Metastasis Of Small Cell Carcinoma Research Articles

Surgical resection of mediastinal metastasis from small cell carcinoma of bladder: case report

BackgroundIsolated mediastinal metastasis from a malignant tumor and small cell carcinoma of the bladder are both very rare.Case presentationA 76-year-old woman who had undergone surgery for bladder cancer twice was referred to our hospital for a right paracardiac mass noted in chest computed tomography findings, and resection of the tumor was performed. Histological analysis of the mediastinal tumor revealed it to be a metastatic small cell carcinoma of the bladder. At 4 months after surgery, multiple metastatic lesions were found in the chest and liver, and chemotherapy for small cell carcinoma was started.ConclusionsWe present this case of mediastinal metastasis of small cell carcinoma of the bladder, which is very rare, to show the importance of surgical resection of an isolated mediastinal tumor. Such a procedure should be considered, as histological diagnosis of the tumor could be useful for determining therapeutic options.

Diffuse bone marrow metastases of small cell carcinoma with associated erythrophagocytosis mimicking acute leukaemia

Diffuse bone marrow metastases of small cell carcinoma with associated erythrophagocytosis mimicking acute leukaemia

A Rare Type of Testicular Metastasis of Small Cell Carcinoma from the Lung: Case Report and Review of the Literature

Testicular neoplasms are approximately one percent of all malignancies in men and seen mostly second-to-fourth decade of life. Testicular metastasis is seen very rare in all literature. Most common metastasis site to testis is prostate except hematologic malignancies. However, from lung cancer is seen rarely either. To our knowledge, herein we report one of the rarest case describing a sixty-two year old male patient with the history of small cell carcinoma (SCC) of the lung and underwent chemotherapy-radiotherapy who admitted to the clinic with testicular mass undergone radical orchiectomy. The histopathologic examination revealed metastatic SCC of the lung.

Diffusion-Weighted Imaging of Brain Metastasis: Correlation of MRI Parameters with Histologic Type.

To compare the diffusion properties of brain metastases as imaging biomarkers in various types of tumours, to determine their histology and origin. Magnetic Resonance Imaging (MRI) and diffusion-weighted imaging (DWI) were used to retrospectively study the data of 143 patients suffering from brain metastases. Four categories of primary tumours with metastases to the brain were included: lung carcinoma (n=102, 71.3%); breast carcinoma (n=27, 18.8%); colon carcinoma (n=8, 5.6%); and others (n=6, 4.2%). The Apparent Diffusion Coefficient (ADCmin ) values, as well as the normalised ADC ratio (nADC), were determined. The lesions on the DWI were categorised as follows: type 1, with negative findings on DWI; type 2, which were isointense with the normal cortical grey matter; type 3, which were hyperintense compared to the normal cortical grey matter. The diffusion type, mean ADCmin, and mean nADC showed statistically significant differences in different types of metastases. In the subgroup analysis, it was found that type 3 was the diffusion type found most extensively in the brain metastases of small cell carcinoma (SCLC) (n=52, 65.8%, p < 0.000). Furthermore, the mean ADCmin and nADC values were the least for the brain metastases of the SCLC (552.0 ± 134.2 and nADC = 0.8 ± 0.1, p < 0.000, respectively). The value of the mean ADCmin was low in the human epidermal growth factor receptor 2 (HER-2) negative groups than in the HER-2 positive groups at 786.8 ± 299.1 vs 844.8 ± 141.3 (p < 0.006). Our findings indicated that there is a correlation between diffusion parameters as imaging biomarkers of the solid component of brain metastases of primary tumours and the tumour histology.

From suspicion of angioedema to the diagnosis of lung cancer

Angioedema is a localized and self-limiting oedema of the subcutaneous and submucosal tissue. Case presentation: 73-year-old man was admitted to the Division of Allergology with the diagnosis of angioedema. Detailed physical examination led to the suspicion of superior vena cava syndrome with secondary face swelling. Biopsy revealed metastasis of small cell carcinoma in superclavicular lymph nodes. Conclusions: Facial swelling, especially recurrent and non-inflammatory, is often, but not always caused by angioedema. Insightful differential diagnosis is crucial before making the final one.

