1
|
Iwuagwu C, Kanakamedala SS, Tinsley S, Mohsin J. CRE24-049: Extrapulmonary Small Cell Carcinoma of Gallbladder Presenting as Acute Cholecystitis. J Natl Compr Canc Netw 2024; 22:CRE24-049. [PMID: 38579888 DOI: 10.6004/jnccn.2023.7315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
- Cindy Iwuagwu
- 1UCF COM/HCA Healthcare GME, Orlando, FL
- 2University of Central Florida College of Medicine, Orlando, FL
| | - Sesha Sai Kanakamedala
- 1UCF COM/HCA Healthcare GME, Orlando, FL
- 2University of Central Florida College of Medicine, Orlando, FL
| | | | | |
Collapse
|
2
|
Briski LM, Aron M, Epstein JI, Russell DH, Assarzadegan N, Delma KS, O'Dell H, Rodriguez E, Montgomery EA, Kryvenko ON. Patterns of Immunoreactivity with TTF-1 Antibodies 8G7G3/1 and SPT24 Suggest Distinct Immunoprofiles Between Most Pulmonary and Nonpulmonary Small Cell Carcinomas. Int J Surg Pathol 2024; 32:230-238. [PMID: 37170625 DOI: 10.1177/10668969231171940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Introduction. Small cell carcinoma can arise from various sites. Herein, we analyze the ability of 2 thyroid transcription factor-1 (TTF-1) antibodies (SPT24 and 8G7G3/1) to separate pulmonary from nonpulmonary small cell carcinoma. Materials and Methods. We analyzed 26 pulmonary and 83 nonpulmonary small cell carcinomas, and 14 Merkel cell carcinomas. Each tumor was stained with SPT24 and 8G7G3/1. Extent of nuclear staining was scored as diffuse (>50%), focal (11%-50%), rare (1%-10%), or negative (<1%). Results. All pulmonary small cell carcinomas were positive for SPT24 and 8G7G3/1. Four Merkel cell carcinomas (29%) were positive for SPT24 (ranging from rare-to-diffuse), while 2 (14%) showed rare expression with 8G7G3/1. For nonpulmonary small cell carcinomas, 69 (83%) were positive for SPT24 and 40 (48%) were positive for 8G7G3/1. For SPT24 positive tumors, the extent of 8G7G3/1 expression was equal in 17 (25%) and less in 52 tumors (75%), including 29 (42%) that were negative for 8G7G3/1. No nonpulmonary small cell carcinoma had more staining with 8G7G3/1 compared to SPT24. The differences in staining between 8G7G3/1 and SPT24 in the nonpulmonary cohort were statistically significant (P < 0.0001) with no significant difference between primary and metastatic lesions for 8G7G3/1 (P = 0.66) or SPT24 (P = 0.77). Conclusion. Most pulmonary small cell carcinomas are diffusely positive for both SPT24 and 8G7G3/1, whereas most nonpulmonary small cell carcinomas exhibit focal-to-no staining with 8G7G3/1 and significantly less staining with 8G7G3/1 compared to SPT24. However, these trends are not absolute and should be interpreted in conjunction with clinical and radiological findings.
Collapse
Affiliation(s)
- Laurence M Briski
- Department of Pathology and Laboratory Medicine, University of Miami Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Manju Aron
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jonathan I Epstein
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Daniel H Russell
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Naziheh Assarzadegan
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Katiana S Delma
- Department of Pathology and Laboratory Medicine, University of Miami Hospital, Miami, FL, USA
| | - Henry O'Dell
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Estelamari Rodriguez
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Oncology, University of Miami Hospital, Miami, FL, USA
| | - Elizabeth A Montgomery
- Department of Pathology and Laboratory Medicine, University of Miami Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Oleksandr N Kryvenko
- Department of Pathology and Laboratory Medicine, University of Miami Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Radiation Oncology, University of Miami Hospital, Miami, FL, USA
| |
Collapse
|
3
|
Kou Z, Wang P, Jia D, Zhu H. Clinical analysis of small-cell carcinoma of the urinary bladder: A case report and review of literature. Asian J Surg 2024; 47:1602-1603. [PMID: 38092594 DOI: 10.1016/j.asjsur.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/01/2023] [Indexed: 03/13/2024] Open
Affiliation(s)
- Zengshun Kou
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, No.5, Donghai Middle Road, Shinan District, Qingdao, Shandong, 266001, China
| | - Peng Wang
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, No.5, Donghai Middle Road, Shinan District, Qingdao, Shandong, 266001, China
| | - Dongmei Jia
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, No.5, Donghai Middle Road, Shinan District, Qingdao, Shandong, 266001, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, No.5, Donghai Middle Road, Shinan District, Qingdao, Shandong, 266001, China.
| |
Collapse
|
4
|
Evangelisti TM, Platoff RM, Khrizman P, Morrison JC, Joneja U, Allen AA, Giugliano DN, Kwiatt ME, McClane SJ. Small Cell Carcinoma of the Rectum-An Unexpected Diagnosis: Current Treatment Options for a Rare and Aggressive Entity. Am Surg 2023; 89:6359-6361. [PMID: 37203324 DOI: 10.1177/00031348231175116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Rectal small cell carcinoma is a rare and aggressive cancer subtype for which a consensus of optimal treatment has not yet been reached. This cancer presents a difficult surgical problem, and thus, the mainstay of treatment tends to mirror that of small cell carcinoma of the lung (chemotherapy, radiation therapy, and immune modulators). This brief report highlights current treatment options available for this rare and difficult entity. There is a significant need for large-center clinical trials and prospective studies to help determine the best treatment regimen to effectively care for patients with small cell carcinoma of the rectum.
Collapse
Affiliation(s)
| | | | - Polina Khrizman
- Cooper University Hospital, Department of Hematology and Medical Oncology, Camden, NJ, USA
| | - Jamin C Morrison
- Cooper University Hospital, Department of Hematology and Medical Oncology, Camden, NJ, USA
| | - Upasana Joneja
- Cooper University Hospital, Department of Pathology, Camden, NJ, USA
| | - Ashleigh A Allen
- Cooper University Hospital, Department of Pathology, Camden, NJ, USA
| | | | - Michael E Kwiatt
- Cooper University Hospital, Department of Surgery, Camden, NJ, USA
| | - Steven J McClane
- Cooper University Hospital, Department of Surgery, Camden, NJ, USA
| |
Collapse
|
5
|
Feng BJ, Li TH, Li YH, Feng JX, Zhang J, Ma JY, Wang YW, Lu SS. Case series of ovarian neuroendocrine carcinoma: overview of clinicopathological features. BMC Womens Health 2023; 23:595. [PMID: 37953251 PMCID: PMC10641945 DOI: 10.1186/s12905-023-02722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Ovarian neuroendocrine carcinoma (O-NEC) is a relatively uncommon neoplasm, and the current knowledge regarding its diagnosis and management is limited. In this series, our objective was to provide an overview of the clinicopathological characteristics of the disease by analyzing clinical case data to establish a theoretical foundation for the diagnosis and management of O-NEC. CASE PRESENTATION We included three patients in the present case series, all of whom were diagnosed with primary O-NEC based on pathomorphological observation and immunohistochemistry. Patient 1 was a 62-year-old patient diagnosed with small cell carcinoma (SCC) of the pulmonary type. Post-surgery, the patient was diagnosed with stage II SCC of the ovary and underwent standardized chemotherapy; however, imaging examinations conducted at the 16-month follow-up revealed the existence of lymph node metastasis. Unfortunately, she passed away 21 months after the surgery. The other two patients were diagnosed with carcinoid tumors, one at age 39 and the other at age 71. Post-surgery, patient 2 was diagnosed with a carcinoid in the left ovary, whereas patient 3 was diagnosed with a carcinoid in her right ovary based on clinical evaluation. Neither of the cases received adjuvant therapy following surgery; however, they have both survived for 9 and 10 years, respectively, as of date. CONCLUSION Primary O-NECs are rare and of diverse histological types, each of which has its own unique biological features and prognosis. SCC is a neoplasm characterized by high malignancy and a poor prognosis, whereas carcinoid tumors are of lesser malignancy and have a more favorable prognosis.
Collapse
Affiliation(s)
- Bao-Jie Feng
- Department of Gynecology, the Fourth Hospital of Hebei Medical University, No.12 of Jian-kang Road, Chang-an District, Shijiazhuang, 050011, China
| | - Tian-Hua Li
- Department of Gynecology, the Fourth Hospital of Hebei Medical University, No.12 of Jian-kang Road, Chang-an District, Shijiazhuang, 050011, China
| | - Yue-Hong Li
- Department of Pathology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Jing-Xuan Feng
- Department of Clinical Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Jun Zhang
- Department of Gynecology, the Fourth Hospital of Hebei Medical University, No.12 of Jian-kang Road, Chang-an District, Shijiazhuang, 050011, China
| | - Jun-Ying Ma
- Department of Gynecology, the Fourth Hospital of Hebei Medical University, No.12 of Jian-kang Road, Chang-an District, Shijiazhuang, 050011, China.
| | - Yan-Wei Wang
- Department of Gynecology, the Fourth Hospital of Hebei Medical University, No.12 of Jian-kang Road, Chang-an District, Shijiazhuang, 050011, China
| | - Su-Shuang Lu
- Department of Gynecology, The First Hospital of Hebei Medical University, Shijiazhuang, 050032, China
| |
Collapse
|
6
|
de la Sota-Montero R, Corral-Blanco M, Aguado-Agudo M, Revuelta-Salgado F, García-Lujan R, de Granda-Orive JI. Primary Tracheal Small Cell Carcinoma: A Diagnostic Challenge. Arch Bronconeumol 2023; 59:752-753. [PMID: 37813802 DOI: 10.1016/j.arbres.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Raquel de la Sota-Montero
- Respiratory Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
| | - Marta Corral-Blanco
- Respiratory Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - María Aguado-Agudo
- Respiratory Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - Fernando Revuelta-Salgado
- Respiratory Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - Ricardo García-Lujan
- Respiratory Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | | |
Collapse
|
7
|
Bose S, Khaja MS. Carcinoma of unkown primary, presenting as estrogen receptor positive small cell carcinoma of breast without a breast lesion - case report on a rare entity. Clin Med (Lond) 2023; 23 Suppl 6:13-14. [PMID: 38614704 DOI: 10.7861/clinmed.23-6-s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
|
8
|
Witkowski L, Nichols KE, Jongmans M, van Engelen N, de Krijger RR, Herrera-Mullar J, Tytgat L, Bahrami A, Mar Fan H, Davidson AL, Robertson T, Anderson M, Hasselblatt M, Plon SE, Foulkes WD. Germline pathogenic SMARCA4 variants in neuroblastoma. J Med Genet 2023; 60:987-992. [PMID: 36813544 PMCID: PMC10570933 DOI: 10.1136/jmg-2022-108854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
Heterozygous germline pathogenic variants (GPVs) in SMARCA4, the gene encoding the ATP-dependent chromatin remodelling protein SMARCA4 (previously known as BRG1), predispose to several rare tumour types, including small cell carcinoma of the ovary, hypercalcaemic type, atypical teratoid and malignant rhabdoid tumour, and uterine sarcoma. The increase in germline testing of SMARCA4 in recent years has revealed putative GPVs affecting SMARCA4 in patients with other cancer types. Here we describe 11 patients with neuroblastoma (NBL), including 4 previously unreported cases, all of whom were found to harbour heterozygous germline variants in SMARCA4 Median age at diagnosis was 5 years (range 2 months-26 years); nine were male; and eight of nine cases had tumour location information in the adrenal gland. Eight of the germline variants were expected to result in loss of function of SMARCA4 (large deletion, truncating and canonical splice variants), while the remaining four were missense variants. Loss of heterozygosity of the wild-type SMARCA4 allele was found in all eight cases where somatic testing was performed, supporting the notion that SMARCA4 functions as a classic tumour suppressor. Altogether, these findings strongly suggest that NBL should be included in the spectrum of SMARCA4-associated tumours.
