Small cell lung cancer with thyroid gland oligometastasis: A case report

Oligo-Metastatic Disease in Oncology: Exploring the Limits and the Potential of Genetic Assessment

Oligo-metastatic disease (OMD) in the field of oncology denotes a distinct subset of metastatic tumors characterized by less aggressive biological behavior and extended survival times in comparison to their widely metastatic counterparts. While there is a general consensus regarding the existence of OMD, there remains a lack of widely accepted criteria for its a priori identification at the time of presentation. This review delves into the concept of OMD, placing a particular emphasis on the significance of understanding the limitations and potential of genetic assessments. It explores how these aspects are crucial in advancing our comprehension of this phenomenon. In a rapidly advancing era of precision medicine, understanding the intricacies of OMD opens up exciting possibilities for tailored treatment approaches. By elucidating the genetic underpinnings and dynamic nature of this condition, we stand to improve patient outcomes and potentially shift the paradigm of metastatic cancer management.

Oligo-Metastatic Cancers: Putative Biomarkers, Emerging Challenges and New Perspectives

Some cancer patients display a less aggressive form of metastatic disease, characterized by a low tumor burden and involving a smaller number of sites, which is referred to as "oligometastatic disease" (OMD). This review discusses new biomarkers, as well as methodological challenges and perspectives characterizing OMD. Recent studies have revealed that specific microRNA profiles, chromosome patterns, driver gene mutations (ERBB2, PBRM1, SETD2, KRAS, PIK3CA, SMAD4), polymorphisms (TCF7L2), and levels of immune cell infiltration into metastases, depending on the tumor type, are associated with an oligometastatic behavior. This suggests that OMD could be a distinct disease with specific biological and molecular characteristics. Therefore, the heterogeneity of initial tumor burden and inclusion of OMD patients in clinical trials pose a crucial methodological question that requires responses in the near future. Additionally, a solid understanding of the molecular and biological features of OMD will be necessary to support and complete the clinical staging systems, enabling a better distinction of metastatic behavior and tailored treatments.

Metastatic lung carcinoma in thyroid aspirates: A case series and literature review illustrating diagnostic challenges

BACKGROUND

Papillary thyroid carcinoma (PTC) is the most common primary malignant thyroid neoplasm and malignant diagnosis in thyroid aspirates. Metastatic adenocarcinoma of lung is an under-recognized mimicker which overlaps cytomorphologically and immunocytochemically with PTC. This case series reviews thyroid aspirates of metastatic lung carcinomas, aiming to address the similarities and methods of differentiating this entity from PTC.

METHODS

Thyroid aspirates of metastatic lung carcinomas were obtained by a computerized search. Clinico-cytological features and ancillary test results were reviewed. Literature review was performed for published cases of metastatic lung carcinomas in thyroid aspirates.

RESULTS

A total of 14 cases were found, including nine adenocarcinomas, three TTF1-positive non-small cell lung carcinomas (NSCLCs), one small cell carcinoma and one squamous cell carcinoma. The adenocarcinomas and TTF1-positive NSCLCs displayed PTC-like features including papillae/papillary-like fronds (n=6/12, 50%), nuclear grooves (n=5/12, 41.7%) and inclusions (n=1/12, 8.3%), chromatin clearing (n=3/12, 25%), calcifications (n=3/12, 25%) and multinucleated giant cells (n=2/12, 16.7%). Useful distinguishing features observed were prominent nucleoli, coarse chromatin, mitosis, and necrosis. TTF-1 immunocytochemistry was positive in most cases (n=5/6, 83.3%), while PAX8 and thyroglobulin were consistently negative. EGFR exon 19 deletion was detected on cell block preparation in a single case, corresponding to its lung primary. Literature search yielded 84 cases of metastatic malignancies, with lung carcinomas comprising of 3.6%-33.3% in case series of metastatic malignancies.

CONCLUSION

Metastatic adenocarcinoma of lung and PTC share significant cytomorphological and immunocytochemical similarities. A high degree of caution, meticulous clinico-cytological assessment and prudent use of ancillary techniques is necessary to avoid potential misdiagnosis.

Knockdown of circ‑PVT1 inhibits the progression of lung adenocarcinoma and enhances the sensitivity to cisplatin via the miR‑429/FOXK1 signaling axis

Lung cancer is one of the most prevalent cancers in China, and its incidence and morbidity remain high due to various independent factors. Lung adenocarcinoma (ADC) is the most common type of non‑small cell lung carcinoma. Circular RNA plasmacytoma variant translocation 1 (circ‑PVT1) plays an oncogenic role in various types of cancer, but the specific role of circ‑PVT1 in lung ADC has not yet been reported. In the present study, circ‑PVT1 was knocked down in A549 cells and the cell viability, proliferation, migration and invasion were measured via MTT, colony formation, wound healing and Transwell assays, respectively. Then, the cell viability of A549 cells with circ‑PVT1‑knockdown or ‑overexpression was detected after exposure to cisplatin (DDP). After confirming the associations among circ‑PVT1, microRNA (miR)‑429 and forkhead box k1 (FOXK1) using various tools and assays, the cellular functions of A549 cells treated with combined short hairpin (sh)RNA‑circ‑PVT1 and miR‑429 inhibitor/pcDNA3.1‑FOXK1 were tested again. The expression of circ‑PVT1 was found to be increased in lung ADC cells, and shRNA‑circ‑PVT1 led to decreased cell viability, proliferation, migration and invasion. The expression of circ‑PVT1 was higher in A549/DDP cells than that in A549 cells, and the activity of caspase‑3 was also activated by DDP in A549/DDP cells transfected with shRNA‑circ‑PVT1, whereas it was inactivated by DDP in A549 cells transfected with circ‑PVT1 overexpression plasmid. Furthermore, the decreased cell viability, proliferation, invasion and migration induced by shRNA‑circ‑PVT1 could be abated by transfection with miR‑429 inhibitor and pcDNA3.1‑FOXK1. In conclusion, interference of circ‑PVT1 inhibits the progression of lung ADC and enhances its sensitivity to DDP via miR‑429/FOXK1, which may provide a theoretical basis for the use of novel targets in the treatment of lung ADC.