The liver is a common visceral site for metastatic tumours. Radiological features of the liver, fine needle aspiration cytology (FNAC) and histopathological evaluation (HPE) of liver nodules have a significant role in pre-operative diagnosis of liver lesions. In an intraoperative setting, frozen section biopsy plays a major diagnostic modality but the role of imprint cytology of liver nodules is also appealing. Imprint cytology is a valuable and precise tool in diagnosing the lesions for a rapid intraoperative diagnosis. This study presents a case of colorectal cancer liver metastasis diagnosed by imprint cytology intraoperatively.
Frozen Sections ; Adenocarcinoma ; Liver ; secondary

INTRODUCTIONThe interesting topic of cutaneous and subcutaneous metastasis from rectal carcinoma is discussed using 3 cases.

CLINICAL PICTUREThe first case was a 70-year-old man with T3N2M0 rectal mucinous adenocarcinoma, who developed an inflammatory subcutaneous metastasis at the left scapula 2 years after anterior resection. The second case was a 51-year-old man with T4N2M0 splenic flexure mucinous adenocarcinoma, who developed metastatic disease including a subcutaneous secondary to the back. The third case was a 53-year-old woman who developed vulval recurrence 10 months after abdomino-perineal resection for a low T3N1M0 rectal adenocarcinoma.

TREATMENTAll underwent wide resection.

CONCLUSIONThis entity is rare and usually signifies disseminated disease if found remote from the resection site and warrants a thorough metastatic work up. A high index of suspicion is recommended when encountered with unresolving skin lesions in cancer patients.

Adenocarcinoma ; pathology ; secondary ; Adenocarcinoma, Mucinous ; pathology ; secondary ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Connective Tissue ; pathology ; secondary ; Rectal Neoplasms ; pathology ; Skin Neoplasms ; pathology ; secondary ; Subcutaneous Tissue

A 65-year-old male patient presented multiple cutaneous nodules on trunk and an erythematous inflammatory lesion resembling erysipelas on left side of neck. Result of skin biopsies disclosed groups of metastatic adenocarcinoma cells in the dermis, subcutaneous tissue, and lumina of the lymphatic vessels. Histopathologic examination of the stomach, along with the gastroscope, established that the cutaneous metastasis was of stomach origin.
Adenocarcinoma/pathology/*secondary ; Aged ; Humans ; Male ; Skin Neoplasms/pathology/*secondary ; Stomach Neoplasms/*pathology

Breast cancer is a common malignancy in women and frequently metastasizes to various organs such as liver, lung, brain, bone and so on. But metastasis to gastrointestinal tract is rare. We describe a 73-year-old woman with small intestinal metastasis of breast cancer. She was diagnosed as right breast cancer in stage I, received modified radical mastectomy 6 years ago and had been followed up without any evidence of residual disease. During investigation for lower abdominal pain and weight loss of 9 kg, we found a small bowel mass. The histology of the tissue taken from small bowel mass was adenocarcinoma, poorly differentiated. The immunohistochemical stain of this specimen showed 75% positivity of estrogen receptor and 90% positivity of progesterone receptor. This is a case of small bowel metastasis from breast cancer and we report this case with a review of literatures.
Adenocarcinoma/*secondary ; Aged ; Breast Neoplasms/*pathology ; English Abstract ; Female ; Humans ; Intestinal Neoplasms/diagnosis/*secondary ; Intestine, Small

Adenocarcinoma ; secondary ; Colonic Neoplasms ; pathology ; Humans ; Male ; Middle Aged ; Skin Neoplasms ; secondary

Adenocarcinoma ; secondary ; Aged, 80 and over ; Cryptorchidism ; pathology ; Humans ; Male ; Prostatic Neoplasms ; pathology ; Testicular Neoplasms ; secondary

The study examined the association between calcified liver metastases and the histopathology of the primary colorectal carcinoma in Chinese. The clinical, pathological and CT data were retrospectively analyzed in 210 patients (mean age: 54.2 years) with liver metastases from colorectal carcinoma. Plain CT scanning and contrast-enhanced scanning were performed in all the patients. For the contrast-enhanced examination, iohexol was injected by using a high pressure syringe at a flow rate of 2.5-3.0 mL/s. The arterial phase lasted approximately 25 s and the portal venous phase about 60 s. All patients had no history of chronic liver diseases and had never received interventional treatments. χ(2)-test was used to analyze the rate of calcification in the liver metastasis from colorectal cancer of different differentiation degrees. Among the 210 cases of liver metastases, 22 patients (10.5%) were found to have calcified liver metastases on CT scan. Two patients with calcified liver metastasis received lumpectomy and developed calcification in recurrent tumors. Another two patients had calcification in newly developed tumor masses. And the calcification in the newly developed masses was similar to that of their primary counterparts in terms of morphology and distribution. On the enhanced CT scan, the tumors exhibited no enhancement during hepatic arterial phase and showed slight rim enhancement during portal venous scan in the 22 cases. The calcification became obscure on contrast-enhanced scans. Histopathologically, the primary tumors were well-differentiated adenocarcinoma in 6 cases, moderately-differentiated adenocarcinoma in 10, poorly-differentiated adenocarcinoma in 4 and mucinous adenocarcinoma in 2 among the 22 cases. No statistical correlation was noted between the incidence of calcified liver metastasis and the pathological subtypes and differentiation degrees of the primary colorectal carcinoma. It was concluded that calcified liver metastases may result from colorectal adenocarcinomata of different differentiation degrees or mucinous adenocarcinomata in Chinese population. There is no correlation between calcification of liver metastases and the pathological subtype of the primary colorectal carcinoma in Chinese, which is different from the findings that calcified metastases were associated with colorectal mucinous adenocarcinoma in other ethnic groups.
Adenocarcinoma ; pathology ; secondary ; Adenocarcinoma, Mucinous ; pathology ; secondary ; Adult ; Aged ; Calcinosis ; pathology ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; secondary ; Male ; Middle Aged