Collapse
Affiliation(s)
- Leora Witkowski
- Core Molecular Diagnostic Laboratory, McGill University Health Centre, Montreal, Québec, Canada
- Department of Human Genetics, McGill University, Montreal, Québec, Canada
| | - Kim E Nichols
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Marjolijn Jongmans
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Ronald R de Krijger
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Lieve Tytgat
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Armita Bahrami
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Helen Mar Fan
- Genetic Health Queensland, The University of Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Aimee L Davidson
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Thomas Robertson
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| | | | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Sharon E Plon
- Department of Pediatrics/Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - William D Foulkes
- Lady Davis Institute and Segal Cancer Centre, Sir Mortimer B Davis Jewish General Hospital, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| |
Collapse
|
9
|
Cho WC, Vanderbeck K, Nagarajan P, Milton DR, Gill P, Wang WL, Curry JL, Torres-Cabala CA, Ivan D, Prieto VG, Aung PP. SOX11 Is an Effective Discriminatory Marker, When Used in Conjunction With CK20 and TTF1, for Merkel Cell Carcinoma: Comparative Analysis of SOX11, CK20, PAX5, and TTF1 Expression in Merkel Cell Carcinoma and Pulmonary Small Cell Carcinoma. Arch Pathol Lab Med 2023; 147:758-766. [PMID: 36745184 DOI: 10.5858/arpa.2022-0238-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT.— Distinction between Merkel cell carcinoma (MCC) and pulmonary small cell carcinoma (PSmCC) can be challenging, even with the aid of immunohistochemistry (IHC) analysis of CK20 and TTF1, as these tumors occasionally lack classic immunophenotypes (CK20+/TTF1- in MCC and CK20-/TTF1+ in PSmCC). OBJECTIVE.— To evaluate the diagnostic utility of SOX11 and PAX5 IHC for distinguishing MCCs from PSmCCs and compare it with that of CK20 and TTF1 IHC. DESIGN.— SOX11, PAX5, CK20, and TTF1 expression (pattern, intensity, and proportion of tumor cells expressing protein) was assessed in 31 primary and 16 metastatic MCCs and 20 primary and 9 metastatic PSmCCs. RESULTS.— SOX11 expression was present in all MCCs and was predominantly strong and diffuse. Only 19% of primary and 38% of metastatic MCCs exhibited diffuse PAX5 expression; none exhibited strong immunoreactivity. Strong and diffuse SOX11 expression was seen in less than 25% of primary and metastatic PSmCCs. PAX5 expression was rare in PSmCCs and was mostly weak and focal/patchy. SOX11 expression in at least 26% of tumor cells, with at least moderate intensity, favored the diagnosis of MCC over PSmCC (P < .001). Furthermore, SOX11 expression was more likely than CK20 expression to be strong or diffuse in sentinel lymph node (SLN) metastases of MCC, indicating that SOX11 is superior to CK20 for detecting tumor deposits in SLNs in MCC. CONCLUSIONS.— Our findings indicate that SOX11 not only is a powerful marker for distinguishing MCCs from PSmCCs, especially when used in conjunction with CK20 and TTF1, but also has utility for screening SLNs in MCC.
Collapse
Affiliation(s)
- Woo Cheal Cho
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Kaitlin Vanderbeck
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Priyadharsini Nagarajan
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | | | - Pavandeep Gill
- The University of Texas MD Anderson Cancer Center, Houston; and the Department of Pathology, Royal Jubilee Hospital, Victoria, British Columbia, Canada (Gill). Cho, Vanderbeck, and Aung contributed equally to this manuscript
| | - Wei-Lien Wang
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Jonathan L Curry
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Carlos A Torres-Cabala
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Doina Ivan
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Victor G Prieto
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| | - Phyu P Aung
- From the Departments of Pathology (Cho, Vanderbeck, Nagarajan, Wang, Curry, Torres-Cabala, Ivan, Prieto, Aung)
| |
Collapse
|
10
|
Mohanty P, Mohapatra AS, Sabat D, Nayak J. Unusual histomorphological spectrum of urinary bladder cancers and their treatment modalities revisited: Our experience with series of five cases. J Cancer Res Ther 2023; 19:617-623. [PMID: 37470584 DOI: 10.4103/jcrt.jcrt_134_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Urinary bladder cancer is the eighth-most frequent carcinoma in men, commonly occurs in elderly male. Major risk factors are smoking, chronic cystitis, urinary stones. The most common histologic variant of bladder cancer is urothelial carcinoma (UC), but certain variants are unusual yet aggressive for which there is no consensus guideline of therapy. Those entities include neuroendocrine tumors both primary and metastatic, squamous cell carcinoma, and sarcomatoid carcinoma. Neuroendocrine tumors comprise carcinoid, small-cell carcinoma, and large-cell carcinoma. Aim The present study is undertaken to highlight certain biological features of these unusual aggressive histological forms of bladder carcinoma and their recent treatment modality to prevent recurrence, metastasis, upgrading of tumor stage, and enable surprisingly complete remission. Methods This piece of hospital-based perspective study was done from June 2018 to May 2020. Both transurethral resection of bladder tumor and cystectomy surgical samples of the symptomatic patients were collected from the urology department of our institute along with demographic data. Then processed, stained in both routine H and E stain and immunohistochemical stains (Immunohistochemistry [IHC]) like PanCK, NSE, synaptophysin, chromogranin, etc. Results Total number of bladder cancer encountered was 42 cases; of these five rare variants were observed, i.e., one case each of primary and secondary small cell neuroendocrine carcinoma, one large cell carcinoma, one squamous cell carcinoma (SCC), and one case of sarcomatoid carcinoma. Histomorphology with IHC conferred the diagnosis then multimodality therapy (neoadjuvant/radiotherapy/surgery) was installed and followed up. Conclusion The unconventional forms of UC can be easily diagnosed by histomorphology and can have better survival with the help of the recent multimodal treatment approach.
Collapse
Affiliation(s)
- Pranita Mohanty
- Department of Pathology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Ajit S Mohapatra
- Department of Pathology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Debabrat Sabat
- Department of Urology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Jhasaketan Nayak
- Department of Hemato-oncology, AIIMS, Bhubaneswar, Odisha, India
| |
Collapse
|
11
|
An Autoantibody Subset Can Be Used for SCLC Early Detection. Cancer Discov 2023; 13:526. [PMID: 36661372 DOI: 10.1158/2159-8290.CD-RW2023-009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Posttranslational modifications induce autoantibodies in small cell lung cancer and predict risk.
Collapse
|
12
|
Chrabańska M, Ryszawy J, Drozdzowska B. Combined renal small cell carcinoma: an extremely rare and unexpected case. Pol Arch Intern Med 2023; 134:16590. [PMID: 37874247 DOI: 10.20452/pamw.16590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
|
13
|
Fan J, Li H, Zhou C, Xiong W, Villamil C, Ionescu D, Oo HZ, Contreras-Sanz A, Black PC, Wang G. Classifying Pulmonary and Urinary High-grade Neuroendocrine Carcinoma by CK7 Immunohistochemistry. Appl Immunohistochem Mol Morphol 2022; 30:459-468. [PMID: 35603802 DOI: 10.1097/pai.0000000000001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/17/2022] [Indexed: 11/26/2022]
Abstract
High-grade neuroendocrine carcinoma (HGNEC) is subclassified into small cell carcinoma (SmCC) and large cell neuroendocrine carcinoma (LCNEC). Although both are clinically aggressive, the SmCC and LCNEC need to have different treatment strategies, and accurate pathologic diagnosis is challenging. We studied a large retrospective cohort (186 cases) of HGNEC of bladder and lung to investigate the abundance of cytokeratin (CK) 7 expression and staining pattern in SmCC and LCNEC. Overall, the pulmonary and urinary HGNEC exhibited several different CK7 staining patterns, including negative staining (n=28), dot-like staining (n=73), partial membranous staining (n=26), and complete membranous staining (n=60). Overall, 88.9% (44/49) of pulmonary SmCC and 88.0% (44/50) of urinary SmCC showed negative or dot-like patterns for CK7, while 90.8% (59/65) of pulmonary LCNEC and 72.7% (16/22) of urinary LCNEC showed partial or complete membranous patterns for CK7 (χ 2 =105.05, P <0.0001). The distinct staining patterns were also present in those mixed SmCC and LCNEC. In addition, the specimen types or fixation did not affect CK7 staining patterns. In conclusion, CK7 has a high differential value for SmCC and LCNEC and could help guide personalized treatment for patients.
