Rare Case Of Metastatic Adenocarcinoma Research Articles

Lung Adenocarcinoma Metastasis to the Vocal Cord.

Metastases to the vocal cord from a distant organ are extremely rare. This case showed metastatic adenocarcinoma on the vocal cord of lung origin in a 75-year-old nonsmoking female with a history of lung adenocarcinoma surgery 2years earlier. The vocal cord mass was surgically removed, and the biopsy confirmed metastatic adenocarcinoma of lung origin with thyroid transcription factor (TTF)-1 positivity. A further evaluation found recurrence in the lung. The patient received gefitinib. Here, we report an extremely rare case of metastatic adenocarcinoma on the vocal cord from the lung which is the first report to our knowledge.

1307 A Rare Case of Metastatic Adenocarcinoma to the Pancreas Secondary to a Primary Lung Malignancy

INTRODUCTION: Metastatic pancreatic tumors are an infrequent occurrence. Pancreatic metastasis from non-small-cell lung cancer (NSCLC) is rare and might present with few symptoms when the tumor is small. Here, we report such an occurrence of metastatic pancreatic adenocarcinoma secondary to primary lung malignancy. CASE DESCRIPTION/METHODS: A 62-year-old male presented with cough, shortness of breath, early satiety and abdominal pain for a few days. His medical history was notable for hypertension, congestive heart failure, emphysema, and heavy cigarette use. He was hemodynamically stable on presentation. Initial labs were pertinent for NT-proBNP 969 pg/ml, low white blood cells 3.5 K/uL, low hemoglobin 11.7 gm/dL, elevated lipase 566 units/L, and elevated INR 3.2. Chest X-ray showed left basilar consolidation with pleural effusion. CT chest/abdomen/pelvis revealed 3 cm × 4 cm × 5 cm lower lobe consolidation in left lung (Figure 1), 2 cm × 2 cm × 2 cm low-attenuation lesion in pancreatic head, and multiple sclerotic lesions of thoracolumbar spine. Preliminary infectious workup was negative. He was started on empiric antibiotics for community-acquired pneumonia. Further testing for malignancy revealed a normal level of CA19-9 22.9 IU/ml, CEA 1.3 ng/ml, and PSA 0.83 ng/ml. He underwent upper endoscopic ultrasound (EUS) which showed 28 mm × 25 mm hypoechoic mass in the pancreatic head (Figure 2). The preliminary diagnosis was consistent with “adenocarcinoma”. Further immunostaining analysis of pancreatic mass was positive for TTF1 (Figure 3) and PD-L1, negative for p63 and CK5/6 compatible with primary lung adenocarcinoma. The lung mass was not biopsied in view of the presumptive diagnosis - primary lung adenocarcinoma with secondary metastasis to pancreas. After discharge, he was due to follow up in the Oncology clinic for more definitive treatment. DISCUSSION: There have been only a few reported cases of pancreatic metastases in the setting of primary lung malignancy. Among the subtypes of lung malignancy, pancreatic involvement is more common in small cell carcinoma whereas it is much less common in adenocarcinoma. Clinical presentation may range from asymptomatic to acute pancreatitis. EUS guided FNA and immunostaining studies tend to be the diagnostic tool of choice to differentiate between primary and secondary tumors. Identification of pancreatic metastases is important as it confers poorer prognosis and worse survival.

A Rare Case of Metastatic Adenocarcinoma of Stomach Metastasizing into Metachronous Gist of Small Intestine

A Rare Case of Metastatic Adenocarcinoma of Stomach Metastasizing into Metachronous Gist of Small Intestine

A Rare Case of Metastatic Adenocarcinoma with Signet Ring Cells of Unknown Primary Diagnosed on a Myocardial Biopsy

A Rare Case of Metastatic Adenocarcinoma with Signet Ring Cells of Unknown Primary Diagnosed on a Myocardial Biopsy

Metastatic adenocarcinoma of left supraclavicular fossa from occult primary ovarian cancer

Most of the metastatic cervical lymphadenopathy results from the upper aerodigestive tract [1]. Asymptomatic primary ovarian cancer in the presence of metastatic left supraclavicular lymph nodes is rare [2]. Whether to identify the primary tumor or to manage Stage IV ovarian cancer represents a clinical dilemma. We report a rare case of metastatic adenocarcinoma of the left supraclavicular fossa resulting from occult primary ovarian cancer. A healthy 53-year-old menopausal woman, parity 2002, presented with a growing lump as large as 8 6 3 cm in her left supraclavicular fossa; she had had the mass for 3 months, which on biopsy was diagnosed as a metastatic papillary tumor (Fig. 1A). She underwent panendoscopy (nasolaryngoscopy, bronchoscopy, gastroenteroscopy) and a series of imaging studies for primary malignancy, which demonstrated only lymphadenopathy in the left axillary region to the supraclavicular region (Fig. 2A). Finally, abdominal computed tomography showed a right pelvic mass measuring 13.5 7.4 10.5 cm with a cystic component and enlarged lymph nodes from the para-aortic to paracaval space. The patient had a gynecological oncology consultation and underwent exploratory laparotomy. The histopathology confirmed papillary serous cystoadenocarcinoma of both ovaries, coexisting with omentum cake and enlarged pelvic lymph nodes. The patient underwent a debulking operation with a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node dissection. However, because of unresectable status of multiple tumor metastases to the para-aortic, axillary, and supraclavicular lymph nodes, the

Metastatic colon cancer presenting as Pancoast's disease

We report a rare case of metastatic adenocarcinoma of the sigmoid colon that presented as Pancoast's disease.

Metastatic adenocarcinoma of bilateral cavernous sinus and optic nerve with unknown primary mimicking orbital pseudotumor

Bilateral cavernous sinus and optic nerve metastases is extremely rare. We report an extremely rare case of metastatic adenocarcinoma of bilateral cavernous sinus and optic nerve with unknown primary presenting as orbital pseudotumor. She underwent bilateral optic nerve decompression and the diagnosis was established by biopsy.

Metastatic adenocarcinoma of the ethmoids in a patient with previous gastric adenocarcinoma: a case report

Metastatic carcinoma of the ethmoids is very rare. Of the few cases reported in the literature, the majority are renal in origin. Although metastases from the gastrointestinal tract have been reported, there are no known cases of metastases from the stomach. We present a rare case of metastatic adenocarcinoma of the ethmoids in a patient previously treated for adenocarcinoma of the stomach and describe the possible mechanisms of spread. The patient had a craniofacial resection of the tumour but unfortunately died four weeks post-operatively from acute liver failure probably caused by a liver metastasis.

Cutaneous Metastasis from a Parotid Adenocarcinoma

We present a rare case of metastatic adenocarcinoma of the parotid gland to the skin. Reviewing the histologic features of the primary parotid gland and comparing the microscopic sections and immunohistochemical studies, we concluded the skin tumor to be metastases from the parotid adenocarcinoma. By histologic examination alone, it is difficult to distinguish an eccrine sweat gland carcinoma from a metastatic carcinoma of the salivary gland. Immunohistochemical analysis may not be conclusive. Therefore, clinical history and clinicopathologic correlation are essential in arriving at an accurate diagnosis in these cases.