Lung metastases are more common in metastatic disease in differentiated thyroid carcinoma (DTC). Because of its insidious onset and slow development, clinical diagnosis is relatively difficult. Some possible diagnostic methods for detecting the lung metastasis of DTC including serological examination, radionuclide imaging and other medical imaging patterns are discussed in this paper. The progress and the current situation about investigation of those modalities which are in the early diagnosis, recurrent and clinical evaluation for the lung metastasis of DTC are briefly reviewed. Therefore, it is expected to promote DTC with lung metastasis to a higher diagnostic level.
Humans ; Lung Neoplasms ; diagnosis ; secondary ; Neoplasm Metastasis ; Thyroid Neoplasms ; pathology

OBJECTIVETo improve the diagnosis and treatment of far advanced prostate cancer without clinically detectable bone metastasis.

METHODSCancer metastatic lesions were found in the liver and lungs respectively of two patients on routine medical examination, and only an abnormally elevated level of the serum prostate specific antigen (PSA) was observed in the following system examinations. The patients were diagnosed as having prostate cancer by prostate biopsy. MRI showed a discontinued prostate capsule, and ECT revealed no bone metastasis. Diagnostic treatment was conducted by giving LHRHa combined with antiandrogens. One of the patients underwent surgical castration at 12 months, and both received intensity modulated radiation therapy (80 Gy) at 15 and 18 months, respectively.

RESULTSThe metastatic lesions in the liver and lungs of the patients were either absent or significantly reduced after treated by maximal androgen blockade for 3 months, and all disappeared after 6 months'treatment, with the PSA level stabilized at less than 0.02 microg/L in one patient, and around 0.5 microg/L in the other. Antiandrogen treatment was suspended after radiotherapy. The results of liver, lung and bone scanning were normal during the 12-month follow-up, and the PSA level was below 1.0 microg/L.

CONCLUSIONRemote metastasis of prostate cancer may occur in ectosteal organs first, which deserves special attention. A combination of different treatment methods promises satisfactory results.

Aged ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; diagnosis ; pathology ; therapy

Phyllodes tumor is a rare breast tumor. A 45-year-old woman who underwent left mastectomy 12 years ago was found to have infiltrates in both lungs in a health examination. Combining histological examinations of the lung and breast samples, the diagnosis of borderline phyllodes tumor metastases to the lung was made. It is the longest interval to our knowledge that the metastases occurred 12 years after primary phyllodes tumor.
Breast Neoplasms ; complications ; surgery ; Female ; Humans ; Lung Neoplasms ; secondary ; Middle Aged ; Phyllodes Tumor ; diagnosis ; secondary

Epithelioid hemangioendothelioma is a neoplasm of vascular origin with a low-to-intermediate malignant potential and is one of the rare sarcomas arising from the liver. Its etiology is unknown and its clinical outcome is unpredictable. There is no generally accepted therapeutic strategy because of its rarity and the variable natural course between hemangioma and angiosarcoma. We report a case of a 64-year old woman who underwent hepatic resection due to epithelioid hemangioendothelioma in the right lobe that progressed to extrahepatic metastases of the bone, pleura, and peritoneum 22 months later. However, after resection there was no primary hepatic recurrence.
Bone Neoplasms/diagnosis/pathology/secondary ; Female ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology/*secondary ; Hepatectomy ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Lung Neoplasms/diagnosis/pathology/secondary ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo report the MRI features of intracranial metastases of lung cancer.

METHODSA total of 858 patients with history of primary lung cancer suspicious of brain metastases was retrospectively reviewed with MRI.

RESULTS1. Of the 858 patients, 393 (45.8%) had brain metastases on MRI. The primary tumor was lung adenocarcinoma in 117 (29.8%), small cell lung cancer in 110 (28.0%), squamous cell cancer in 52 (13.2%), adenosquamous cancer in 16 (4.1%), large cell carcinoma in 2 (0.5%) and carcinoid in 1 (0.3%). The histopathological types of the primary tumor were unknown in 95 (24.2%). 2. Meningeal metastasis was found in 19 patients with lung cancer. The primary tumor was of adenocarcinoma lung in 6, small cell lung cancer in 5, squamous cell carcinoma in 4 and the remaining 4 were of unknown histopathological type. 3. Edema around the lesion: in 120 cases, there was no obvious edema; the edema was slight in 98 cases, moderate in 70, serious in 86.

CONCLUSIONThe brain metastasis of lung cancer is of common occurrence. MRI with enhancement is very helpful in the establishment of diagnosis.

Adenocarcinoma ; diagnosis ; secondary ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Carcinoma, Small Cell ; diagnosis ; secondary ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged ; Retrospective Studies

Gastric metastasis of lung carcinoma is a rare entity which is detected mostly at autopsy. Patients diagnosed as having those on lifetime are extremely rare. In addition to our case, 54 cases of lung carcinoma metastasis to the gastro-intestinal tract have been reported in the literature since 1961. We report a case of gastric metastasis originated from small cell lung carcinoma. The patient was a 87-year-old man. He refused lung biopsy and further treatment and died 2 months after the diagnosis. This is the case of gastric metastsis originated from lung carcinoma, which was confirmed by immunohistochemical staining.
Aged ; Aged, 80 and over ; Carcinoma, Small Cell/diagnosis/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Stomach Neoplasms/diagnosis/*secondary

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.
Carcinoma, Non-Small-Cell Lung/*diagnosis ; Heart Neoplasms/diagnosis/*secondary ; Heart Ventricles/pathology ; Humans ; Lung Neoplasms/*diagnosis ; Male ; Middle Aged

A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma ; diagnosis ; pathology ; Adenocarcinoma of Lung ; Bone Neoplasms ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Nose Neoplasms ; secondary

OBJECTIVETo study the clinical characteristics and MR imaging features of intracranial metastasis from malignant tumors.

METHODS1271 patients who had history of primary tumor and suspected of cranial metastasis had MRI on Philips Gyroscan T5-NT MR scanner. The sequences included pre-contrast T(1)WI, FLAIR, and postcontrast transversal, sagittal, and coronal T(1)WI. All of the clinical data and MRI features of the patients were recorded and analyzed.

RESULTSOf 547 patients with intracranial metastasis, 393 came from lung cancer (71.9%), 10% of 547 patients were found to have the presenting symptoms of cranial metastasis. 526 had parenchymal cerebral metastasis, and 21 only meningeal metastasis. Of these 526 patients found to have brain metastasis, 164 had single metastasis (31.2%), and 362 multiple (68.8%). Most of the cerebral metastatic lesions showed uniform or ring enhancement after intravenous injection of contrast medium, dura-arachnoid metastasis showed continuous and thick-curve enhancement at the cerebral convex, but not extending to the sulcus, while pia-dura metastasis displayed as thin and linear or nodular enhancement extending to the adjacent sulci.

CONCLUSIONThe most common primary lesion with metastasis to the brain were lung cancers, followed by breast and gastrointestinal cancers. By using gadolinium-DTPA enhanced MR imaging, many single and small cerebral metastasis could be found earlier.

Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; pathology ; Female ; Gastrointestinal Neoplasms ; pathology ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged

Bronchial Neoplasms ; diagnosis ; secondary ; surgery ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged