomy, as lobular carcinoma is difficult to detect. The use of PET-CT may be beneficial for the identification of an unexpected mass.
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Affiliation(s)
- Sultana Razia
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Kentaro Nakayama
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Mayu Tsukao
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Kohei Nakamura
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Masako Ishikawa
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Tomoka Ishibashi
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Noriyoshi Ishikawa
- Department of Organ Pathology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Kaori Sanuki
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Hitomi Yamashita
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Ruriko Ono
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Mohammad Mahmud Hossain
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Toshiko Minamoto
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
| | - Satoru Kyo
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan
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Clinicopathological characteristics of fallopian tube metastases from primary endometrial, cervical, and nongynecological malignancies: a single institutional experience. Virchows Arch 2017; 471:363-373. [DOI: 10.1007/s00428-017-2186-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/15/2017] [Accepted: 06/27/2017] [Indexed: 12/29/2022]
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Yamamoto Y, Miyagawa Y, Ehara T, Koyama M, Nakamura S, Takeuchi D, Muranaka F, Kitazawa M, Miyagawa S. Three Cases of Pseudo-Meigs' Syndrome Secondary to Ovarian Metastases from Colorectal Cancer. Case Rep Surg 2017; 2017:5235368. [PMID: 28373923 PMCID: PMC5360969 DOI: 10.1155/2017/5235368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/22/2017] [Indexed: 11/17/2022] Open
Abstract
Pseudo-Meigs' syndrome is used to describe cases of ascites and/or pleural effusion associated with ovarian neoplasms other than benign tumors, which improve after removal of the ovarian lesion. We present three cases of pseudo-Meigs' syndrome secondary to ovarian metastasis from colorectal cancer. In case 1, the patient has severe dyspnea and hypoxia due to massive right pleural effusion; therefore preoperative thoracic drainage was needed. In case 2, the patient needed paracentesis every two or three days to improve abdominal distension. After two courses of 5-fluorouracil, levofolinate, and oxaliplatin (mFOLFOX6), her ascites could be controlled by diuretics without aspiration and her general condition improved. Then she underwent operation. In case 3, the patient developed a massive pleural effusion and ascites coincident with a rapid enlargement of ovarian tumor after resection and adjuvant chemotherapy for rectal cancer. In all cases, pleural effusions and/or ascites resolved and general conditions and daily activities of the patients improved after oophorectomy. They are all currently in good health without recurrence of pleural effusion or ascites. In patients with suspected pseudo-Meigs' syndrome secondary to ovarian metastasis of colorectal cancer, operation including oophorectomy may reduce pleural effusions and/or ascites and improve the general condition.
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Affiliation(s)
- Yuta Yamamoto
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yusuke Miyagawa
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takehito Ehara
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Makoto Koyama
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Nakamura
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Daisuke Takeuchi
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Futoshi Muranaka
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masato Kitazawa
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shinichi Miyagawa
- Department of Gastroenterological Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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71
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Giordano G, Cruz Viruel N, Silini EM, Nogales FF. Adenocarcinoma of the Lung Metastatic to the Ovary With a Signet Ring Cell Component. Int J Surg Pathol 2017; 25:365-367. [PMID: 28178894 DOI: 10.1177/1066896917691613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A nonsmoker 45-year-old woman, presented with a solid right ovarian mass. Microscopic examination revealed heterogeneous histology with tubular formations and extensive signet ring cell component that resembled the usual appearance of metastatic gastric carcinoma to the ovary. Moreover, the histology also showed solid nests of cells with a microvacuolated basophilic cytoplasm similar to those found in adenosquamous cervical carcinoma of glassy cell type. However, analysis of the patient's past history revealed a lung adenocarcinoma, diagnosed 4 years before, which prompted an immunohistochemical differential diagnosis, showing a strong expression for TTF-1 and Napsin A. A cervical primary was excluded taking into account both macroscopic findings and the negative expression of PAX8 and absence of human papillomavirus-related marker p16. This confirmed the pulmonary origin of ovarian tumor despite its heterogeneous morphology. This is the first reported case of ovarian metastatic lung adenocarcinoma, with a signet ring cell component and solid nests, mimicking both metastatic gastric carcinoma and adenosquamous carcinoma of glassy cell type.
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Affiliation(s)
| | - Nelly Cruz Viruel
- 2 Department of Pathology University of Granada Medical School, Granada, Spain
| | | | - Francisco F Nogales
- 2 Department of Pathology University of Granada Medical School, Granada, Spain
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72
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Ribeiro Gomes J, Belotto M, D'Alpino Peixoto R. The role of surgery for unusual sites of metastases from colorectal cancer: A review of the literature. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2017; 43:15-19. [DOI: 10.1016/j.ejso.2016.05.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 05/12/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
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73
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Karapantzos I, Zarogoulidis P, Karanikas M, Thomaidis V, Charalampidis C, Karapantzou C. Obstruction of the right stem bronchus due to ovarian local metastasis: a 5-year follow-up. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:445. [PMID: 27999779 DOI: 10.21037/atm.2016.10.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Currently interventional bronchoscopy is used for debulking, desobstruction and airway patency stabilization. The interventional techniques are being used for both benign and malignant cases. There are two types of stents that are currently being used, silicon and self-expandable metallic. The method of application and stent remains for the treating physician to choose. In the current case we will present a case of metastatic disease from ovarian cancer in the airway lumen and a long term follow-up.
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Affiliation(s)
- Ilias Karapantzos
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Pulmonary Department, Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michail Karanikas
- General Surgery Department, "Genisis" Private Clinic, Thessaloniki, Greece
| | - Vasilis Thomaidis
- Department of Maxillofacial Surgery, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | - Chrysa Karapantzou
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
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74
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Matsushita H, Watanabe K, Wakatsuki A. Metastatic gastric cancer to the female genital tract. Mol Clin Oncol 2016; 5:495-499. [PMID: 27882232 DOI: 10.3892/mco.2016.1035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023] Open
Abstract
Metastases to the female genital tract from gastric cancer are rare, but they significantly worsen the prognosis of such patients. The potential routes for metastasis to the female genital tract from gastric cancer include hematogenous spread, lymphatic spread and surface implantation. The rate of lymphatic metastasis to the ovary from gastric cancer has been reported to be higher compared with that from colorectal cancer. Uterine or Fallopian tube metastases are usually secondary to ovarian metastases, which are typically identified prior to the detection of gastric cancer in half of all synchronous cases, with complaints of abdominal distention, pain, palpable mass, or abnormal uterine bleeding. The prognosis of patients with female genital tract metastases from gastric cancer is extremely poor, and is worse compared with that of other primary sites, such as the breast and colorectum. In the past, surgical intervention in such patients consisted mainly of palliative resection to relieve the symptoms associated with a sizeable pelvic mass. However, recent retrospective studies based on a relatively small number of patients have reported that surgical tumor debulking plus chemotherapy may improve the prognosis of patients with metastatic ovarian cancer originating from gastric cancer.
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Affiliation(s)
- Hiroshi Matsushita
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan
| | - Kazushi Watanabe
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan
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75
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Çift T, Aslan B, Bulut B, İlvan Ş. Unusual uterine metastasis of invasive ductal carcinoma: A case report. Turk J Obstet Gynecol 2016; 13:164-166. [PMID: 28913115 PMCID: PMC5558310 DOI: 10.4274/tjod.88964] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/24/2016] [Indexed: 12/01/2022] Open
Abstract
Metastatic carcinoma of the uterus usually originates from other genital sites. Extragenital metastases such as breast are rare. A woman aged 34 years with a history of breast cancer was referred to the gynecology outpatient clinic for routine follow-up. Diagnostic tests and gynecologic examination revealed a uterine mass, which was removed with laparotomy. The pathologic investigation revealed metastasis of invasive lobular breast cancer. Chemotherapy was given and the patient has been under follow-up for 3 years with normal imaging on comput-erized tomographic examination and positron-emission tomography-computerized tomographic. It should be kept in mind that patients with breast cancer who have received tamoxifen may develop primary endometrial cancers, and may also demonstrate uterine metastases. With successful treatment these patients can obtain dis-ease-free survival.
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Affiliation(s)
- Tayfur Çift
- Bursa Yüksek İhtisas Training and Research Hospital, Clinic of Gynecology and Obstetrics, Bursa, Turkey
| | - Berna Aslan
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Berk Bulut
- Okmeydanı Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, Turkey
| | - Şennur İlvan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pathology, İstanbul, Turkey
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76
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Soh JM, Scott GA, Pavlovitz BT, Mercurio MG. Metastatic rectal adenocarcinoma and anal squamous cell carcinoma masquerading as vulvar lymphangioma circumscriptum. J OBSTET GYNAECOL 2016; 36:876-878. [PMID: 27616148 DOI: 10.1080/01443615.2016.1188271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jonathan M Soh
- a Department of Dermatology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Glynis A Scott
- b Departments of Dermatology and Pathology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Brian T Pavlovitz
- c Department of Pathology , Rochester General Hospital , Rochester , NY , USA
| | - Mary Gail Mercurio
- d Departments of Dermatology and Obstetrics and Gynecology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
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77
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Kinoshita Y, Yoshizawa K, Yuri T, Tsubur A, Shikata N. Endocervical metastasis of pancreatic cancer: A rare case report of long-term survival. HUMAN PATHOLOGY: CASE REPORTS 2016. [DOI: 10.1016/j.ehpc.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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78
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Moey MYY, Hassan OA, Papageorgiou CN, Schnepp SL, Hoff JT. The potential role of HER2 upregulation in metastatic breast cancer to the uterus: a case report. Clin Case Rep 2016; 4:928-934. [PMID: 27761241 PMCID: PMC5054465 DOI: 10.1002/ccr3.602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 01/29/2016] [Accepted: 05/22/2016] [Indexed: 12/22/2022] Open
Abstract
Abnormal uterine bleeding in a patient on maintenance hormonal therapy for breast cancer should raise concern for endometrial abnormalities including rare uterine metastasis from the breast. Hormonal receptor profile changes in metastatic lesions favoring human epidermal growth factor receptor 2 (HER2) overexpression may be involved in the pathogenesis of metastasis to the uterus.
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Affiliation(s)
- Melissa Y Y Moey
- Saba University School of Medicine The Bottom Saba Dutch Caribbean The Netherlands
| | - Omer A Hassan
- Saba University School of Medicine The Bottom Saba Dutch Caribbean The Netherlands
| | - Christos N Papageorgiou
- SSM Cancer Care St. Mary's Health Center St. Louis Missouri USA; Division of Hematology and Oncology Department of Internal Medicine Saint Louis University School of Medicine St. Louis Missouri USA
| | | | - John T Hoff
- SSM Health St. Mary's Health Center St. Louis Missouri USA; Division of Gynecologic Oncology Department of Obstetrics and Gynecology Saint Louis University School of Medicine St. Louis Missouri USA
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79
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Metastatic Ovarian Tumors Originating From a Small Bowel Adenocarcinoma - A Case Report and Brief Literature Review. Int J Gynecol Pathol 2016; 36:253-260. [PMID: 27513076 DOI: 10.1097/pgp.0000000000000314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Approximately 1.6% of tumors metastatic to the ovary of nongynecologic origin are from a small bowel adenocarcinoma (SBA). However, the incidence of SBA is extremely rare (0.23 cases/100,000 people), which suggests a high frequency of ovarian metastasis, although the reason is unknown. To identify the characteristics of ovarian tumor metastasis from SBA, we reviewed 72 cases reported in the English literature, including the case presented in this report. The mean age of the patients was 46.7 yr. Solitary ovarian metastasis was observed in 67% of the cases, and ovarian metastasis was accompanied by peritoneal dissemination in 33% of the cases. Although duodenal adenocarcinoma has the highest incidence among the SBAs, jejunal adenocarcinoma, particularly that at the proximal end, is the type of SBA that most frequently metastasizes to the ovary. Among the cases of ovarian metastasis from SBA, 51% were bilateral, 33% were unilateral to the right ovary, and 16% were unilateral to the left ovary.
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80
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Ruffolo R, Suster S. Diffuse Histiocytic Proliferation Mimicking Mesothelial Hyperplasia in Endocervicosis of the Female Pelvic Peritoneum. Int J Surg Pathol 2016. [DOI: 10.1177/106689699300100202] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Two cases of a diffuse histiocytic proliferation that mimicked mesothelial hyperplasia in the pelvic peritoneum of premenopausal women with endocervicosis are presented. The lesions were found incidentally on laparoscopic examination for pelvic pain and appeared as small friable excrescenses attached to the serosal surface of the pelvis. Histologic examination revealed a dense proliferation of round to oval cells with abun dant eosinophilic cytoplasm and large, hyperchromatic nuclei showing focal invagina tions and occasional mitoses. The cells appeared to infiltrate the surrounding connec tive tissue in single files and were closely associated with sloughed strands of small, cuboidal mesothelial cells as well as with larger glands lined by mucinous epithelium. Immunohistochemical studies showed cytoplasmic staining of these cells with MAC387, HAM56, and alpha-1-antichymotrypsin antibodies, thus supporting their histiocytic nature. The close association of the histiocytic proliferation with the endo cervicotic glands raises the possibility that the process may have resulted as a reaction to rupture and extrusion of the mucous contents of the glands into the surrounding stroma. These lesions must be distinguished from reactive or neoplastic mesothelial proliferations involving the female pelvic peritoneum. Int J Surg Pathol 1(2):101-106, 1993
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81
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Di Tommaso L, Rahal D, Bresciani G, Roncalli M. Cutaneous Melanoma Metastatic to Uterine Adenomyoma: Report of a Case. Int J Surg Pathol 2016; 13:223-5. [PMID: 15864390 DOI: 10.1177/106689690501300217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rare cases of metastasis to uterine polyps have been reported in English literature but not, to the best of our knowledge, to uterine adenomyomas. All these cases are represented by breast cancer, most of them involving tamoxifen-associated polyps. We first report a case of cutaneous malignant melanoma metastatic to uterine adenomyoma. A computed tomography scan did not reveal any further evidence of disease, suggesting that this metastatic localization may represent something more than a fortuitous case. Based on these observations it is suggested that a subset of malignant melanoma and breast cancer cells share a sort of “homing” phenomenon to polypoid lesions of uterus, due probably to the presence of some chemokines and their specific receptors. Pathologists should be aware of this possibility in order to look carefully for metastatic implants in similar lesions. It is proposed that chemokine profile of neoplastic cells can be a useful tool in predicting metastatic targets.
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Affiliation(s)
- Luca Di Tommaso
- Department of Pathology, School of Medicine University of Milan, Humanitas Clinical Institute, Rozzano, Italy
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82
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Abstract
FDG avid uterine cervical masses are most commonly due to primary cervical carcinoma; however, history and differential diagnoses are critical when interpreting FDG PET/CT studies. A 51-year-old woman with newly diagnosed moderately differentiated adenocarcinoma of the rectum underwent FDG PET/CT for staging, which revealed the hypermetabolic primary rectal tumor and nodal metastases. Additionally, FDG avid focus in the anterior cervix without a CT correlate was present. Cervical metastasis was suspected, and further evaluation with MRI and histopathologic correlation was recommended, which confirmed cervical metastasis. This case illustrates an unusual case of FDG-avid cervical metastasis from rectal adenocarcinoma.
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83
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Lin DM, Barkan GA, Chatt G, Park JW, Gattuso P. Vaginal fine-needle aspiration: A useful alternative to biopsy. Diagn Cytopathol 2016; 44:665-9. [PMID: 27220040 DOI: 10.1002/dc.23504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/02/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Vaginal fine-needle aspiration (FNA) is infrequently performed to assess palpable lesions. We perform the first multi-institutional study to evaluate this procedure. METHODS We retrospectively reviewed vaginal FNAs performed at two institutions for the past 27 years. Clinical, cytological and histological data were reviewed and tabulated. RESULTS We identified 43 specimens from 39 patients (mean age 56 years, range 18-86 years). Twenty four patients (62%) had prior malignancies from the following sites: gynecologic tract (22), bladder (1), and breast (1). Twenty four specimens were malignant, 18 were benign (including eight cases from patients with prior malignancy) and one was unsatisfactory. Of 28 FNA specimens from patients with a malignant history, 18 (64%) were positive for malignancy. The most common malignancies were metastatic ovarian carcinoma (50%), squamous cell carcinoma (25%), and uterine cancer (17%). Mean time to metastasis/recurrence was 16 months and was longest in patients with ovarian metastasis (26 months) compared to other malignancies (P = 0.002). The most common benign diagnoses were cysts (33%) and inflammation (22%). In 27 cases with histological correlation, there were 20 true positives, six true negatives and one false negative (sensitivity =95%, specificity =100%). Seven patients had a recent Pap test with two true positives, two true negatives, and three false negatives (sensitivity = 40%, specificity = 100%). CONCLUSION Vaginal FNA is usually performed to rule out a secondary malignancy, often of ovarian origin. Vaginal metastases from extra-gynecologic sites are rare. FNA is both highly sensitive and specific and may be a safe and effective alternative to biopsy. Diagn. Cytopathol. 2016;44:665-669. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | - Ji-Weon Park
- Rush University Medical Center, Chicago, Illinois
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84
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Shah B, Tang W, Karn S. An Up-to-Date Understanding of the “Krukenberg Tumor” Mechanism. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/arsci.2016.42005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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85
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Rema P, Muralee M, Jayasudha AV, Suchetha S, Ahmed I. Carcinoma Breast with Endometrial Metastasis. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2015. [DOI: 10.1007/s40944-015-0027-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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86
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Lokadasan R, Ratheesan K, Sukumaran R, Nair SP. Metastatic lobular carcinoma of breast mimics primary cervix carcinoma: two case reports and a review of the literature. Ecancermedicalscience 2015; 9:571. [PMID: 26435744 PMCID: PMC4583243 DOI: 10.3332/ecancer.2015.571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Indexed: 12/05/2022] Open
Abstract
Invasive lobular carcinoma (ILC) of the breast exhibits unusual clinicopathological, radiological, histological, and metastatic patterns. We present here two cases of ILC of the breast that presented with an unusual pattern of metastasis involving the uterus. Our first patient presented to her primary gynaecologist with profuse vaginal bleeding and underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. She had fibroadenoma excised from her left breast four years previously. Histopathology revealed lobular carcinoma diffusely infiltrating uterus, cervix, and bilateral ovaries. Retrospective examination of the left breast showed induration along the previous fibroadenoma excision scar. A biopsy from the scar suggested lobular carcinoma. Our second patient presented with a hard indurated cervix mass that mimicked primary cervix carcinoma. She had ILC of the right breast four years previously for which she underwent mastectomy followed by adjuvant chemotherapy and radiotherapy. She was on tamoxifen. Further evaluation at presentation with imaging showed extensive intra-abdominal disease involving peritoneum with moderate ascites, adnexal masses, and confluent para-aortic nodal mass. A cervix biopsy confirmed metastasis from lobular carcinoma. Metastatic involvement of the genital tract should be considered in women with a history of breast cancer who present with abnormal vaginal bleeding, suspicious pelvic examination, or radiological findings. We suggest such patient be vigorously screened with biopsy even if the patient is disease-free for several years. It is crucial to differentiate the metastasis from primary carcinoma of the genital tract as there are vast differences in the management of each.