Collapse
Affiliation(s)
| | | | - Chen Zhou
- University of British Columbia
- Department of Pathology, British Columbia Cancer Vancouver Centre
| | - Wei Xiong
- University of British Columbia
- Department of Pathology, St. Paul's Hospital, Vancouver, BC, Canada
| | - Carlos Villamil
- University of British Columbia
- Department of Pathology, British Columbia Cancer Vancouver Centre
| | - Diana Ionescu
- University of British Columbia
- Department of Pathology, British Columbia Cancer Vancouver Centre
| | - Htoo Z Oo
- Department of Urologic Sciences, University of British Columbia
| | | | - Peter C Black
- Department of Urologic Sciences, University of British Columbia
| | - Gang Wang
- University of British Columbia
- Department of Pathology, British Columbia Cancer Vancouver Centre
| |
Collapse
|
14
|
Hussain M, Abbott M, Zargham R, Pabani A, Khan OF. Evolution of an invasive ductal carcinoma to a small cell carcinoma of the breast: A case report. Medicine (Baltimore) 2022; 101:e28433. [PMID: 35029184 PMCID: PMC8758025 DOI: 10.1097/md.0000000000028433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Small cell carcinoma (SCC) is a rare subtype of breast cancer and presents a complex diagnostic and treatment challenge, due to paucity of data. To the best of our knowledge, most cases of breast SCC reported in the literature describe a de novo breast primary. Our case is unique as it describes the evolution of an invasive ductal carcinoma after treatment into a SCC of the breast. PATIENT CONCERNS AND DIAGNOSIS We report a case of a 53-year-old female, lifelong non-smoker, who initially presented with breast mass noted on self examination. Breast and axillary lymph node biopsy demonstrated a hormone receptor positive invasive ductal carcinoma with a metastatic T3 lesion. INTERVENTION She was treated with first-line palbociclib/letrozole with initial clinical response, and at progression was switched to capecitabine with no response. Repeat biopsy of the axillary lesion showed evolution of the tumor into a triple negative breast cancer. She was then treated with third-line paclitaxel and radiation therapy with good initial response. She eventually had further disease progression and presented with a new mediastinal lymphadenopathy causing SVC syndrome. Biopsy of this showed a small cell variant of breast neuroendocrine carcinoma. Due to the evolution of histology in this case, a retrospective review of her initial breast specimen as well as the second biopsy from the axilla was conducted which confirmed that the mediastinal lymphadenopathy was metastatic from the original breast tumor. OUTCOMES AND LESSONS We speculate that the initial treatment allowed a minority of treatment-resistant neuroendocrine cells to grow and become the dominant face of the tumor. Our patient had an excellent response to carboplatin/etoposide and consolidative locoregional radiotherapy but presented with an early intracranial recurrence. This is a similar pattern of metastases as seen in lung SCC and highlights a potential role for prophylactic cranial irradiation in breast SCC. Further studies are needed to better understand the biology and treatment of breast SCC which continues to present a challenge for clinicians.
Collapse
Affiliation(s)
- Marya Hussain
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Marcia Abbott
- Department of Pathology and Laboratory Medicine, Cummings Medical School, University of Calgary, Calgary, Alberta
| | - Ramin Zargham
- Department of Pathology and Laboratory Medicine, Cummings Medical School, University of Calgary, Calgary, Alberta
| | - Aliyah Pabani
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Omar F. Khan
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| |
Collapse
|
15
|
Canberk S, Thodou E, Bongiovanni M. Small-Cell Malignancies of Thyroid: Challenge Solved? Acta Cytol 2022; 66:307-318. [PMID: 35016187 DOI: 10.1159/000520876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022]
Abstract
"Small-cell malignancies of thyroid" is an unsolved dilemma. This term represents an umbrella terminology in thyroid, encompassing for a small group of tumors in which some of them are well-recognized tumors like medullary thyroid carcinoma, poorly differentiated thyroid carcinoma, and primary thyroid lymphomas and teratoma, whereas the remaining are less known as primary neuroendocrine carcinoma of thyroid, primary extraskeletal Ewing family tumors, and adamantinoma-like Ewing sarcoma. When the issue comes to evaluate a cytological sample predominantly composed of small-cell morphology, metastatic small-cell carcinomas to thyroid also should be excluded. In this review, our group focused on the main cytomorphological and clinical clues of each entity that help to set up a correct differential diagnosis. The literature discussions were also included for the entities that are not yet recognized by the mother publication WHO. A key point of the issue's simple algorithm based on FNAC with small-cell morphology of thyroid was suggested by the authors.
Collapse
Affiliation(s)
- Sule Canberk
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
- Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Eleni Thodou
- Department of Pathology, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | | |
Collapse
|
16
|
Abstract
Small-cell lung carcinoma (SCLC) is a high-grade aggressive disease that belongs to the neuroendocrine (NE) group of lung tumors that also includes typical carcinoid, atypical carcinoid, and large-cell NE carcinoma. SCLC has specific histological diagnostic criteria that are sometimes troublesome to be assessed in cytological samples that indeed represent the most frequent source of diagnostic material due to the typical advanced presentation at the onset of SCLC. However, cytological preparations could be in some instances more reliable than histology due to the better preservation of nuclear details. Cytological criteria for diagnosis of SCLC include high cellularity, small cell size, scant cytoplasm, coarsely granulated chromatin with "salt-and-pepper" appearance, inconspicuous or absent nucleoli, Azzopardi crush effect, and necrotic debris in the background. Despite being distinctive, these features could be incomplete to differentiate SCLC with other small-cell neoplasia. Therefore, immunocytochemical determination of diagnostic biomarkers is crucial to achieve a confident diagnosis. Furthermore, recent findings on molecular and transcriptomic studies of SCLC revealed the potential rise of new predictive and prognostic biomarkers that, whenever validated by immunocytochemistry, may potentially assist to tailor the best therapy, including immune checkpoint inhibition.
Collapse
Affiliation(s)
- Luisella Righi
- Pathology Unit, Department of Oncology, University of Torino at San Luigi Hospital, Orbassano (Torino), Italy
| | - Marco Volante
- Pathology Unit, Department of Oncology, University of Torino at San Luigi Hospital, Orbassano (Torino), Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Torino at City of Health and Science, Torino, Italy,
| |
Collapse
|
17
|
Han LM, VandenBussche CJ, Abildtrup M, Chandra A, Vohra P. A Review of Effusion Cytomorphology of Small Round Cell Tumors. Acta Cytol 2021; 66:336-346. [PMID: 34218227 DOI: 10.1159/000516497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Small round cell tumors (SRCTs) are a broad category of diverse malignant tumors composed of monotonous undifferentiated cells. Involvement of serous fluids by SRCT is rare; however, the identification of exfoliated malignant cells is a crucial component of management and has significant implications for treatment and prognosis. The most common effusion tumors with SRCT morphology include Ewing sarcoma, synovial sarcoma, rhabdomyosarcoma (RMS), small-cell neuroendocrine carcinoma (SCNC), and desmoplastic SRCT, and the cytomorphologic distinction between these tumors is challenging. The purpose of this article is to describe the morphologic features of the most common SRCT in fluids and propose helpful ancillary testing. SUMMARY Effusion SRCTs display similar primitive and undifferentiated morphologic features although each has subtle variations. Ewing sarcoma is a mesenchymal neoplasm and harbors characteristic translocations t(11;22) (EWSR1-FLI1) or t(21;22) (EWSR1-ERG). In fluids, Ewing sarcoma shows poorly differentiated cells of variable size with round to oval nuclei, prominent nucleoli, and scant cytoplasm. In contrast, synovial sarcoma typically involves extremities and expresses a fusion transcript in t(X;18) (SS18-SSX). This soft tissue neoplasm demonstrates uniform cells with irregular nuclear contours, characteristic nuclear folding, and scant cytoplasm. RMS is a neoplasm arising from skeletal muscle, and the alveolar subtype demonstrates a translocation in t(2;13) (PAX3-FOXO1). The malignant cells show a spectrum of small round cells and pleomorphic large cells with rhabdoid morphology. RMS cells characteristically express myogenin and MyoD1, markers of skeletal muscle differentiation. Although SCNC is not a classic SRCT, the morphology is similar. SCNC demonstrates tight clusters of malignant cells with nuclear molding and salt-and-pepper chromatin. This tumor classically has neuroendocrine differentiation and is positive for synaptophysin and chromogranin on immunohistochemistry. And last, desmoplastic SRCT typically presents as an intra-abdominal mass in young men and characteristically harbors the translocation t(11;22) (p13;q12) (EWSR1-WT1). Cytomorphologically, the tumor shows small monomorphic cells occasionally arranged as rosette-like structures. KEY MESSAGE The diagnosis of SRCT can be made in effusion samples and is best achieved with a combination of morphologic features, clinical history, and ancillary testing.
Collapse
Affiliation(s)
- Lucy M Han
- Department of Pathology, University of California, San Francisco, California, USA
| | | | - Mads Abildtrup
- Department of Histopathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Ashish Chandra
- Department of Cellular Pathology, St. Thomas' Hospital, London, UK
| | - Poonam Vohra
- Department of Pathology, University of California, San Francisco, California, USA,
| |
Collapse
|
18
|
Ribeiro EA, Maleki Z. p16 immunostaining in cytology specimens: its application, expression, interpretation, and challenges. J Am Soc Cytopathol 2021; 10:414-422. [PMID: 33422456 DOI: 10.1016/j.jasc.2020.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION p16 immunostaining is considered as a surrogate marker for human papillomavirus (HPV)-related head and neck squamous cell carcinomas (HNSCC). Herein, the utility of p16 is evaluated in cytology specimens. MATERIAL AND METHODS The electronic data of a large academic institution was searched for cytology cases accompanied by p16 (2014-2018). Cases were categorized based on body sites. P16 staining was quantified (negative [0%], focal/patchy, or diffusely positive [>70%]). HPV testing was correlated where available. RESULTS A total of 372 cases were included (male:female, 239:133). The largest differences in application of p16 between men and women were in head/neck cases (209 versus 59) and the abdominal cases (1 versus 33), respectively. p16 diffuse staining is seen in most squamous cell carcinomas, small cell carcinomas, and gynecologic serous carcinomas. p16 expression was patchy or negative in most adenocarcinoma, neuroendocrine carcinoma, spindle cell neoplasms, and benign conditions. HPV testing was done on 217 cases including 138 cases with strong p16 (127 HPV+/11 HPV-), 20 cases with focal/patchy P16 staining (6 HPV+/14 HPV-) and 59 cases with negative p16 staining (3 HPV+/56 HPV-). CONCLUSIONS Diffuse p16 staining aids in the diagnosis of HPV-related carcinomas, particularly HPV-related HNSCC, across the body and according to sex. In contrast, focal/patchy p16 staining does not correlate with HPV status across various body sites. In conclusion, intensity of p16 matters and should be correlated with cytomorphology, clinical history, and ancillary studies (eg, p40 immunostaining) for an accurate diagnosis and preventing diagnostic pitfalls.
Collapse
MESH Headings
- Abdominal Neoplasms/diagnosis
- Abdominal Neoplasms/metabolism
- Abdominal Neoplasms/pathology
- Abdominal Neoplasms/virology
- Adenocarcinoma/diagnosis
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Adenocarcinoma/virology
- Adult
- Aged
- Aged, 80 and over
- Alphapapillomavirus/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/metabolism
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/virology
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/metabolism
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/virology
- Cyclin-Dependent Kinase Inhibitor p16/metabolism
- Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods
- Female
- Head and Neck Neoplasms/diagnosis
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/pathology
- Head and Neck Neoplasms/virology
- Human Papillomavirus DNA Tests/methods
- Humans
- Immunohistochemistry/methods
- In Situ Hybridization/methods
- Male
- Middle Aged
- Papillomavirus Infections/diagnosis
- Papillomavirus Infections/metabolism
- Papillomavirus Infections/parasitology
- Papillomavirus Infections/virology
- Retrospective Studies
- Squamous Cell Carcinoma of Head and Neck/diagnosis
- Squamous Cell Carcinoma of Head and Neck/metabolism
- Squamous Cell Carcinoma of Head and Neck/pathology
- Squamous Cell Carcinoma of Head and Neck/virology
Collapse
Affiliation(s)
- Efrain A Ribeiro
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland
| | - Zahra Maleki
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland.
| |
Collapse
|
19
|
Zhang M, Shi W, Zhang QW, Wang W, Li QY. [Diagnosis and treatment of small cell neuroendocrine carcinoma of the prostate]. Zhonghua Nan Ke Xue 2021; 27:219-225. [PMID: 34914303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the clinical manifestations, pathological features and treatment of small cell neuroendocrine carcinoma of the prostate (SCPCa). METHODS We reported 1 case of SCPCa treated in Jinan People's Hospital and analyzed the clinical data on another 57 cases reported in China. RESULTS Of the total number of cases, 52 (91.2%) had urinary tract symptoms, including 40 cases of urinary tract obstruction symptoms and 53 (91.2%) had abnormal prostatic nodules on digital rectal examination, 17 (29.8%) with PSA > 4 μg/L. The clinical data on 43 (75.4%) of the cases were valuable for the assessment of clinical stages, including 30 cases with confirmed metastases and another 20 with lymph node and distant metastases. Thirty-seven of the cases (64.9%) were reported with immunohistochemical results, 30 (52.6%) with follow-up data (followed up for 1-24 months, with median survival time of 8 months, and a 1-year survival rate of 16.7%), and another 26 with therapeutic information, 14 treated by chemotherapy, with a median survival time of 11 months and a 1-year survival rate of 28.6%, significantly higher than in the non-chemotherapy groups (P<0.01). CONCLUSIONS Small cell carcinoma of the prostate is highly malignant with poor prognosis. Its clinical symptoms mainly include urinary tract obstruction, its definite diagnosis chiefly depends on histopathology and immunohistochemistry, and its treatment recommended is chemotherapy-based comprehensive protocol.
Collapse
Affiliation(s)
- Min Zhang
- Department of Urology, Jinan People's Hospital, Jinan, Shandong 271100, China
| | - Wei Shi
- Department of Urology, Yantai Affiliated Hospital of Binzhou Medical College, Yantai, Shandong 264000, China
| | - Qi-Wei Zhang
- The Second Department of Urology, Liaocheng Second People's Hospital, Liaocheng, Shandong 252000, China
| | - Wei Wang
- Department of Urology, Zibo Maternity and Childcare Hospital, Zibo, Shandong 255029 China
| | - Qing-Yuan Li
- Department of Urology, The Affected Hospital of Guilin Medical College, Guilin, Guangxi 541000, China
| |
Collapse
|
20
|
Karnezis AN, Chen SY, Chow C, Yang W, Hendricks WPD, Ramos P, Briones N, Mes-Masson AM, Bosse T, Gilks CB, Trent JM, Weissman B, Huntsman DG, Wang Y. Re-assigning the histologic identities of COV434 and TOV-112D ovarian cancer cell lines. Gynecol Oncol 2021; 160:568-578. [PMID: 33328126 PMCID: PMC10039450 DOI: 10.1016/j.ygyno.2020.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/05/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The development of effective cancer treatments depends on the availability of cell lines that faithfully recapitulate the cancer in question. This study definitively re-assigns the histologic identities of two ovarian cancer cell lines, COV434 (originally described as a granulosa cell tumour) and TOV-112D (originally described as grade 3 endometrioid carcinoma), both of which were recently suggested to represent small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), based on their shared gene expression profiles and sensitivity to EZH2 inhibitors. METHODS For COV434 and TOV-112D, we re-reviewed the original pathology slides and obtained clinical follow-up on the patients, when available, and performed immunohistochemistry for SMARCA4, SMARCA2 and additional diagnostic markers on the original formalin-fixed, paraffin-embedded (FFPE) clinical material, when available. For COV434, we further performed whole exome sequencing and validated SMARCA4 mutations by Sanger sequencing. We studied the growth of the cell lines at baseline and upon re-expression of SMARCA4 in vitro for both cell lines and evaluated the serum calcium levels in vivo upon injection into immunodeficient mice for COV434 cells. RESULTS The available morphological, immunohistochemical, genetic, and clinical features indicate COV434 is derived from SCCOHT, and TOV-112D is a dedifferentiated carcinoma. Transplantation of COV434 into mice leads to increased serum calcium level. Re-expression of SMARCA4 in either COV434 and TOV-112D cells suppressed their growth dramatically. CONCLUSIONS COV434 represents a bona fide SCCOHT cell line. TOV-112D is a dedifferentiated ovarian carcinoma cell line.
Collapse
MESH Headings
- Animals
- Carcinoma, Ovarian Epithelial/diagnosis
- Carcinoma, Ovarian Epithelial/drug therapy
- Carcinoma, Ovarian Epithelial/genetics
- Carcinoma, Ovarian Epithelial/pathology
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/genetics
- Carcinoma, Small Cell/pathology
- Cell Dedifferentiation/genetics
- Cell Line, Tumor/drug effects
- Cell Line, Tumor/pathology
- DNA Helicases/analysis
- DNA Helicases/deficiency
- DNA Helicases/genetics
- Enhancer of Zeste Homolog 2 Protein/antagonists & inhibitors
- Female
- Gene Expression Profiling
- Humans
- Mice
- Nuclear Proteins/analysis
- Nuclear Proteins/deficiency
- Nuclear Proteins/genetics
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/pathology
- Transcription Factors/analysis
- Transcription Factors/deficiency
- Transcription Factors/genetics
- Exome Sequencing
- Xenograft Model Antitumor Assays
Collapse
Affiliation(s)
- Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Shary Yuting Chen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Winnie Yang
- Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - William P D Hendricks
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Pilar Ramos
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Natalia Briones
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, QC, Canada; Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey M Trent
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Bernard Weissman
- Department of Pathology and Laboratory Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
| | - Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada.
| |
Collapse
|
21
|
Iida T, Muramatsu T, Kajiwara H, Kato N, Itoh H, Narayama T, Machida H, Ikeda M, Shida M, Hirasawa T, Mikami M. Small Cell Neuroendocrine Carcinoma of the Endometrium with Difficulty Identifying the Original Site in the Uterus. Tokai J Exp Clin Med 2020; 45:156-161. [PMID: 33300584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/14/2020] [Indexed: 06/12/2023]
Abstract
Diagnosis of malignant uterine tumor with continuous lesions from the uterine body to the cervix, i.e., endometrial or cervical cancer, depends on the main site of the lesions. However, it may be difficult to differentiate advanced cancer that is widespread in the uterus. We experienced a patient who was diagnosed with small cell neuroendocrine carcinoma (SCNEC) based on histopathological characteristics of SCNEC in the endometrium. This tumor frequently coexists with endometrioid carcinoma, but we had difficulty finding the original site of SCNEC in the endometrium. The patient was a 59-year-old, two-parous woman who underwent hysterectomy after diagnosis of malignant uterine tumor. Preoperative cervical and endometrial histology permitted diagnosis of SCNEC. Imaging showed that most of the anterior uterine wall from the uterine body to cervix was replaced by tumors. Histopathologic findings for the resected uterus showed that most of these tumors were SCNEC, but components of endometrioid carcinoma had developed from the endometrium just beneath the fundus to the lower uterine body. The growth pattern of endometrioid carcinoma was endophytic. Based on this finding, the patient was diagnosed with endometrial SCNEC associated with endometrioid carcinoma. The patient initially responded well after postoperative chemotherapy, but early recurrence led to death at three months after the first treatment. This case shows that SCNEC in the uterine body is likely to coexist with endometrioid carcinoma. These findings are useful to determine the original site in postoperative pathological diagnosis of highly advanced tumors. SCNEC is a rapidly progressive and aggressive tumor in clinical practice, but some cases have a relatively good initial response to chemotherapy and it is important to start treatment early.
Collapse
MESH Headings
- Antineoplastic Agents/administration & dosage
- Biomarkers, Tumor/blood
- Carcinoma, Endometrioid/diagnosis
- Carcinoma, Endometrioid/drug therapy
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/surgery
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/surgery
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/surgery
- Combined Modality Therapy
- Diagnosis, Differential
- Diffusion Magnetic Resonance Imaging
- Disease Progression
- Endometrial Neoplasms/diagnosis
- Endometrial Neoplasms/drug therapy
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/surgery
- Fatal Outcome
- Female
- Humans
- Hysterectomy
- Middle Aged
- Neoplasms, Multiple Primary
- Postoperative Care
Collapse
Affiliation(s)
- Tetsuji Iida
- Department of Obstetrics and Gynecology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Pressey JG, Dandoy CE, Pater LE, Sroga Rios J, Sisson R, Dasgupta R, Szabo S. Small cell carcinoma of the ovary hypercalcemic type (SCCOHT): Comprehensive management of a newly diagnosed young adult. Gynecol Oncol 2020; 158:538-546. [PMID: 32654763 DOI: 10.1016/j.ygyno.2020.06.160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
SCCOHT is an aggressive malignancy linked to alterations of SMARCA4. We describe the diagnosis and therapy of a 32 year old who received multi-agent chemotherapy and underwent a second look operation with HIPEC followed by high-dose chemotherapy with stem cell transplant. Supportive care, oncofertility, and genetic counseling are described.
Collapse
Affiliation(s)
- Joseph G Pressey
- Department of Pediatrics, University of Cincinnati College of Medicine, United States of America; Division of Oncology, Cincinnati Children's Hospital Medical Center, United States of America.
| | - Christopher E Dandoy
- Department of Pediatrics, University of Cincinnati College of Medicine, United States of America; Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, United States of America
| | - Luke E Pater
- Department of Radiation Oncology, University of Cincinnati College of Medicine, United States of America
| | - Julie Sroga Rios
- Department of Obstetrics & Gynecology, University of Cincinnati College of Medicine, United States of America
| | - Rebecca Sisson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, United States of America
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, United States of America
| | - Sara Szabo
- Department of Pathology, University of Cincinnati College of Medicine, United States of America; Division of Pathology, Cincinnati Children's Hospital Medical Center, United States of America
| |
Collapse
|
23
|
Xia L, Guo X, Liu T, Xu X, Jiang J, Wang F, Cheng Z, Zhu H, Yang Z. Multimodality imaging of naturally active melanin nanoparticles targeting somatostatin receptor subtype 2 in human small-cell lung cancer. Nanoscale 2019; 11:14400-14409. [PMID: 31334537 DOI: 10.1039/c9nr04371c] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Somatostatin receptor subtype 2 (SSTR2) is highly expressed in pulmonary neuroendocrine tumors, which account for approximately 25% of all lung cancers including small-cell lung cancer (SCLC). It is possible to establish SCLC-specific imaging agents for multimodal imaging to obtain tumor integrity information. Herein, we constructed novel multifunctional organic melanin nanoparticles (MNPs) as a carrier and surface-loaded somatostatin analog octreotide to produce a human small-cell lung cancer-targeted nanoprobe OCT-PEG-MNPs. MNPs have an excellent photoacoustic imaging (PAI) function and can be directly chelated with the magnetic resonance contrast agent Mn2+, and N-bromo succinimide (NBS) can be used as an oxidant to label the nanoparticles with the long half-life radionuclide 124I by an electrophilic substitution reaction. Therefore, (124I, Mn) OCT-PEG-MNPs can not only be used for PAI but also be used for positron emission tomography (PET) and magnetic resonance imaging (MRI). The NCI-H69 SCLC tumor xenograft model with high SSTR2 expression was constructed to evaluate the multimodal imaging ability of (124I, Mn) OCT-PEG-MNPs. This nanoprobe showed good imaging abilities in PAI, MRI and PET. The PA images showed that the photoacoustic signal in the NCI-H69 tumor site gradually increased with time, and the NCI-H69 xenograft showed a clear increase in the T1-weighted signal intensity after injection of Mn-OCT-PEG-MNPs at 24 h compared to that in the prescan. MicroPET and biodistribution studies showed that the uptake of NCI-H69 tumors (8.03 ± 0.37% ID g-1) was significantly higher than that in the control A549 model (3.35 ± 0.54% ID g-1) after injection of (124I, Mn) OCT-PEG-MNPs at 24 h. The (124I, Mn) OCT-PEG-MNPs were successfully applied to multimodal imaging in a small-cell lung cancer model with high SSTR2 expression. This nanoprobe may be considered for clinical trials since it combines the numerous advantages of organic nanoparticles.
Collapse
Affiliation(s)
- Lei Xia
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Balanis NG, Sheu KM, Esedebe FN, Patel SJ, Smith BA, Park JW, Alhani S, Gomperts BN, Huang J, Witte ON, Graeber TG. Pan-cancer Convergence to a Small-Cell Neuroendocrine Phenotype that Shares Susceptibilities with Hematological Malignancies. Cancer Cell 2019; 36:17-34.e7. [PMID: 31287989 PMCID: PMC6703903 DOI: 10.1016/j.ccell.2019.06.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/04/2019] [Accepted: 06/06/2019] [Indexed: 01/01/2023]
Abstract
Small-cell neuroendocrine cancers (SCNCs) are an aggressive cancer subtype. Transdifferentiation toward an SCN phenotype has been reported as a resistance route in response to targeted therapies. Here, we identified a convergence to an SCN state that is widespread across epithelial cancers and is associated with poor prognosis. More broadly, non-SCN metastases have higher expression of SCN-associated transcription factors than non-SCN primary tumors. Drug sensitivity and gene dependency screens demonstrate that these convergent SCNCs have shared vulnerabilities. These common vulnerabilities are found across unannotated SCN-like epithelial cases, small-round-blue cell tumors, and unexpectedly in hematological malignancies. The SCN convergent phenotype and common sensitivity profiles with hematological cancers can guide treatment options beyond tissue-specific targeted therapies.
Collapse
Affiliation(s)
- Nikolas G Balanis
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
| | - Katherine M Sheu
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
| | - Favour N Esedebe
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
| | - Saahil J Patel
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
| | - Bryan A Smith
- Department of Microbiology, Immunology, and Molecular Genetics, UCLA, Los Angeles, CA 90095, USA
| | - Jung Wook Park
- Department of Microbiology, Immunology, and Molecular Genetics, UCLA, Los Angeles, CA 90095, USA
| | - Salwan Alhani
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
| | - Brigitte N Gomperts
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA 90095, USA; UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital UCLA, Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA 90095, USA
| | - Jiaoti Huang
- Department of Pathology, Duke University School of Medicine, Durham, NC 27708, USA
| | - Owen N Witte
- Department of Microbiology, Immunology, and Molecular Genetics, UCLA, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA 90095, USA.
| | - Thomas G Graeber
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA 90095, USA; Crump Institute for Molecular Imaging, UCLA, Los Angeles, CA 90095, USA; California NanoSystems Institute, UCLA, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA 90095, USA.
| |
Collapse
|
25
|
Wang ZC, Lin RW, Zhou JF, Gui ZH, Wang SS, Chen ZQ, Xiang ST. [Small-cell carcinoma of the prostate: A report of 2 cases and review of the literature]. Zhonghua Nan Ke Xue 2019; 25:150-153. [PMID: 32216202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the clinicopathological characteristics and improve the clinical treatment of prostatic small-cell carcinoma (PSCC). METHODS We reported 2 cases of PSCC derived from prostate cancer after treated by androgen blockade and prostate electrotomy and reviewed the relevant literature. RESULTS Two patients with PSA elevation were diagnosed with prostate cancer by prostatic puncture biopsy and treated by maximum androgen blockade, which reduced their total PSA to the normal level. Later, due to difficult urination, they both underwent prostate electrotomy, followed by chemotherapy or radiotherapy for PSCC confirmed by postoperative pathology. Nevertheless, they died at 8 to 9 months after the discovery of PSCC. CONCLUSIONS PSCC can derive from prostate cancer after treatment, which may be attributed to the pathological mutation induced by long-term endocrine therapy. PSCC is more malignant than prostate cancer, and its prognosis is poor.
Collapse
Affiliation(s)
- Zhi-Chao Wang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Rong-Wu Lin
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China
| | - Jian-Fu Zhou
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Ze-Hong Gui
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Shu-Sheng Wang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Zhi-Qiang Chen
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| | - Song-Tao Xiang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China
| |
Collapse
|
26
|
Abstract
INTRODUCTION Primary small cell carcinoma (SCC) after renal transplantation is very rare. Here, we reported 1 case of primary SCC after renal transplantation and analyzed its clinical and pathological characteristics. CASE PRESENTATION A 55-year-old female underwent renal transplantation in our hospital 2 years ago and had been using tacrolimus for immunosuppressive therapy. Because of abdominal distention, the patient was admitted to our hospital. Computed tomography (CT) showed a malignant tumor of left kidney. Patient underwent surgical treatment and radical nephrectomy and lymph node dissection were selected. Postoperative pathological diagnosis was primary renal parenchyma and ureteral SCC. The patient has been treated with combination chemotherapy of lowpol (100 mg per day) and etoposide (10 mg per day). His vital signs are stable now, and he is receiving further treatment in our hospital. CONCLUSION Because of immunosuppressive drugs use, the incidence of malignancies has increased significantly after renal transplantation. This case highlights the difficulty of diagnosis of primary SCC and the necessity of checking for neuroendocrine tumor after organ transplantation.
Collapse
|
27
|
Iliyas M, Dona D, Devi U, Noorunnisa N. Primary small cell neuroendocrine carcinoma of the anterior mediastinum presenting with trepopnea. BMJ Case Rep 2018; 11:e225014. [PMID: 30567086 PMCID: PMC6301506 DOI: 10.1136/bcr-2018-225014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report the case of an elderly man who had visited many physicians with breathlessness and was treated in an outpatient care. The cause of breathlessness was not evaluated, which turned out to be a slow-growing tumour in the mediastinum. Later, we diagnosed it to be a case of neuroendocrine carcinoma arising from the anterior mediastinum. The patient had succumbed to death because of the delayed diagnosis. A simple chest X-ray could have helped to make an early diagnosis. This case is reported with the intention to bring into light the effect of delayed diagnosis of a rare disease presenting with a very common symptom.
Collapse
Affiliation(s)
- Mohamed Iliyas
- Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Das Dona
- Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Uma Devi
- Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India
| | - Naseem Noorunnisa
- Department of Pathology, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India
| |
Collapse
|
28
|
Nakra T, Biswas R, Pandey R, Yadav R. Synchronous endometrioid carcinoma of the endometrium and small cell neuroendocrine carcinoma of the cervix: a rare combination. BMJ Case Rep 2018; 2018:bcr-2018-227155. [PMID: 30413462 DOI: 10.1136/bcr-2018-227155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Synchronous multiple primaries of female genital tract are uncommon, with the most frequently encountered combination being of endometrium and ovary. Concurrent primary tumours of endometrium and cervix are rare. We report a case of coexistent endometrioid carcinoma of the endometrium and small cell neuroendocrine carcinoma of the cervix in 48-year-old woman who presented with menometrorrhagia and was detected to have metastases to distant sites on imaging. She underwent multimodality treatment which resulted in a significant reduction in the tumour bulk.
Collapse
Affiliation(s)
- Tripti Nakra
- Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rituparna Biswas
- Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
| | - Rambha Pandey
- Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajni Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
29
|
Henzen C. [CME: Paraneoplastic Endocrine Syndromes]. Praxis (Bern 1994) 2018; 107:1309-1315. [PMID: 30482117 DOI: 10.1024/1661-8157/a003132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
CME: Paraneoplastic Endocrine Syndromes Abstract. Paraneoplastic endocrine syndromes are caused by ectopic hormone production by malignant tumor cells. Knowledge of paraneoplastic endocrine syndromes may allow a timely diagnosis of the underlying cancer at a treatable stage and, on the other hand, appropriate treatment of the endocrine manifestations reduces morbidity and mortality of the affected patients. The most common endocrine syndromes are paraneoplastic hypercalcaemia, caused by the secretion of PTHrP, and hyponatremia, caused by the inadequate secretion of ADH. Although there may be clinical symptoms like fatigue, nausea/vomiting and renal insufficiency for hypercalcaemia and gait disturbances and mental alterations for hyponatremia, the diagnosis must be confirmed by laboratory testing and prompt the search for associated tumors.
Collapse
Affiliation(s)
- Christoph Henzen
- 1 Innere Medizin/Endokrinologie und Diabetologie, Luzerner Kantonsspital
| |
Collapse
|
30
|
Iqbal MS, Matthews S, Chambers A, Kelly C, Ahmed O, Adams J. Small cell neuroendocrine carcinoma of the alveolar process of maxilla. Oral Oncol 2018; 86:308-311. [PMID: 30297229 DOI: 10.1016/j.oraloncology.2018.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Alveolar Process/diagnostic imaging
- Alveolar Process/pathology
- Alveolar Process/surgery
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/therapy
- Chemotherapy, Adjuvant
- Fatal Outcome
- Female
- Humans
- Maxilla/diagnostic imaging
- Maxilla/pathology
- Maxilla/surgery
- Maxillary Neoplasms/diagnosis
- Maxillary Neoplasms/pathology
- Maxillary Neoplasms/therapy
- Maxillary Osteotomy
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/therapy
- Radiotherapy, Adjuvant
- Treatment Outcome
Collapse
Affiliation(s)
- Muhammad Shahid Iqbal
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
| | - Sarah Matthews
- Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anne Chambers
- Department of Pathology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Charles Kelly
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Omar Ahmed
- Department of Plastic Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James Adams
- Department of Maxillofacial Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
31
|
Kleinig P, Russell P. Lesson of the month 2: An unusual cause of depression in an older man: Cushing's syndrome resulting from metastatic small cell cancer of the prostate. Clin Med (Lond) 2018; 18:432-434. [PMID: 30287444 PMCID: PMC6334104 DOI: 10.7861/clinmedicine.18-5-432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article describes the case of an older patient whose main presenting problem was depression. A constellation of clinical and biochemical features led to a search for medical causes of his low mood, which uncovered ectopic adrenocorticotropic hormone (ACTH) secretion. Post-mortem examination showed that the source of ACTH was small cell neuroendocrine carcinoma of the prostate, and that the patient had died from the sequelae of profound immune suppression.
Collapse
Affiliation(s)
- Paul Kleinig
- Southern Adelaide Local Health Network, Adelaide, Australia
| | | |
Collapse
|
32
|
Zhang Y, Ouyang W, Sun G, Ding B, Yan L, Wang Z, Guan W, Li H, Hu Z, Xu H, Wang S, Ye Z. Pure Small Cell Carcinoma of Prostate: A Report of 8 Cases. Urol Int 2018; 101:263-268. [PMID: 30269133 DOI: 10.1159/000493160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/21/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe characteristics of pure small cell carcinoma of prostate (SCCP) and assess the prognostic factors. PATIENTS AND METHODS We summarized data of pure SCCP from published studies and ours and made Kaplan-Meier analysis and Cox regression to evaluate prognosis factors. RESULTS A total of 2,213 patients with prostate cancer was identified, of which eight (0.36%) patients were pure SCCP. The mean age at diagnosis was 61 years old. And there were 2 patients diagnosed at 34 and 50 years old respectively. Symptoms of these patients were similar to patients with prostate adenocarcinoma. Serum prostate specific antigen of 7 patients was at normal level. Five patients received chemotherapy, average overall survival (OS) was 9.75 months; 3 only received conservative treatment, average OS was 4 months. By univariate and multivariate Cox analysis, chemotherapy is an independent predictor of survival. Kaplan-Meier analysis demonstrated that chemotherapy was associated with longer OS. CONCLUSION Clinical characteristics, examination and treatment strategy of pure SCCP are very different from prostate adenocarcinoma. According to the data from published studies and from our studies, the average survival of patients receiving chemotherapy is longer than those who received other treatment modalities.
Collapse
|
33
|
Weil EL, Richards LW, Salonen BR. 64-Year-Old Woman With General Malaise and Hypercalcemia. Mayo Clin Proc 2018; 93:1144-1148. [PMID: 29804727 DOI: 10.1016/j.mayocp.2017.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Erika L Weil
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Lukas W Richards
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Bradley R Salonen
- Advisor to residents and Consultant in General Internal Medicine, Mayo Clinic, Rochester, MN.
| |
Collapse
|
34
|
Najjar F, Alammar M, Al-Massarani G, Almalla N, Japawe A, Ikhtiar A. Circulating endothelial cells and microparticles as diagnostic and prognostic biomarkers in small-cell lung cancer. Lung Cancer 2018; 124:23-30. [PMID: 30268466 DOI: 10.1016/j.lungcan.2018.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/31/2018] [Accepted: 06/29/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES It has been proposed that circulating endothelial cells (CECs) and microparticles (MPs) may be useful for the assessment of patients with non-small-cell lung cancer (NSCLC). However, little is known about the potential clinical relevance of these biomarkers in small-cell lung cancer (SCLC). Therefore, we investigated the utility of baseline levels of CECs and MPs in SCLC patients. MATERIALS AND METHODS An immunomagnetic separation (IMS) technique was used to isolate and quantify CECs in the peripheral blood, while plasma samples were analyzed using flow cytometry for the measurement of circulating MPs. RESULTS We prospectively collected data from 56 patients and 41 healthy individuals. Forty-three patients presented at initial diagnosis and 13 patients presented at relapse. Baseline levels of CECs and MPs were significantly higher in SCLC patients either at initial diagnosis or at relapse than in healthy subjects (p < 0.0002 and p < 0.007, respectively). However, estimated tumor volume (ETV) was significantly correlated with basal MP values (p < 0.0001) but not with pretreatment CECs (p = 0.57). The amount of baseline CECs and MPs was significantly lower in patients with an objective response (OR, n = 23) than in those with progressive disease (PD, n = 15) after treatment (p = 0.016 and 0.05, respectively). With cut-off values of 110 cells/mL for CECs and 1257 events/μL for MPs according to receiver operating characteristics (ROC) analysis, baseline levels of these biomarkers were not significantly correlated with either progression-free survival (PFS) or overall survival (OS). However, patients with 6-month PFS displayed significantly decreased pretreatment CEC counts (p = 0.042), whereas basal MP values significantly increased in 1-year survivors compared with those in non-survivors (p = 0.05). CONCLUSION Our results suggest that baseline CECs and MPs may be predictive biomarkers of tumor response and long-term survival in SCLC patients.
Collapse
Affiliation(s)
- Fadi Najjar
- Biomarkers Laboratory, Radiation Medicine Department, Atomic Energy Commission of Syria (AECS), 17 Nissan Street, P.O. Box 6091, Damascus, Syria.
| | - Moosheer Alammar
- Division of Thoracic Oncology, Oncology Department, Albairouni University Hospital, Hall 2 (A 30/3), Homs Harasta Road, Damascus, Syria
| | - Ghassan Al-Massarani
- Biomarkers Laboratory, Radiation Medicine Department, Atomic Energy Commission of Syria (AECS), 17 Nissan Street, P.O. Box 6091, Damascus, Syria
| | - Nissreen Almalla
- Biomarkers Laboratory, Radiation Medicine Department, Atomic Energy Commission of Syria (AECS), 17 Nissan Street, P.O. Box 6091, Damascus, Syria
| | - Abdulmunim Japawe
- Radiobiology Laboratory, Biotechnology Department, Atomic Energy Commission of Syria (AECS), 17 Nissan Street, P.O. Box 6091, Damascus, Syria
| | - Adnan Ikhtiar
- Radiobiology Laboratory, Biotechnology Department, Atomic Energy Commission of Syria (AECS), 17 Nissan Street, P.O. Box 6091, Damascus, Syria
| |
Collapse
|
35
|
Gálffy G. [Diagnosis and treatment of the neuroendocrine tumors of the lung]. Magy Onkol 2018; 62:113-118. [PMID: 30027939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
Lung neuroendocrine tumors comprise 20% of all pulmonary tumors. Their appearance and behavior are very heterogeneous. Histologically they are divided into four groups, well-differentiated and low-malignant typical carcinoid, poorly differentiated and worse prognosis atypical carcinoid, and highly malignant small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma. Of these, the most common is small cell lung cancer with an incidence of 15%, while those of large cell neuroendocrine tumors and lung carcinoids are 3% and 2%, respectively. The treatment and prognosis of carcinoids are very different from those of highly malignant small cell and large cell neuroendocrine carcinomas. The paper summarizes the characteristics of lung neuroendocrine tumors.
Collapse
|
36
|
Maki R, Sugita S, Ono Y, Miyajima M, Tada M, Takahashi Y, Mishina T, Watanabe A. [p40 Negative Basaloid Squamous Cell Carcinoma of the Lung;Report of a Case]. Kyobu Geka 2018; 71:547-550. [PMID: 30042259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Immunohistochemical staining is important for the differential diagnosis of basaloid squamous cell carcinoma(BSC)and other similar carcinomas, such as small-cell carcinomas and large-cell neuroendocrine carcinomas. p40 is a useful marker of squamous cell carcinoma that can be used for the diagnosis of BSC. We present the case of a 64-year-old man who was referred to our hospital for investigation of an abnormal shadow revealed on chest radiography. Computed tomography(CT) revealed a 16×11 mm nodule in the left lung(S1+2), and a thoracoscopic left upper lobectomy was performed. Histologically, lobular pattern with peripheral palisading was observed and the immunohistochemical staining revealed the tumor cells to be positive for p63 and negative for both p40 and neuroendocrine markers, leading to the diagnosis of BSC.
Collapse
Affiliation(s)
- Ryunosuke Maki
- Department of Thoracic Surgery, Sapporo Medical Universiry, Sapporo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Guzzini F, Cozzi C, Cortese F, Gasparini P, Neri V, Pace L. Adrenal Failure Due to Bilateral Metastases as the Sole Manifestation of Relapsing Lung Carcinoma. Report of Two Cases. Tumori 2018; 75:634-6. [PMID: 2559528 DOI: 10.1177/030089168907500625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe two patients with lung carcinoma in whom adrenal glands were the sole site of tumor relapse, revealed by the appearance of Addison's disease. Both patients showed bilateral adrenal masses on US and/or CAT scans and received hormone replacement therapy, with rapid improvement of their general conditions. One of them, with small-cell carcinoma, could also be treated with further chemotherapy and achieved a second remission. Therefore, we stress that patients with lung carcinoma should be periodically screened for adrenal deposits by US or CAT and undergo prophylactic steroid maintenance whenever metastatic involvement of the glands is detected.
Collapse
Affiliation(s)
- F Guzzini
- U.S.S.L. 9 Divisione di Medicina II, Ospedale di Saronno, Varese, Italy
| | | | | | | | | | | |
Collapse
|
38
|
Giovanella L, Piantanida R, Ceriani L, Bandera M, Novario R, Bianchi L, Roncari G. Immunoassay of Neuron-Specific Enolase (Nse) and Serum Fragments of Cytokeratin 19 (Cyfra 21.1) as Tumor Markers in Small Cell Lung Cancer: Clinical Evaluation and Biological Hypothesis. Int J Biol Markers 2018; 12:22-6. [PMID: 9176714 DOI: 10.1177/172460089701200105] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
NSE is a biochemical marker for small cell lung cancer (SCLC) diagnosis and management. CYFRA 21.1 is a newly developed immunoassay to detect the serum fragments of cytokeratin 19 which are also expressed in SCLC with or without neurofilaments. The aim of this study was to evaluate the diagnostic performance and prognostic role of the two markers in SCLC and their contribution to chemotherapy monitoring and patient follow-up. We studied 62 patients with pathologically proven SCLC: 28 with limited disease (LD) and 34 with extensive disease (ED), and 100 patients with non-malignant pulmonary disease. Immunoradiometric assays (IRMA) were employed to test NSE and CYFRA 21.1 in patients and control subjects. For each patient subset results were expressed as median and interquartile distribution range. NSE and CYFRA 21.1 sensitivity was 0.52 (33/62) and 0.56 (35/62), respectively. In the group of patients with LD, NSE and CYFRA 21.1 sensitivity was 0.42 (12/28) and 0.54 (15/28) and in patients with ED, NSE and CYFRA 21.1 were positive in 0.62 (21/34) and 0.59 (20/34) of cases, respectively. Combining the two markers, a sensitivity of 0.78 (22/28) in LD, 0.82 (28/34) in ED and a global sensitivity of 0.80 (50/62) was obtained. Only NSE was significantly linked to the extension of disease (Mann-Whitney U test p = 0.002) while CYFRA 21.1 did not correlate. The analysis of survival and the evaluation of the two markers at diagnosis showed CYFRA 21.1 to be strongly linked to the patients’ outcome, independently of both clinical prognostic factors and NSE levels (log rank and Cox's model). The markers’ performance during chemotherapy was tested in a group of 33 patients with at least one marker above cut-off. NSE can be considered a reliable marker of tumor mass modifications under chemotherapy, while CYFRA 21.1 expression seems to be relatively independent of tumor volume modifications. An applicable model of biomarkers in SCLC could be the concurrent assay of NSE and CYFRA 21.1 in pre-therapeutic assessment and therapy planning. CYFRA 21.1 does not play an important role during therapy monitoring and follow-up; in these phases NSE alone may be employed.
Collapse
Affiliation(s)
- L Giovanella
- Department of Nuclear Medicine, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | | | | | | | | | | |
Collapse
|
39
|
Bombardieri E, Seregni E, Bogni A, Ardit S, Belloli S, Busetto A, Caniello B, Castelli M, Cianetti A, Correale M. Evaluation of Cytokeratin 19 Serum Fragments (Cyfra 21–1) in Patients with Lung Cancer: Results of a Multicenter Trial. Int J Biol Markers 2018; 9:89-95. [PMID: 7523547 DOI: 10.1177/172460089400900205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recently, a new immunometric assay (Cyfra 21–1) was developed to measure serum concentrations of a soluble fragment of cytokeratin subunit 19. With this method, supplied by Boehringer Mannheim (EIA Test Cyfra 21–1), an Italian multicenter trial was performed in patients with lung cancer. Cyfra 21–1 serum levels were determined in 568 normal subjects (blood donors), 607 patients with non-malignant diseases (491 respiratory diseases) and 730 patients with malignancies. In the latter group 584 had lung cancer. All these 584 patients had pathologically confirmed disease; 314 were epidermoid tumors, 166 adenocarcinomas, 88 small cell cancers and 16 large cell cancers. In the 568 healthy blood donors the mean Cyfra 21–1 value was 0.91 ng/ml (SD 0.47 ng/ml; range 0.05–2.90 ng/ml). A threshold of 1.9 ng/ml was chosen as the upper limit of normality. High levels of Cyfra21–1 were observed in patients with chronic hepatitis (positivity rate: 17/51–33.3%) and with pancreatitis (positivity rate 5/16 - 31.3%). In 114 out of 491 (23.2%) patients with respiratory diseases Cyfra 21–1 showed values greater than 1.9 ng/ml. The overall sensitivity (all stages) of Cyfra 21–1 in lung cancer was 65.6% (383/584). When the histology was considered the highest positivity rates were found in patients with squamous cell tumors (226/314; 72%) followed by adenocarcinomas (105/166; 63%). In patients with SCLC the global sensitivity was 52.3% (46/88). Higher sensitivity of Cyfra 21–1 was observed from stage I to stage IV (53.9% vs 85.7%; Chisquare: p < 0.01). When comparing patients in whom curative resections were possible (up to stage IIIa) with patients suffering from inoperable tumors, a significant difference in Cyfra 21–1 positivies was found (59% vs 81.5%; Chi square p < 0.01).
Collapse
|
40
|
Gendreau V, Montravers F, Philippe C, Talbot JN. Reevaluation of the Usefulness of Systematic Bone Scanning in Initial Staging and follow-up of Small Cell Lung Carcinoma, Taking into Account the Serum Levels of Neuron-Specific Enolase. Int J Biol Markers 2018; 12:148-53. [PMID: 9582603 DOI: 10.1177/172460089701200402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prescription of bone scans (BS) in the initial staging and follow-up of small cell lung carcinoma (SCLC) is a traditional attitude. The availability of the serum neuron-specific enolase (NSE) assay and budget limitations led us to evaluate retrospectively, in 57 patients, the consequences of a more selective attitude, namely to perform BS only in those patients with abnormal serum NSE levels. Both BS and NSE assays were performed in 47 patients referred for initial staging of SCLC; NSE levels were normal in 8 but in 2 of these cases (25%) secondary bone localizations with great clinical significance were discovered at BS. During follow-up, 59 BS were performed in conjunction with NSE assays; 45 NSE levels were in the normal range whereas 17 (38%) corresponding BS were suggestive of bone metastases. In conclusion, due to the frequent occurrence of false-negative results in patients with bone metastases, serum NSE levels proved to be useless in the selection for BS of patients suffering from SCLC.
Collapse
Affiliation(s)
- V Gendreau
- Services de Médecine Nucléaire, Hôpital Tenon, Paris, France
| | | | | | | |
Collapse
|
41
|
Abstract
We investigated the role of tumor markers CEA, NSE, TPS and CYFRA 21.1 in lung cancer diagnosis and staging in 169 patients with histologically confirmed lung cancer (43 SCLC and 126 NSCLC). In SCLC patients NSE and CYFRA 21.1 showed the highest senstitivity and their combination improve significantly the diagnostic sensitivity and accuracy. In NSCLC patients CYFRA 21.1 showed the highest sensitivity and global accuracy and no markers association was as effective as CYFRA 21.1 alone. Based on data from our study it can be concluded that in patients with suspected lung cancer the serum NSE and CYFRA 21.1 assay is a suitable association to confirm the clinical hypothesis. NSE in SCLC and CYFRA 21.1 in NSCLC are useful in the evaluation of disease extent and successive treatment planning.
Collapse
Affiliation(s)
- L Giovanella
- Nuclear Medicine Department, Regional Hospital of Varese, Italy
| | | | | | | | | |
Collapse
|
42
|
Hernández Hernández JR, García García JM, Martínez Muñíz MA, Allende Monclus MT, Ruibal Morell A. Clinical utility of hyaluronic acid values in serum and bronchoalveolar lavage fluid as tumor marker for bronchogenic carcinoma. Int J Biol Markers 2018; 10:149-55. [PMID: 8551057 DOI: 10.1177/172460089501000304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Various authors have proposed the use of hyaluronic acid (HA) as a tumor marker. In order to analyze its usefulness as a marker in bronchogenic carcinoma, the most common carcinoma in men, we determined the HA values in serum and bronchoalveolar lavage fluid (BAL). We performed prospective studies on two groups of patients: 81 diagnosed as having bronchial carcinoma and 34 with benign respiratory diseases. HA values were higher in patients with cancer than in those with benign diseases (serum: 79.8 ng/ml vs 63.7 ng/ml; BAL: 927 ng/mg vs 522 ng/mg). Also, the percentage of patients with levels exceeding the established cutoff was greater in the group with cancer than in the group with benign diseases (serum: 24.6 vs 17.6; BAL: 25.3 vs 3). Statistically significant differences in these percentages were found in BAL (p<0.01). Patients with extended small cell carcinoma had higher HA values (p=0.04) than those with limited disease, and the percentage of patients with abnormal HA values was larger in the group with extended disease than in the group with limited disease (p=0.004). The serial determinations of HA values in serum reflected the clinical evolution after treatment in 73% of the small cell carcinomas. Most of the patients with benign diseases whose HA values exceeded the cutoff level suffered from acute infectious dis-eases. Once these cases were excluded, the specificity of HA value determination in the diagnosis of carcinoma was very high (serum 96%, BAL 100%). The determination of HA levels in serum or BAL did not have any prognostic value in this study. We conclude that the HA levels in serum and BAL could be of interest as a tumor marker, especially in patients with small cell carcinoma.
Collapse
MESH Headings
- Adenocarcinoma/blood
- Adenocarcinoma/diagnosis
- Adenocarcinoma/metabolism
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/metabolism
- Bronchoalveolar Lavage Fluid/chemistry
- Carcinoma, Bronchogenic/blood
- Carcinoma, Bronchogenic/diagnosis
- Carcinoma, Bronchogenic/metabolism
- Carcinoma, Large Cell/blood
- Carcinoma, Large Cell/diagnosis
- Carcinoma, Large Cell/metabolism
- Carcinoma, Small Cell/blood
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/metabolism
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Case-Control Studies
- Female
- Humans
- Hyaluronic Acid/blood
- Hyaluronic Acid/metabolism
- Lung Neoplasms/blood
- Lung Neoplasms/diagnosis
- Lung Neoplasms/metabolism
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- Respiratory Tract Diseases/blood
- Respiratory Tract Diseases/metabolism
Collapse
|
43
|
Abstract
Aims and background To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results The patients were followed up for a mean period (± SD) of 7.4 ± 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 ± 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 ± 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-to-treatment intervals were 41 ± 82 days (median, 10) and 16 ± 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.
Collapse
Affiliation(s)
- All Nihat Annakkaya
- Department of Chest Diseases, Faculty of Medicine, Abant Izzet Baysal University, Duzce, Turkey.
| | | | | | | | | | | |
Collapse
|
44
|
Faisal M, Haider I, Adeel M, Waqas O, Hussain R, Jamshed A. Small cell neuroendocrine carcinoma of nose and paranasal sinuses: The Shaukat Khanum Memorial Cancer Hospital experience and review of literature. J PAK MED ASSOC 2018; 68:133-136. [PMID: 29371736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Small cell neuroendocrine carcinoma (SCNEC) is a rare disease of nose and paranasal sinuses. In contrast to other regions SCNEC of this region has been reported to be recurrent and locally aggressive. No definite treatment has been established till date because of rarity of this disease. The purpose of this descriptive study is to present the series of 8 cases with SNEC of nose and paranasal sinuses. Retrospective review of 8 patients presenting with Small cell neuroendocrine carcinoma of nose and paranasal sinuses, from January, 2005 to December, 2014 treated at Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore was performed to determine the clinical characteristics and outcome of this disease. The subjects were 7 males and 1 female with a mean age of 45±15 years (range 24 to 59 years). Tumours were present in nasal cavity (n=4), ethmoid sinus (n=3) and maxillary sinus (n=1). Almost 50% of patients presented with AJCC stage IV-A. All patients had immunohistochemistry proven diagnosis. All patients (08) received radiotherapy with mean doses 58±Gy (Range 54-66Gy). Surgery was performed in 2 while chemotherapy was administered in 4 patients. Recurrence occurred in 3 patients, one each with loco-regional, distant and both. At a median follow up of 38 months, 5 patients were alive with no evidence of disease. SCNEC is a rare but aggressive neoplasm. Current standard of care varies but multi-modality approach should be the cornerstone in management of SCNEC. Early diagnosis and intervention improve the final outcome.
Collapse
Affiliation(s)
- Muhammad Faisal
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Irfan Haider
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Mohammad Adeel
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Omer Waqas
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Raza Hussain
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Arif Jamshed
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| |
Collapse
|
45
|
Li J, Zhou C, Liu W, Sun X, Meng X. Synchronous diffuse large B-cell lymphoma of the stomach and small cell lung carcinoma: A case report. Medicine (Baltimore) 2017; 96:e8873. [PMID: 29390275 PMCID: PMC5815687 DOI: 10.1097/md.0000000000008873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 10/29/2017] [Accepted: 11/04/2017] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The synchronous occurrence of lung cancer in patients with gastric neoplasms is relatively uncommon, especially the cases of synchronous coexistence of small cell lung carcinoma and diffuse large B-cell lymphoma of the stomach. PATIENT CONCERNS We encountered a case of synchronous primary small cell lung carcinoma and diffuse large B-cell lymphoma of the stomach. A 63-year-old patient with a 7.5 × 5.09 cm mass in the superior lobe of the right lung diagnosed with small cell lung cancer and synchronous diffuse large B-cell lymphoma of the stomach. DIAGNOSES The diseases were diagnosed by the pathological biopsy and immunohistochemical methods. INTERVENTIONS As the patient received CHOP chemotherapy, pulmonary function deterioraed. Etoposide was added to the chemotherapy. OUTCOMES However, after the first treatment, chest computed tomography showed that the mass in the superior lobe of the right lung had increased to 8.5 × 5.2 cm. LESSONS This report draws attention to the fact that the treatment of synchronous tumors is a challenge.
Collapse
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols
- Biopsy
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/pathology
- Cyclophosphamide
- Doxorubicin
- Female
- Gastroscopy
- Humans
- Immunohistochemistry
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Middle Aged
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Prednisone
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/pathology
- Tomography, X-Ray Computed
- Vincristine
Collapse
Affiliation(s)
- Jia Li
- From the Department of Gastroenterology, First Hospital of Jilin University
| | - Changli Zhou
- From the Department of Internal medicine, Nursing School of Jilin University
| | - Wanqi Liu
- From the Department of Gastroenterology
| | - Xun Sun
- From the Department of Pathology
| | - Xiangwei Meng
- From the Department of Gastroenterology, First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
46
|
Abstract
RATIONALE We report a unique case of a tripartite esophageal collision tumor consisting of three separate histologic types. PATIENTS CONCERNS Therapeutic dilemmas on the proper treatment of those rare neoplasms remain unanswered considering both proper surgical therapy and adjuvant therapy. DIAGNOSE In this paper, we report a unique case of a patient with a tripartite esophageal collision tumor consisting of a small cell carcinoma, an adenocarcinoma of medium differentiation and a signet ring cell carcinoma. Diagnosis is difficult as clinical presentation of the patient was undistinguishable from other, commoner tumor types. INTERVENTIONS The patient's diagnostic and therapeutic course along with available data on the collisions tumor's biological behavior and treatment are briefly discussed. OUTCOMES Esophagectomy is the best treatment options for these patients. Unique nature of this tumor demands aggresive oncologic treatment. LESSONS Collision tumors are rare neoplasms consisting of distinct cell populations developing in juxtaposition to one another without any areas of intermingling. Various cell types can be found. However, collision neoplasms of the esophagus combining adenomatous and neuroendocrine components are exceedingly rare, with only 5 cases described to date in the literature. Given their rarity, limited information is available on their tumorigenesis, biological behavior and clinical course. In general, these tumors are aggressive neoplasms and significantly affect patient treatment and prognosis.
Collapse
Affiliation(s)
| | | | - Paraskevi Alexandrou
- Department of Pathology, National and Kapodistrian University of Athens, Athens, Attiki, Greece
| | - Demetrios Moris
- Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH
| | - Evangelia Baliou
- Department of Pathology, National and Kapodistrian University of Athens, Athens, Attiki, Greece
| | | | - Theodore Throupis
- Department of Anatomy, National and Kapodistrian Athens, Athens, Attiki, Greece
| | | |
Collapse
|
47
|
Trichia HJ, Tziakou P, Papatheodorou DC, Lekka J. Cytological Features of the Large Cell Variant of Small Cell Ovarian Carcinoma in Young Patients with Hypercalcemia: Histological Findings and Review of the Literature. Acta Cytol 2017; 61:462-468. [PMID: 28746917 DOI: 10.1159/000477487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To present the cytological features of a very rare and lethal ovarian neoplasm occurring in the young. STUDY DESIGN We reviewed the cytological findings as they presented in touch imprints obtained from an ovarian mass sent to our department for frozen section investigation. RESULTS Smears were highly cellular. The cells were of intermediate size with a moderate amount of microvacuolated, pale, or eosinophilic cytoplasm with indistinct cell borders. The nuclei were of round or oval shape with mild to moderate atypia and indistinct nucleoli. CONCLUSIONS The diagnosis of small cell carcinoma of the ovary can be challenging even histologically. Cytology can be an invaluable adjunct to hematoxylin-eosin sections both pre- or intraoperatively. Although it is a very rare occurrence and cytological results are almost absent in the literature, our case can make cytopathologists more acquainted with the cytological features of this rare tumor entity especially in association with a characteristic clinical profile. Furthermore, the cytological features of small cell carcinoma of the ovary, large cell variant, have only rarely been described in the literature.
Collapse
Affiliation(s)
- Helen J Trichia
- Department of Pathology, Metaxas Memorial Cancer Hospital, Piraeus, Greece
| | | | | | | |
Collapse
|
48
|
Reiters V, Garzaniti N, Windhausen K. [Gabab paraneoplastic encephalitis : about a clinical case]. Rev Med Liege 2017; 72:369-372. [PMID: 28795551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The paraneoplastic limbic encephalitis is a rare disease. It is caused by the presence of autoantibodies creating an inflammatory reaction of the predominant brain parenchyma in the meso-temporal lobe and in other parts of the limbic system. Its presence requires looking for an underlying tumour. The management of this paraneoplastic syndrome includes an immunosuppressive therapy in addition to the treatment of the underlying tumour. However, the management of this disease is not yet standardized.
Collapse
Affiliation(s)
- V Reiters
- Service de Pneumologie, CHU de Liège, site Sart Tilman, Liège, Belgique
| | - N Garzaniti
- Service de Pneumologie, CHU de Liège, site Sart Tilman, Liège, Belgique
| | | |
Collapse
|
49
|
Baggar S, Ouahbi H, Azegrar M, El M'rabet FZ, Arifi S, Mellas N. [Neuroendocrine carcinoma of the cervix: a case report and review of the literature]. Pan Afr Med J 2017; 27:82. [PMID: 28819503 PMCID: PMC5554625 DOI: 10.11604/pamj.2017.27.82.10902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/22/2017] [Indexed: 11/11/2022] Open
Abstract
Small cell neuroendocrine carcinomas of the gynecologic tract are unusual, accounting for only 2% of the cervical cancers. Given the rarity of these tumors and the absence of randomized trials, their diagnosis and treatment programmes are difficult and are essentially based on those of neuroendocrine tumors of the lung. As in the case of the neuroendocrine tumors of the lung and despite multimodal treatment they are associated with a poor prognosis. We here report a new case of small cell neuroendocrine carcinoma of the cervix and, throught a literature review, we highlight the various aspects of this rare entity.
Collapse
Affiliation(s)
| | - Hajar Ouahbi
- Service d'Oncologie Médicale CHU Hassan II, Fès, Maroc
| | | | | | - Samia Arifi
- Service d'Oncologie Médicale CHU Hassan II, Fès, Maroc
| | - Nawfel Mellas
- Service d'Oncologie Médicale CHU Hassan II, Fès, Maroc
| |
Collapse
|
50
|
Miyoshi S, Sasada S, Izumo T, Matsumoto Y, Tsuchida T. Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis. PLoS One 2016; 11:e0167186. [PMID: 27880851 PMCID: PMC5120864 DOI: 10.1371/journal.pone.0167186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/09/2016] [Indexed: 12/03/2022] Open
Abstract
Background Some trials recently demonstrated the benefit of targeted treatment for malignant disease; therefore, adequate tissues are needed to detect the targeted gene. Pleural biopsy using flex-rigid pleuroscopy and pleural effusion cell block analysis are both useful for diagnosis of malignancy and obtaining adequate samples. The purpose of our study was to compare the diagnostic utility between the two methods among patients with malignant pleural disease with effusion. Methods Data from patients who underwent flex-rigid pleuroscopy for diagnosis of pleural effusion suspicious for malignancy at the National Cancer Center Hospital, Japan between April 2011 and June 2014 were retrospectively reviewed. All procedures were performed under local anesthesia. At least 150 mL of pleural fluid was collected by pleuroscopy, followed by pleural biopsies from the abnormal site. Results Thirty-five patients who were finally diagnosed as malignant pleural disease were included in this study. Final diagnoses of malignancy were 24 adenocarcinoma, 1 combined adeno-small cell carcinoma, and 7 malignant pleural mesothelioma (MPM), and 3 metastatic breast cancer. The diagnostic yield was significantly higher by pleural biopsy than by cell block [94.2% (33/35) vs. 71.4% (25/35); p = 0.008]. All patients with positive results on cell block also had positive results on pleural biopsy. Eight patients with negative results on cell block had positive results on pleural biopsy (lung adenocarcinoma in 4, sarcomatoid MPM in 3, and metastatic breast cancer in 1). Two patients with negative results on both cell block and pleural biopsy were diagnosed was sarcomatoid MPM by computed tomography-guided needle biopsy and epithelioid MPM by autopsy. Conclusion Pleural biopsy using flex-rigid pleuroscopy was efficient in the diagnosis of malignant pleural diseases. Flex-rigid pleuroscopy with pleural biopsy and pleural effusion cell block analysis should be considered as the initial diagnostic approach for malignant pleural diseases presenting with effusion.
Collapse
Affiliation(s)
- Shion Miyoshi
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
- Department of Respiratory Medicine, Toho University Omori Medical Center, Ota-Ku, Tokyo, Japan
| | - Shinji Sasada
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Minato-Ku, Tokyo, Japan
- * E-mail:
| | - Takehiro Izumo
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
| | - Yuji Matsumoto
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
| | - Takaaki Tsuchida
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
| |
Collapse
|