Unusual Metastatic Pattern Research Articles

An unusual clinical pattern of cutaneous metastasis: target-like lesions.

An unusual clinical pattern of cutaneous metastasis: target-like lesions.

Uncommon presentation of medulloblastoma.

Medulloblastoma commonly occurs in children as a midline posterior fossa mass arising from the vermis, which appears as a hyperdense, homogeneously enhancing mass on CT scan and is associated with the clinical profile of posterior fossa syndrome. This unique clinico-radiological pattern is considered 'typical', but then medulloblastomas do not follow the typical clinico-radiological pattern in a significant number of cases. Out of the 42 cases of medulloblastoma operated on at SGPGIMS from 1988 to 1998, 29 cases were retrospectively and 13 cases were prospectively studied to detect the atypical clinico-radiological features. The typical radiological feature of a hyperdense homogeneously enhancing mass was seen in only 23 of the 42 patients, while 5 patients had hypodense nonenhancing masses, 13 had cystic changes, and 6 patients had calcifications in their tumours. Three patients presented with tumours in a very unusual location, i.e. the cerebellopontine angle cistern. During follow-up, which ranged from a minimum period of 1 year to a maximum of 9 years, patients came back with metastases at very unusual sites. There were 5 cases of metastases in the frontal and subfrontal area (developed between 5 months and 5 years following surgery), and 1 patient developed a cervical intramedullary metastasis. Two patients developed abdominal metastases and ascites 2 years after definitive surgery and ventriculo-peritoneal shunting. Each of these 2 patients, however, had received a full course of craniospinal irradiation following surgery. Thus, we had a number of cases with an unusual clinical, radiological and metastatic pattern.

Ostéosarcome multifocal. À propos d’un cas

Multifocal osteosarcoma is an uncommon and aggressive presentation of osteosarcoma. We report a case of multifocal osteosarcoma in a 12-year-old boy who was admitted for a tumor of the skull, associated with pleural and pulmonary nodules. A computed tomography scan of the head showed a calcified lesion with intra- and extracranial extent. A biopsy of the skull tumor showed an osteoblastic osteosarcoma. Three weeks later, the patient developed two other tumors of the skull, a tumor of the left shoulder and a pelvic pain. Radiographic studies confirmed the presence of further lytic lesions at these sites. The patient was unresponsive to chemotherapy (high dose methotrexate and doxorubicin) and died nine months later. Multifocal osteosarcoma, or osteosarcomatosis, is a highly aggressive form of osteosarcoma. The multiple lesions can all arise synchronously as primary tumors, or appear to be one dominant site with early and rapid appearance of secondary lesions. The incidence is reported to be between 1 and 10% of osteosarcoma. The histology shows an osteosarcoma of osteoblastic type in most cases. Despite intensive chemotherapy, the prognosis remains poor. The debate remains as to whether or not this clinical presentation represents true multifocality of the disease or a relatively unusual metastatic pattern of osteosarcoma.

Sarcomatoid carcinoma of the pyriform sinus with brain and subcutaneous metastases: an unusual metastatic spread pattern

A 63-year-old man presented a polypoid tumor in the laryngeal space involving the right pyriform fossa. The patient underwent a total laryngectomy with bilateral functional neck dissection, and the diagnosis of sarcomatoid carcinoma with malignant fibrous histiocytoma-like stroma was established. The tumor showed an uncommon behavior, with distant metastases to the brain and to the subcutaneous tissue of the abdominal wall. The patient died 1 year after the development of the metastases. Despite its polypoid pattern of growth, sarcomatoid carcinoma of the larynx may behave very aggressively. It is important for clinicians to be aware of the possibility of distant subcutaneous and brain metastases in sarcomatoid tumors of the laryngeal space. If such metastases develop, the prognosis is ominous, with an average life expectancy of 3 months.

Metastases to the retroperitoneum in patients with extremity soft tissue sarcoma: an unusual metastatic pattern.