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Affiliation(s)
- Rajitha Lokadasan
- Department of Medical Oncology, Regional Cancer Centre, Medical College Campus, Post Bag No 2417, Trivandrum 695011, India
| | - K Ratheesan
- Department of Radiotherapy, Regional Cancer Centre, Trivandrum 695011, India
| | - Renu Sukumaran
- Department of Pathology, Regional Cancer Centre, Trivandrum 695011, India
| | - Sindhu P Nair
- Department of Pathology, Regional Cancer Centre, Trivandrum 695011, India
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87
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Bezpalko K, Mohamed MA, Mercer L, McCann M, Elghawy K, Wilson K. Concomitant endometrial and gallbladder metastasis in advanced multiple metastatic invasive lobular carcinoma of the breast: A rare case report. Int J Surg Case Rep 2015; 14:141-5. [PMID: 26275738 PMCID: PMC4573862 DOI: 10.1016/j.ijscr.2015.07.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/29/2015] [Accepted: 07/29/2015] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION At time of presentation, fewer than 10% of patients have metastatic breast cancer. The most common sites of metastasis in order of frequency are bone, lung, pleura, soft tissue, and liver. Breast cancer metastasis to the uterus or gallbladder is rare and has infrequently been reported in the English literature. PRESENTATION OF CASE A 47 year old female with a recent history of thrombocytopenia presented with abnormal vaginal bleeding. Pelvic ultrasound revealed multiple uterine fibroids and endometrial curettings revealed cells consistent with lobular carcinoma of the breast. Breast examination revealed edema and induration of the lower half of the right breast. Biopsy of the right breast revealed invasive lobular carcinoma. Bone marrow aspiration obtained at a previous outpatient visit revealed extensive involvement by metastatic breast carcinoma. Shortly after discharge, the patient presented with acute cholecystitis and underwent cholecystectomy. Microscopic examination of the gallbladder revealed metastatic infiltrating lobular carcinoma. The final diagnosis was invasive lobular carcinoma of the right breast with metastasis to the bone marrow, endometrium, gallbladder, regional lymph nodes, and peritoneum. DISCUSSION The growth pattern of invasive lobular carcinoma of the breast is unique and poses a challenge in diagnosing the cancer at an early stage. Unlike other types of breast cancer, it tends to metastasize more to the peritoneum, ovary, and gastrointestinal tract. Metastasis to the endometrium or gallbladder is rare. CONCLUSION Metastatic spread should be considered in the differential diagnosis of patients with invasive lobular breast carcinoma presenting with abnormal vaginal bleeding or acute cholecystitis.
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Affiliation(s)
- Kseniya Bezpalko
- Michigan State University, Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA.
| | - Mohamed A Mohamed
- Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA
| | - Leo Mercer
- Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA
| | - Michael McCann
- Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA
| | - Karim Elghawy
- Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA
| | - Kenneth Wilson
- Hurley Medical Center, Trauma Services Department, One Hurley Plaza, Flint, MI 48503, USA
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Waks AG, Lennon J, Yadav BS, Hwang H, dSchapirael Carmen M, Johnson NB, Reynolds K, Schapira L, Gilman PB, Overmoyer B. Metastasis to the Cervix Uteri 15 Years After Treatment of Lobular Carcinoma of the Breast. Semin Oncol 2015; 42:e81-94. [DOI: 10.1053/j.seminoncol.2015.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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89
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Huo Z, Gao Y, Zuo W, Zheng G, Kong R. Metastases of basal-like breast invasive ductal carcinoma to the endometrium: A case report and review of the literature. Thorac Cancer 2015; 6:548-52. [PMID: 26273414 PMCID: PMC4511337 DOI: 10.1111/1759-7714.12195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 10/14/2014] [Indexed: 11/30/2022] Open
Abstract
We present a case of single endometrial metastasis from breast invasive ductal cancer. This case was unique because the immunohistochemical staining was negative for human epidermal growth factor receptor 2/neu and estrogen and progesterone receptors, and positive for cytokeratin 5/6 and epidermal growth factor receptor in the primary and metastatic tumor cells. No gross evidence of tumor was observed in other sites. We identified 12 cases of metastases to the endometrium from breast carcinoma from series and case reports in the literature between 1985 and 2014. This review indicated that hormone receptor-positive invasive lobular breast cancer cells are more likely to metastasize to the endometrium than other cell types in patients over 50 years of age.
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Affiliation(s)
- Zhijun Huo
- Breast Disease Centre, Shandong Cancer Hospital, Shandong Academy of Medical Sciences Ji'nan, China
| | - Yongsheng Gao
- Department of Pathology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences Ji'nan, China
| | - Wenshu Zuo
- Breast Disease Centre, Shandong Cancer Hospital, Shandong Academy of Medical Sciences Ji'nan, China
| | - Gang Zheng
- Breast Disease Centre, Shandong Cancer Hospital, Shandong Academy of Medical Sciences Ji'nan, China
| | - Ronghua Kong
- Breast Disease Centre, Shandong Cancer Hospital, Shandong Academy of Medical Sciences Ji'nan, China
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90
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Vulvar metastasis from bladder cancer. Case Rep Obstet Gynecol 2015; 2015:324634. [PMID: 26000184 PMCID: PMC4426944 DOI: 10.1155/2015/324634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/13/2015] [Accepted: 04/16/2015] [Indexed: 11/17/2022] Open
Abstract
Vulvar metastasis of urothelial carcinoma of the bladder is a very rare entity; few cases are reported in the English literature. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of a patient with vulvar metastasis of urothelial carcinoma of the bladder followed by a brief review of the reported cases in the literature.
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91
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Ahmad Z, Raza A, Patel MR. Endometrial metastasis of lung adenocarcinoma: a report of two cases. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:296-9. [PMID: 25981989 PMCID: PMC4444144 DOI: 10.12659/ajcr.892495] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Case series Patient: Female, 55 • Female, 51 Final Diagnosis: Metastatic lung adenocarcinoma Symptoms: Neck swelling Medication: Erlotinib Clinical Procedure: Lymph node biopsy Specialty: Oncology
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Affiliation(s)
- Zeeshan Ahmad
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ahmad Raza
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Manish R Patel
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
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92
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Gastric Signet-Ring Cell Carcinoma Metastasis to Bilateral Ovarian Granulosa Cell Tumors. Int J Gynecol Pathol 2015; 34:126-31. [DOI: 10.1097/pgp.0000000000000126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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93
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Toyoshima M, Iwahashi H, Shima T, Hayasaka A, Kudo T, Makino H, Igeta S, Matsuura R, Ishigaki N, Akagi K, Sakurada J, Suzuki H, Yoshinaga K. Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report. J Med Case Rep 2015; 9:47. [PMID: 25881005 PMCID: PMC4351848 DOI: 10.1186/s13256-014-0511-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 12/30/2014] [Indexed: 11/22/2022] Open
Abstract
Introduction Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma. Case presentation A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue. Conclusion We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.
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Affiliation(s)
- Masafumi Toyoshima
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Hideki Iwahashi
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. .,Department of Obstetrics and Gynecology, Self-Defense Force Sendai Hospital, Sendai, Japan.
| | - Takashi Shima
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Atsushi Hayasaka
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan. .,Department of Obstetrics and Gynecology, Sendai City Hospital, Sendai, Japan.
| | - Takako Kudo
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Hiromitsu Makino
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Saori Igeta
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Rui Matsuura
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Nobuko Ishigaki
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Kozo Akagi
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
| | - Junko Sakurada
- Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Hiroyoshi Suzuki
- Department of Pathology, Sendai Medical Center, National Hospital Organization, Sendai, Japan.
| | - Kosuke Yoshinaga
- Department of Obstetrics and Gynecology, Sendai Medical Center, National Hospital Organization, 2-8-8, Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan.
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94
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Cholangiocarcinoma presenting as uterine metastasis. Case Rep Obstet Gynecol 2015; 2014:204915. [PMID: 25610676 PMCID: PMC4294282 DOI: 10.1155/2014/204915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 11/17/2022] Open
Abstract
Metastases to the female genital tract are rare, with metastatic disease restricted to the uterus being even less frequent. The primary tumor is most often intragenital rather than extragenital. The diagnosis is usually made after occurrence of gynecological symptoms. We describe the case of a 26-year-old female, in whom a curettage for menorrhagia revealed a uterine malignancy, at first thought to be a carcinosarcoma. Biochemistry only showed iron deficiency anemia. Imaging showed discrepant results with liver lesions, suspect of neoplastic or inflammatory disease. She underwent an abdominal hysterectomy and, peroperatively, a frozen section of a mass in the liver hilus demonstrated a cholangiocarcinoma. The diagnosis of a uterine metastasized cholangiocarcinoma was made. We emphasize the fact that uterine metastases have to be excluded in every woman with abnormal uterine bleeding and a personal history of malignancy. However, our case also indicates that gynecological metastatic disease may be the first presentation of an extragenital primary neoplasm.
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95
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Kajimoto N, Tsukamoto Y, Hao H, Watanabe T, Tsubamoto H, Kuribayashi K, Kamiya H, Shibata E, Nakano T, Hirota S. Uterine metastasis of lung adenocarcinoma revealed by the same epidermal growth factor receptor mutation in both lung and endometrial biopsies. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.ctrc.2015.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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96
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Rabban JT, Vohra P, Zaloudek CJ. Nongynecologic Metastases to Fallopian Tube Mucosa. Am J Surg Pathol 2015; 39:35-51. [DOI: 10.1097/pas.0000000000000293] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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97
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Corrado G, Pomati G, Russo A, Visca P, Vincenzoni C, Patrizi L, Vizza E. Ovarian metastasis from thyroid carcinoma: a case report and literature review. Diagn Pathol 2014; 9:193. [PMID: 25358556 PMCID: PMC4220057 DOI: 10.1186/s13000-014-0193-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/23/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Papillary thyroid carcinoma is rarely associated with metastatic disease. The most common sites of metastasis are the lungs and bones, while only few cases of ovarian metastasis are described in literature. CASE We report the case of a 51 years old woman, treated 9 years before for papillary thyroid carcinoma, presenting to our Institute with a pelvic ovarian mass revealed by ultrasound imaging. After bilateral salpingo-oophorectomy, the histologic examination detected a left ovarian metastasis from papillary thyroid carcinoma. CONCLUSION Even if the diagnosis of ovarian metastasis from thyroid carcinoma is often controversial, it should be considered when a woman with an ovarian lesion of unknown origin, has a personal history of malignant thyroid disease. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_193.
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Affiliation(s)
- Giacomo Corrado
- Department of Oncological Surgery, Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Giulia Pomati
- Surgery Department, Gynecology Section and Obstetrics, Tor Vergata University, Rome, Italy.
| | - Andrea Russo
- Pathology Department, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - Paolo Visca
- Pathology Department, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - Cristina Vincenzoni
- Surgery Department, Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - Lodovico Patrizi
- Surgery Department, Gynecology Section and Obstetrics, Tor Vergata University, Rome, Italy.
| | - Enrico Vizza
- Surgery Department, Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
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98
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Xu Q, Li XL, Yu YW, Dong LR, Shen JG, Wang LB. Right cryptorchid testicular metastasis from descending colon carcinoma: a case report of "Krukenberg tumor" in male. Asian J Androl 2014; 17:171-2. [PMID: 25337848 PMCID: PMC4291869 DOI: 10.4103/1008-682x.142769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | | | | | | | | | - Lin-Bo Wang
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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99
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Vulvar Metastasis of an Early-Stage Well-Differentiated Endometrial Cancer After Minimally Invasive Surgery. J Minim Invasive Gynecol 2014; 21:708-11. [DOI: 10.1016/j.jmig.2014.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 01/31/2014] [Accepted: 01/31/2014] [Indexed: 11/20/2022]
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100
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Euscher E, Malpica A. Use of immunohistochemistry in the diagnosis of miscellaneous and metastatic tumors of the uterine corpus and cervix. Semin Diagn Pathol 2014; 31:233-57. [PMID: 24863030 DOI: 10.1053/j.semdp.2014.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Uncommon tumors in the uterus present diagnostic challenges. In some cases, the tumor subtype is usually seen outside the gynecologic tract and the possibility of a uterine primary is not considered. In other cases, histologic overlap with more common uterine tumors leads to potential misdiagnosis. Finally, metastatic carcinoma may involve the uterus and cervix. Rarely, symptoms related to the uterine metastasis may precede diagnosis of an extrauterine primary. Without the proper clinical context, the possibility of a missed diagnosis is increased. One must first be aware of these possibilities, but immunoperoxidase studies are often necessary to confirm the diagnosis. In this review, unusual and metastatic tumors involving the uterine corpus and cervix and immunoperoxidase studies used to diagnosis such tumors are discussed.
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Affiliation(s)
- Elizabeth Euscher
- The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 85, Houston, Texas 77030.
| | - Anais Malpica
- The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 85, Houston, Texas 77030
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