OBJECTIVETo study the clinicopathologic characteristics of metastatic carcinomas to the spleen.

METHODSSixteen cases of metastatic carcinoma to the spleen were retrieved from archival clinical, surgical pathology and autopsy records. The demographic data (including sex and age of patients), clinical symptoms, primary sites, tumor histologic types, gross appearance of spleen and growth patterns within the spleen were analyzed.

RESULTSAmong the 16 patients studied, 12 were males and 4 were females. The male predilection was obvious. The age ranged from 48 to 90 years, the median age 66.5 years. Major clinical symptoms included discomfort in the left upper quadrant, pain, emaciation and loss of appetite. Splenomegaly was noted in some patients and computerized tomography could show space-occupying lesions in the spleen. In general, lung was the most common primary site for splenic metastasis and accounted for 43.8% of all cases (7/16). In male patients, primary lung tumor was found in 50.0% cases (6/12). On the other hand, primary ovarian tumor was commonly seen in females (2/4). Histologically, undifferentiated carcinoma of lung was frequently encountered (25.0%, 4/16), including 3 cases of small cell undifferentiated carcinoma and 1 case of large cell undifferentiated carcinoma. Other histologic tumor types included bronchioloalveolar carcinoma (2 cases), colonic adenocarcinoma (2 cases), ovarian serous papillary adenocarcinoma (2 cases), and prostatic adenocarcinoma (2 cases). The commonest histologic tumor type found in male patients was pulmonary undifferentiated carcinoma. The growth patterns of metastatic carcinoma in spleen included nodular, diffuse and multinodular. Most cases presented as a single splenic nodule. Sometimes, tumors with high metastatic potential (5/16) showed diffuse and multinodular growth patterns. Examples of these tumors included small cell undifferentiated carcinoma (3 cases), pulmonary adenocarcinoma (1 case) and prostatic adenocarcinoma (1 case).

CONCLUSIONSMetastatic carcinoma to the spleen is rare. Understanding of the clinicopathologic characteristics is helpful in guiding clinical management and pathologic diagnosis.

Adenocarcinoma ; secondary ; Adenocarcinoma, Bronchiolo-Alveolar ; secondary ; Aged ; Aged, 80 and over ; Carcinoma, Small Cell ; secondary ; Colonic Neoplasms ; pathology ; Cystadenocarcinoma, Serous ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Ovarian Neoplasms ; pathology ; Prostatic Neoplasms ; pathology ; Spleen ; pathology ; Splenic Neoplasms ; secondary

OBJECTIVETo summarize the surgical treatment experiece and to investigate the prognosis of the patients with ovarian metastasis from colorectal cancer.

METHODSThe data of 67 patients with synchronous or asynchronous ovarian metastasis from colorectal cancer surgically treated between January 1989 and December 2005 were collected and analyzed retrospectively using Statistical Package for the Social Sciences (Release 11.5, SPSS, Inc). Prognostic factors were analyzed using chi2 test. Survival analysis was estimated by the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis was carried out by Cox regression.

RESULTSThe overall 1-, 3- and 5-year survival of these 67 patients was 71.0%, 18.7% and 9.2%, respectively. Univariate analysis revealed that the metastasis was confined in the ovary or pelvis only, unilateral/double ovarian metastasis, and operation mode were all statistically significant prognostic factors (P <0.05). Cox regression analysis showed that the operation mode was the most important prognostic factor (OR = 3.531, P <0.001).

CONCLUSIONSurgical treatment is still the most effective mode in the treatment for the ovary metastasis from colorectal cancer.

Adenocarcinoma ; secondary ; surgery ; Adenocarcinoma, Mucinous ; secondary ; surgery ; Adult ; Aged ; Carcinoma, Signet Ring Cell ; secondary ; surgery ; Colorectal Neoplasms ; pathology ; Female ; Follow-Up Studies ; Humans ; Hysteroscopy ; methods ; Middle Aged ; Ovarian Neoplasms ; secondary ; surgery ; Ovariectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

Adenocarcinoma ; pathology ; secondary ; surgery ; Adult ; Bone Marrow Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Postoperative Period ; Stomach Neoplasms ; pathology ; surgery