Small Cell Cancer of the Pleura, Kidney, and Thymus

Primary small cell carcinoma of the lesser omentum

Although pulmonary small cell carcinoma (SCC) is seen frequently, SCC that originates from the extrapulmonary organs is extremely rare. We herein report a case of a SCC located in the lesser omentum. A 61-year-old male was admitted to our department due to intermittent epigastralgia for 2 months. Ultrasonography (US) revealed an irregular hypoechoic mass measuring about 58 mm × 50 mm × 45 mm under the left lobe of the liver. Magnetic resonance imaging (MRI) was performed to verify the irregular mass with T1- and T2- weighted images between the left lobe of liver and the stomach. At laparotomy, the well-circumscribed neoplasm was found in the lesser omentum, and the fundus of the neoplasm was located in the root of left gastric artery. Intraoperative microscopic evaluation of frozen sections revealed malignancy of the lesser omentum. Resection of the neoplasm was performed, and the combined resection of the vagal nerve was also performed for the partial adhesion. Pyloroplasty was performed for avoiding delayed gastric emptying caused by combined resection of vagal nerve. The lymph nodes dissection at lesser curvature and right cardia was also performed with a negative result. Based on the histological findings, the final diagnosis of primary lesser omental SCC was confirmed. The pathologic staging showed locoregional disease.

Small cell carcinoma originating from the cavernous sinus

BACKGROUND

We report a rare case of small cell carcinoma originating from the right cavernous sinus in a 55-year-old male. The patient had sudden onset of right abducens palsy following right oculomotor palsy.

METHODS

Post-contrast T1-weighted MRI revealed a mass lesion of 3-cm maximum size occupying the right cavernous sinus and extending to the right middle cranial fossa. After biopsy via the frontozygomatic approach, one radiosurgery treatment was followed by four cycles of chemotherapy (cisplatin together with VP-16 therapy), after which the lesion diminished dramatically in size.

RESULTS

Complete remission has currently been achieved. The patient recovered from the extraocular muscle paresis and returned to his previous work. Although it is considered possible that small cell carcinoma can occur wherever neuroendocrine cells exist, a lesion originating in the cranium is extremely rare. To the best of our knowledge, this is the first report of small cell carcinoma of intracranial origin.

Primary small cell neuroendocrine carcinoma of the kidney: morphological, immunohistochemical, ultrastructural, and cytogenetic study of a case and review of the literature

Poorly differentiated neuroendocrine carcinomas (PDNECs) of the kidney are extremely rare high-grade cancers accounting for only 42 cases reported in the literature. In this paper, we describe the morphological, immunohistochemical, ultrastructural, and for the first time, cytogenetic features of a renal PDNEC. In addition, we have reviewed the literature and compared the published clinicopathological data with our morphological and genetic results. The tumor arose within the kidney parenchyma and showed the typical histological features of a pure small cell PDNEC. Fluorescence in situ hybridization study demonstrated a complex chromosomal assessment indicative of a high degree of chromosome instability with gain of multiple chromosomes, loss of p53, and amplification of myc gene. These results suggest that renal PDNEC has a different genetic background to renal clear cell carcinoma, mainly characterized by the loss of the short arm of chromosome 3. Conversely, genetic alterations seem to resemble those of type 2 papillary renal cell carcinoma. The review of the literature demonstrated that PDNECs are associated with poor prognosis and that parenchymal tumors show some differences from those arising in the pelvis, in that parenchymal tumors are purely neuroendocrine while pelvic tumors are mostly mixed neuroendocrine-exocrine neoplasms.

Refractory Pleural Small Cell Carcinoma in Never Smoker. A Case Report

A 47-year-old woman who had never smoked was evaluated for chest wall pain, cough and dyspnea that proved to be due to neoplastic right pleural disease with effusion. Cytological examination of the pleural fluid and histological analysis of a biopsy specimen of the pleural mass obtained during thoracoscopy were consistent with a diagnosis of small cell carcinoma. The patient was treated with two lines of chemotherapy and with octreotide, but without any clinical or radiological benefit. Since there was immunohistochemical overexpression of epidermal growth factor receptor, the patient was treated with gefitinib. Despite an initial clinical improvement she died due to disease progression. This case of a refractory pleural small cell carcinoma, which is an extremely rare disease, is the first reported in a never smoker and the first to be fully characterized for EGFR status.