Small Cell Carcinoma ex-Pleomorphic Adenoma of the Parotid Gland

Small cell carcinoma (SCC) is a high-grade malignancy usually encountered in the lungs but also seen in almost any site including the salivary glands. SCC is important to recognize because it often metastasizes widely and is treated with systemic chemotherapy. Carcinoma ex pleomorphic adenoma is a malignant epithelial neoplasm arising in a pre-existing benign mixed tumor (i.e., pleomorphic adenoma, PA). While virtually any salivary carcinoma can arise from a PA, to our knowledge SCC ex-PA has not been described. We report a case of a woman presenting with fullness of the right neck and a parotid gland mass. The tumor was resected and evaluated grossly, by light microscopy, and by immunohistochemistry. Grossly, a 1.6cm well-circumscribed nodule was identified within the parotid. Microscopic examination revealed foci of SCC associated with high-grade adenocarcinoma, in the background of a PA. The SCC was immunoreactive for cytokeratin in a dot-like pattern and neuroendocrine markers synaptophysin and CD56. Despite the focal nature of the SCC in the parotid, a pure SCC metastasis was present in one neck level II lymph node. The patient was free of disease with 8months of follow-up. Our case illustrates that: (1) although rare, in the salivary glands SCC may arise from lower grade neoplasms including PAs; (2) SCC ex PA may metastasize as pure SCC even if the primary SCC component was focal; (3) adequate sampling of PAs is crucial to prevent missing a rare SCC that must be treated with chemotherapy.

Abstract 5299: VEGF receptor-3 interacts with PI3K directly to regulate lymphangiogenesis

Abstract Dissemination of malignant cells into the regional lymph nodes is a common occurrence in many cancers. The vascular endothelial growth factor (VEGF) family is a major regulator spread of cancer to lymph nodes via induction of lymphangiogenesis. We have used primary lymphatic endothelial cells and clinical material to investigate VEGF-C/VEGF receptor (VEGFR)-3 signalling pathways. We found that treatment with VEGF-C induced activation of PI3K/Akt and MEK/Erk in lymphatic endothelial cells. Furthermore, activation of PI3K/Akt by VEGF-C/VEGFR-3 resulted in phosphorylation of P70S6K, eNOS, PLCγ1, and Erk1/2. Importantly, a direct interaction between PI3K and VEGFR-3 in lymphatic endothelial cells was demonstrated both in vitro and in clinical specimens, where it was associated with the presence of lymph node metastases in small cell carcinoma of the lung. Blocking PI3K abolished VEGF-C-stimulated lymphatic endothelial cell tube formation and migration. Our findings demonstrate that specific VEGFR-3 signalling pathways are activated in lymphatic endothelial cells by VEGF-C. The importance of PI3K in VEGF-C/VEGFR-3-mediated lymphangiogenesis provides a potential therapeutic target for tumor lymphatic metastasis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5299. doi:1538-7445.AM2012-5299

Anti-Hu-associated Paraneoplastic Encephalomyelitis with Esophageal Small Cell Carcinoma

A 63-year-old woman had anti-Hu-associated paraneoplastic encephalomyelitis (anti-Hu syndrome) caused by esophageal small cell carcinoma (SCC). The patient developed bilateral limbic encephalitis, followed by myelitis, brain stem encephalitis, and autonomic failure. Extensive examination demonstrated SCC of the abdominal lymph nodes that was retrospectively diagnosed as metastasis of esophageal SCC on autopsy. The neuropathological findings were characterized by widespread neuronal loss and gliosis in the central nervous system, as well as patchy loss of myelin and axons in the spinal nerve roots with perivascular lymphocytic infiltration. This is the first detailed clinical and neuropathological report of anti-Hu syndrome caused by esophageal SCC.

Bone marrow metastasis of small cell carcinoma of the lung mimicking Burkitt lymphoma/leukemias

Bone marrow metastasis of small cell carcinoma of the lung mimicking Burkitt lymphoma/leukemias

Symptomatic brain metastases from small-cell carcinoma of the urinary bladder: The Netherlands Cancer Institute experience and literature review

BackgroundThe incidence of symptomatic brain metastases in small-cell carcinoma of the urinary bladder (SCBC) is unknown. This precludes advice about prophylactic cranial irradiation (PCI). Patients and methodsThe medical records of all patients with SCBC seen at The Netherlands Cancer Institute from 1993 to 2009 (n=51) were reviewed. Limited disease (LD) was defined as any pT, cN0–1, and cM0. Patients with LD were offered bladder-preserving treatment involving combined chemoradiotherapy. Patients with extensive disease (ED) were treated with palliative chemotherapy. PCI was not applied in any patient. ResultsAmong 39 patients with LD, median disease-specific survival was 35 months. Four developed symptomatic brain metastases after a median follow-up of 15 months (range 3–24) and were treated with whole-brain radiotherapy. No patient with ED developed symptomatic brain metastases during a median follow-up of 6 months. The reported incidence of brain metastases in SCBC in the literature ranges between 0% and 40%. On the basis of all reported series, the pooled estimate of the cumulative incidence of brain metastases is 10.5% (95% confidence interval 7.5% to 14.1%). ConclusionsThe incidence of symptomatic brain metastases from SCBC is significantly lower than that from small-cell lung cancer. Therefore, we do not routinely advise PCI in patients with SCBC.