Extremity soft tissue sarcoma (STS) metastasizes preferentially to the lungs via the hematogenous route. Metastases in extrapulmonary sites such as bone, brain, and subcutaneous tissues are observed less frequently. To the authors' knowledge, limb STS primarily metastasizing to the retroperitoneum has not been described to date. The current study reviews the clinical course, management, and patient prognosis in such a pattern of metastasis. Records of patients with retroperitoneal metastases originating from an extremity STS between 1994-1998 were reviewed. Patient demographics, primary tumor site, other tumor sites, local recurrence, distant metastasis, treatment, and survival were analyzed. Ten patients were included in the study. All had primary STS of different histologic types and high histologic grade confined to a lower limb. The retroperitoneal metastases were diagnosed between 6-120 months (mean, 45 months) after diagnosis of the primary sarcoma. At that time, one patient had evidence of local recurrence of the primary tumor site, two patients had lung metastases, and one patient had diffuse bone metastases. Eight patients were eligible for surgery. In six of these patients the metastases were excised completely. The median follow up was 12 months. Of the six patients who underwent complete resection, 3 were alive at last follow-up with no evidence of disease after 12 months, 14 months, and 24 months, respectively. Two patients with recurrent retroperitoneal disease and one patient with retroperitoneal and lung metastases died despite systemic chemotherapy. Extremity STS can metastasize hematogenously to the retroperitoneum, a fact that mandates a high index of suspicion and abdominal imaging studies during the follow-up of such patients. Retroperitoneal metastases necessitate aggressive surgical resection to enable prolongation of survival.

An unusual cutaneous metastasis of a chondrosarcoma

We report a case of cutaneous metastases from a scapular chondrosarcoma in a 85-year-old man. The metastatic skin lesion was noted nine years after resection of the primary tumor. Metastases to lung and soft tissues had occurred four years earlier. The patient also had a history of malignant melanoma. Although this case illustrates an unusual pattern of metastases, we conclude that the appearance of cutaneous lesions in a patient with a prior history of chondrosarcoma should alert the clinician to the possibility of a metastatic chondrosarcoma.

Malignant cutaneous mixed tumor

To the Editor.— In response to the article by Harrist et al in the November 1981Archives(117:719-724) entitled "Cutaneous Malignant Mixed Tumor," we report herein on one of the cases (No. 1). The unusual pattern of metastases and the unprecedented clinical course of the tumor prompted us to provide this follow-up evaluation. Report of a Case.— In 1973, a 72-year-old man noted a lesion on the plantar aspect of his left foot. The mass gradually enlarged. It was excised in 1978 and diagnosed as a malignant mixed tumor of the skin. In 1980 the patient was admitted to the New England Medical Center, Boston, because of pain in his left leg, at which time roentgenograms showed a large lytic defect in the tibial diaphysis. A biopsy specimen confirmed the diagnosis of malignant cutaneous mixed tumor. The patient received radiation treatment to the tibia. Repeated roentgenograms showed further osseous destruction

Adenocarcinoma of the fallopian tube: Report of a case with an unusual pattern of metastasis and response to combination chemotherapy

A patient with stage I fallopian tube adenocarcinoma had disease recurrence in both lungs shortly after completing adjuvant therapy with intraperitoneal 32P and parenteral cyclophosphamide. She achieved a complete clinical response to cisplatin, Adriamycin, and cyclophosphamide (PAC) chemotherapy, but was subsequently found to have brain metastasis. The implications of these observations for understanding the natural history and optimal therapy of this disease are discussed.

Signet ring carcinoma of the female breast: a clinicopathologic analysis of 24 cases.

