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

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

We report a case of pathologically proven simultaneous duodenal and colonic metastases about four years after nephrectomy for mixed clear and granular cell type renal cell carcinoma (RCC). A 76-year-old female patient who had undergone a left radical nephrectomy 4 years previously for RCC presented with a 1-month history of dyspepsia and pain in the right upper abdomen. An abdominopelvic CT scan showed circumferential wall thickening with high enhancement at the second portion of the duodenum and additional enhancement of an irregular protruding mass into the lumen of the ascending colon. A gastroscopy showed a large and ulcerative protruding mass nearly obstructing the second portion of the duodenum. A colonoscopy revealed a polypoid, nodular and purplish mass in the ascending colon. Microscopy of the biopsy specimen showed the features identical to those of the RCC which was resected 4 years earlier in this patient. We believe this to be the first case illustrating a metastatic renal cell carcinoma as simultaneous duodenal and colon masses.
Aged ; Carcinoma, Renal Cell/pathology/*secondary ; Case Report ; Colonic Neoplasms/pathology/*secondary ; Duodenal Neoplasms/pathology/*secondary ; Female ; Human ; Kidney Neoplasms ; Time Factors

No abstract available.
Colonic Neoplasms/*pathology/radiography ; Female ; Human ; Liver Neoplasms/radiography/*secondary ; Middle Aged ; Tomography, X-Ray Computed

Adenocarcinoma ; pathology ; Aged, 80 and over ; Colonic Neoplasms ; pathology ; Humans ; Male ; Nasal Septum ; pathology ; Neoplasm Metastasis ; Nose Neoplasms ; secondary

BACKGROUND/AIMS: It has been reported that the risk of gastric polyp is increased in various colonic polyposis syndromes or in series of patients with sporadic colonic polyps. However, there are only a few large case controlled studies of colon cancer incidence in gastric cancer patients who underwent colonoscopy. The aims of this study were to determine the incidence of colorectal neoplasm and to evaluate the necessity of colonoscopic surveillance in patients with gastric cancer. METHODS: We performed colonoscopy in 105 patients with gastric cancer who agreed to undergo colonoscopy before or after 6 months from gastric resection between January 2002 and December 2004 in Kangbuk Samsung hospital. As a control group, 269 consecutive, age and sex matched patients without gastric neoplasm on gastroscopy who underwent colonoscopy within 6 months for the evaluation of various gastrointestinal symptoms during the year 2004 were included. Endoscopic reports and pathological results were reviewed retrospectively. RESULTS: In the patient group, adenomatous polyps were diagnosed in 24/105 patients (22.9%) and colorectal adenocarcinoma in 10/105 patients (9.5%). In the control group, adenomatous polyps were diagnosed in 78/269 patients (29.0%) and colorectal adenocarcinoma in 2/269 patients (0.7%). The incidence of colorectal adenocarcinoma between the patient group and control group showed significant differences (odds ratio 11.04, p=0.003). CONCLUSIONS: The risk of colorectal adenocarcinoma increases significantly in patients with gastric cancer. We suggest that the patients with gastric cancer might carry a high risk for colorectal cancer whom require surveillance colonoscopy.
Adenocarcinoma/*diagnosis/*secondary ; Adenomatous Polyps/diagnosis ; Colonic Polyps/diagnosis ; *Colonoscopy ; Colorectal Neoplasms/*diagnosis/*secondary ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/*diagnosis ; Stomach Neoplasms/*pathology

We report herein a case of 72-year-old woman in whom liver metastasis of colon cancer was presented with a marked elevation of serum alpha-fetoprotein (AFP) level. She was transferred to our hospital for multiple liver masses found on ultrasonogram. Abdominal computed tomogram revealed multiple low-density masses in the liver and wall thickening of the hepatic flexure of colon. The serum AFP level was 10,718.8 ng/mL. Colonoscopic findings of ulcerofungating mass suggested liver metastasis from colon cancer. However, the possibility of combined hepatocellular carcinoma could not be ruled out due to serum AFP elevation. Both colon and liver biopsies revealed moderately differentiated tubular adenocarcinoma. Using an immunohistochemical staining, the adenocarcinoma in liver showed focal positive to AFP, but not in colon. This case represents a very rare case of colon cancer with a marked elevation of serum AFP.
Aged ; Colonic Neoplasms/*pathology ; Female ; Humans ; Liver Neoplasms/*diagnosis/radiography/*secondary ; Tomography, X-Ray Computed ; alpha-Fetoproteins/*analysis

Animals ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Liver Neoplasms ; metabolism ; secondary ; Lymphatic Metastasis ; Neoplasm Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Protein Tyrosine Phosphatases ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

Primary lung cancer is a leading cause of cancer-related deaths in Korea. Approximately 50% of patients have metastatic disease at the time of presentation. The preferential sites of extrapulmonary spread include lymph nodes, liver, brain, adrenal glands, and bones. Gastrointestinal metastasis from primary lung cancer is extremely rare and only a few case reports have been published. Herein, we report a case of metastatic colon cancer from primary lung adenocarcinoma, presenting multiple cecal polypoid masses.
Adenocarcinoma/*diagnosis/radionuclide imaging/*secondary ; Aged ; Colonic Neoplasms/diagnosis/etiology/*secondary ; Diagnosis, Differential ; Humans ; Lung Neoplasms/*diagnosis/pathology/radionuclide imaging ; Male ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVESingle mode of radiofrequency ablation (RFA) often leads to limited ablation in the zone of necrosis. This study clarifies the efficacy of combining temperature- and power-controlled RFA for malignant liver tumors.

METHODSBetween April 2008 and August 2008, 58 patients with malignant liver tumors received RFA at Sun Yat-sen University Cancer Center. The patients were divided into 2 groups using a random number table: one group received combined temperature- and power-controlled RFA (the combination group), and the other group received power-controlled RFA alone (the control group).

RESULTSThree patients were lost to follow-up and 55 patients were included for evaluation. Twenty-five patients with 29 tumors were treated by the combination RFA, and 27 tumors (93.1%) achieved either complete response (CR) or partial response (PR). One patient had a seriously decreased heart rate. In the control group, 30 patients with 32 tumors received power-controlled RFA, and 29 tumors (90.6%) achieved CR or PR. There were no serious complications. There was no difference between the combination and control groups in treatment time ((13.3 +/- 1.3) min vs. (10.2 +/- 2.3) min, P = 0.459). The number of sessions of RFA for the combination group was less than that of control group (1.3 sessions vs. 2.4 sessions), but the difference was not significant (P = 0.579).

CONCLUSIONRFA controlling both temperature and power is effective and safe for patients with malignant liver tumors, and the number of sessions of RFA for the combination group was less than that of the control group.

Adult ; Aged ; Catheter Ablation ; methods ; Colonic Neoplasms ; secondary ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; blood ; pathology ; secondary ; therapy ; Male ; Middle Aged ; Remission Induction ; Temperature ; alpha-Fetoproteins ; metabolism