Widespread Metastases in Small Cell Carcinoma of the Prostate on FDG PET/CT

A 72-year-old man recently diagnosed with a small cell carcinoma of the prostate was referred for staging of the primary malignancy. F-18-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) revealed extensive hypermetabolic metastatic involvement of the liver, multiple small metastatic nodules in the lungs, and a solitary bone metastasis to the left scapula, in addition to increased FDG uptake in the enlarged prostate. Serum prostate-specific antigen level was within normal limits. Although FDG PET is not a helpful imaging method for evaluating prostatic adenocarcinoma, it may be useful in staging of small cell carcinoma of the prostate.

MASH1: a useful marker in differentiating pulmonary small cell carcinoma from Merkel cell carcinoma

Merkel cell carcinoma is the cutaneous counterpart of small cell carcinoma, and the most important differential diagnosis is cutaneous metastasis of small cell carcinoma of the lung. There have been a handful of studies reporting on the utility of a variety of immunohistochemical markers that distinguish between the two entities. Achaete-scute complex-like 1 (MASH1, ASCL1) is important in the development of the brain and the diffuse neuroendocrine system including pulmonary neuroendocrine cells. A recent study, using a cDNA array, identified Mash1 as one of the best classifier genes to differentiate pulmonary small cell carcinoma from Merkel cell carcinoma. We immunohistochemically applied this finding to the diagnostic setting. A total of 30 cases of Merkel cell carcinoma and 59 cases of small cell carcinoma of the lung were immunostained with anti-MASH1 and TTF-1 antibodies. Of 59 small cell carcinomas, 49 (83%) expressed MASH1 in nuclear staining whereas out of 59 small cell carcinomas, 43 (73%) expressed TTF-1 in nuclear staining. MASH1 was completely negative in all 30 Merkel cell carcinomas whereas TTF-1 expression was seen in 1 of the 30 Merkel cell carcinomas (3%). MASH1 is a useful adjunct marker for differentiating small cell carcinoma of the lung from Merkel cell carcinoma.

Small Cell Carcinoma of the Lung Presenting with Ocular Metastasis

Metastasis to the eye is rare but it may be the presenting symptom. Therefore awareness of the radiological findings of metastasis may aid in establishing its diagnosis. Here we report an ocular metastasis of small cell carcinoma of the lung presenting with pulmonary and ocular manifestations.

A Case of a Dieulafoy Lesion Treated using Coil Embolization in a Child

Primary small cell carcinoma (SCC) of stomach is a rare and highly aggressive malignancy with extremely poor prognosis. We report a 71-year-old man with upper abdominal pain diagnosed as single hepatic metastasis of SCC from mixed SCC and adenocarcinoma of the stomach. An endoscopic examination showed the presence of Borrmann type 2 gastric cancer, 2 cm in size on the lesser curvature of antrum. An abdominal CT scan revealed a huge dumbbell shaped mass with peripheral arterial enhancement and central low density in left lobe of the liver. Endoscopic biopsies showed solid proliferation of small, monotonous tumor cells with hyperchromatic nuclei and scanty cytoplasm. The neoplastic cells were positive for immunostaining with anti-chromogranin and anti-synaptophysin. There were also other neoplastic cells with gland formation being positive for anti- cytokeratin. On the basis of these findings, we made a final diagnosis of mixed SCC and adenocarcinoma of the stomach. In addition, we also confirmed hepatic metastasis of SCC through the microscopic finding and immunostaining of tissues of liver mass. Conclusively, we report a case of hepatic metastasis of SCC only from mixed SCC adenocarcinoma of the stomach.