Signet ring carcinomas of the breast have been separated recently as an aggressive subtype of breast cancer, distinct from mucinous (colloid) carcinomas. Twenty-four cases of signet ring breast cancer (2% of total breast cancers at the authors' institution) were analyzed. The authors' study indicates that histogenetically such lesions are derived from lobular, not ductal, cells since mucin patterns and ultrastructural features are shared. In addition, in each of our 24 cases, infiltrating lobular carcinoma was identified; in 11 of these (46%) lobular carcinoma in-situ (LCIS) was also noted. Signet ring carcinomas show an unusual metastatic pattern with a propensity to involve serosal surfaces and mimicking gastrointestinal disease or retroperitoneal fibrosis. These tumors are associated with a poor prognosis, with 60% of our 24 patients dead of disease at 7 years. The distinctive clinical and pathologic features of signet ring carcinoma warrant separation of this group of tumors from other forms of breast cancer.

Guest Editorial: Priapism

No AccessJournal of Urology1 Feb 1981Guest Editorial: Priapism Chester C. Winter Chester C. WinterChester C. Winter More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)54974-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Guest Editorial: Priapism." The Journal of Urology, 125(2), p. 212 © 1981 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByAbber J, Lue T, Luo J, Juenemann K and Tanagho E (2018) Priapism Induced by Chlorpromazine and Trazodone: Mechanism of ActionJournal of Urology, VOL. 137, NO. 5, (1039-1042), Online publication date: 1-May-1987.Gibel L, Reiley E and Borden T (2018) Intracorporeal Cavernosa Streptokinase as Adjuvant Therapy in the Delayed Treatment of Idiopathic PriapismJournal of Urology, VOL. 133, NO. 6, (1040-1041), Online publication date: 1-Jun-1985.Robbins D, Crawford E and Lackner H (2018) Late Development of a Urethrocavernous Fistula After Cavernospongiosum Shunt for PriapismJournal of Urology, VOL. 132, NO. 1, (126-127), Online publication date: 1-Jul-1984.Robbins D, Crawford E and Lackner L (2018) Priapism Secondary to Prazosin OverdoseJournal of Urology, VOL. 130, NO. 5, (975-975), Online publication date: 1-Nov-1983.Venable D, Hastings D and Misra R (2018) Unusual Metastatic Patterns of Prostate AdenocarcinomaJournal of Urology, VOL. 130, NO. 5, (980-985), Online publication date: 1-Nov-1983. Volume 125Issue 2February 1981Page: 212 Advertisement Copyright & Permissions© 1981 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Chester C. Winter More articles by this author Expand All Advertisement Loading ...

Carcinoma of the Cervix with an Unusual Pattern of Metastases

Summary: A case report is presented of a 40‐year‐old Sikh female with carcinoma of the cervix and extensive secondary deposits involving the skull, vertebrae, ribs, clavicles, pelvis and long bones of both upper and lower extremities. The liver and lung parenchyma, common sites for distant metastases in carcinoma of the cervix, were free of disease, whereas the heart, a rare site, was involved. The history and clinical course was short. Death was due to hypercalcaemia, resulting from the extensive skeletal metastases.

An Unusual Remission of Prostatic Carcinoma With Pulmonary Metastases

No AccessJournal of Urology1 Aug 1969An Unusual Remission of Prostatic Carcinoma With Pulmonary Metastases Clayton C. Stenberg and R. Carl Bunts Clayton C. StenbergClayton C. Stenberg Current address: Lakes Region General Hospital, Laconia, New Hampshire 03246. More articles by this author and R. Carl BuntsR. Carl Bunts More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)62120-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1969 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byVenable D, Hastings D and Misra R (2018) Unusual Metastatic Patterns of Prostate AdenocarcinomaJournal of Urology, VOL. 130, NO. 5, (980-985), Online publication date: 1-Nov-1983.Falkowski W and O’Conor V (2018) Long-Term Survivor of Prostatic Carcinoma with Lung MetastasesJournal of Urology, VOL. 125, NO. 2, (260-262), Online publication date: 1-Feb-1981. Volume 102Issue 2August 1969Page: 236-239 Advertisement Copyright & Permissions© 1969 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Clayton C. Stenberg Current address: Lakes Region General Hospital, Laconia, New Hampshire 03246. More articles by this author R. Carl Bunts More articles by this author Expand All Advertisement PDF downloadLoading ...