Bone marrow metastasis of small cell carcinoma of the lung mimicking Burkitt lymphoma/leukaemia

Bone marrow metastasis of small cell carcinoma of the lung mimicking Burkitt lymphoma/leukaemia

Metastasis of Small Cell Carcinoma of Lung Into an Ovarian Mucinous Neoplasm: Immunohistochemistry as a Useful Ancillary Technique for Diagnosis and Classification of Rare Tumors

The authors report the first case of ovarian mucinous adenocarcinoma with metastasis from a synchronous small cell neuroendocrine carcinoma of the lung. A 62-year-old white woman presented with weight loss and increased abdominal girth. She was found to have a large, complex cystic mass in the pelvis, and during the staging evaluation, a large, right pulmonary hilar mass was detected. Bronchial brushing as well as transbronchial fine-needle aspiration was diagnostic of small cell carcinoma. The patient received 3 cycles of chemotherapy with carboplatin and subsequently underwent a supracervical hysterectomy and bilateral salpingo-oophorectomy. A large, multiloculated cystic mass was found arising from the right ovary. Microscopic examination disclosed a mucinous neoplasm with both mucinous cystadenoma and mucinous papillary adenocarcinoma components. A microscopic focus of cells with "atypical" cytomorphologic features was detected within the mucinous neoplasm. Immunohistochemistry showed that group of cells to be positive for thyroid transcription factor 1 and chromogranin, confirming them to be metastasis from the pulmonary small cell neuroendocrine carcinoma. This case, in addition to being the first reported case of such metastasis, also highlights the diagnostic utility of immunohistochemistry as a reliable and very useful ancillary technique for the diagnosis of neoplasms with unusual clinical and/or histomorphologic presentations. The clinical and prognostic implications are also discussed.

Mantle Cell Lymphoma in Lymph Nodes with Metastatic Small Cell Carcinoma of Lung: A Diagnostic and Treatment Dilemma

We report a rare case of small cell carcinoma (SCC) of lung, metastatic to ipsilateral hilar and peribronchial lymph nodes with synchronous mantle cell lymphoma (MCL), in a 58-year-old female. She was treated with Cisplatin, Etoposide, and Rituximab, and remained in complete remission for approximately two and a half years following the initial diagnosis. To the best of our knowledge, synchronous SCC and MCL or SCC metastatic to lymph nodes involved by MCL has not been previously reported. In this case, the features of MCL were very inconspicuous in the lymph nodes with extensive metastases of SCC. The presence of MCL was confirmed by immunohistochemistry and fluorescence in situ hybridization (FISH). The co-existence of lymphoma and metastatic carcinoma in the same lymph node, as seen in this case, highlights the significance of analyzing subtle lymphoid architectural changes, and applying ancillary studies such as immunohistochemistry and molecular analysis in suspicious cases. The management of synchronous SCC and MCL requires consideration of their respective biologic behavior, and cumulative toxicity of treatment regimens of both tumors. In such cases an optimum treatment strategy should be adopted to cover both malignancies with minimal toxic effect.

Coexisting basal cell carcinoma and metastatic small cell carcinoma of lung

The coexistence of basal cell carcinoma with a cutaneous metastasis is rare; it is most frequently associated with lung cancer. We report an unusual case of contralateral metachronous metastasis of small-cell carcinoma of the lung to a site of basal cell carcinoma.

肺癌皮膚転移の５例

We report 5 cases of metastatic lung carcinoma to the skin. The 5 patients, 4 male and one female, ranged in age from 35 to 80 years. Clinical manifestations were intracutaneous or subcutaneous nodules, which were located on various sites: the head, trunk, and inguinal region and finger. Histologic examination revealed 3 cases of adenocarcinoma and 2 cases of small cell carcinoma. Duration between occurrence of skin metastasis and death was from 4 to 14 months. No expression of cytokeratin 20 (CK20) was observed in any cases. The results suggested that CK20 is a useful marker in the differentiation between merkel cell carcinoma and skin metastasis of small cell carcinoma, or between metastasis from the lung and that from the gastrointenstinal (GI) tract because merkel cell carcinoma and adenocarcinoma of GI tract express CK20 in general. [Skin Cancer (Japan) 2000; 15: 179-184]

Bone marrow scintigraphy in small cell carcinoma of the lung

A comparative study of bone marrow scintigraphy using 99Tcm-nanocolloid, conventional bone scintigraphy and bone marrow biopsy were performed in 35 patients with histologically proven small cell carcinoma of the lung to determine whether bone marrow scintigraphy has a role in the early detection of bone marrow metastases. The sensitivity, specificity and accuracy for detection of metastases were 100, 92 and 94%, respectively, in bone marrow scintigraphy, 91, 88 and 89%, respectively, in bone scintigraphy, and 50, 100 and 86%, respectively in bone marrow biopsy. This study confirmed that bone marrow scintigraphy is a useful technique for the detection of early metastases. Bone marrow scintigraphy is also suggested as the first choice examination in clinical practice for diagnosis of metastases in small cell carcinoma of the lung.