1.A case of occult breast cancer presenting with intestinal obstruction as the initial symptom.
Zijuan WANG ; Lin TANG ; Xiaohui HUANG ; Taoli WANG ; Hongyue LIAN ; Miduo TAN
Journal of Central South University(Medical Sciences) 2024;49(12):2016-2022
Occult breast cancer (OBC) refers to a type of breast cancer where no primary lesion is detected through physical examination, imaging, and pathology. This report presents a clinical case of OBC with intestinal obstruction as the initial symptom. A 67-year-old female with no underlying conditions presented to Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University with intestinal obstruction. Contrast-enhanced CT of the abdomen showed thickening of the lower rectum and ascending colon, suggestive of a neoplastic lesion. Chest CT showed multiple enlarged lymph nodes in the left axilla. Colonoscopy revealed only mucosal congestion, roughness, and thickening. Suspecting an intestinal tumor, laparoscopic radical resection of the rectal stenosis was performed. Postoperative pathology indicated poorly differentiated adenocarcinoma of the rectum. Immunohistochemistry showed positive expression of estrogen receptor (ER), progesterone receptor (PR), GATA-binding protein 3 (GATA3), and cytokeratin 7 (CK7), suggesting breast cancer metastasis. Breast MRI revealed multiple proliferative nodules in both breasts (breast imaging reporting and data system, BI-RADS 2). Biopsies of the right lower-inner breast, bilateral axillary, and supraclavicular lymph nodes were performed. No carcinoma was found in the right breast tissues; however, small foci of carcinoma was detected in the right axillary lymph nodes, and poorly differentiated carcinoma of suspected breast origin was found in the bilateral supraclavicular and left axillary lymph nodes. The final diagnosis was OBC with lymph node and rectal metastasis. The patient died 16 months postoperatively. OBC often lacks identifiable primary breast lesions, and gastrointestinal metastases are particularly rare. Clinical manifestations are frequently masked by symptoms of metastatic lesions, making diagnosis challenging. Clinicians should maintain a high index of suspicion. Due to rapid disease progression and multiorgan involvement, prognosis is extremely poor. Early identification of the primary lesion in OBC is crucial for improving outcomes.
Humans
;
Female
;
Aged
;
Intestinal Obstruction/etiology*
;
Breast Neoplasms/pathology*
;
Adenocarcinoma/diagnosis*
;
Neoplasms, Unknown Primary/complications*
;
Rectal Neoplasms/complications*
3.Primary Adenocarcinoma with Focal Choriocarcinomatous Differentiation in the Sigmoid Colon.
Sook Kyoung OH ; Hyung Wook KIM ; Dae Hwan KANG ; Cheol Woong CHOI ; Yu Yi CHOI ; Hong Kyu LIM ; Ja Jun GOO ; Sung Yeol CHOI
The Korean Journal of Gastroenterology 2015;66(5):291-296
Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma.
Adenocarcinoma/*diagnosis/drug therapy/pathology
;
Antineoplastic Agents/administration & dosage
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
CA-19-9 Antigen/analysis
;
Chorionic Gonadotropin, beta Subunit, Human/blood
;
Colon, Sigmoid/pathology
;
Colonic Neoplasms/*diagnosis/drug therapy/pathology
;
Colonoscopy
;
Constipation/etiology
;
Female
;
Fluorouracil/therapeutic use
;
Humans
;
Leucovorin/therapeutic use
;
Liver Neoplasms/secondary
;
Middle Aged
;
Organoplatinum Compounds/therapeutic use
;
Prognosis
;
Tomography, X-Ray Computed
4.RE: Metastasis of Gallbladder Adenocarcinoma to Bauhin's Valve: An Extremely Rare Cause of Intestinal Obstruction.
Edoardo VIRGILIO ; Valentina GIACCAGLIA ; Genoveffa BALDUCCI
Korean Journal of Radiology 2014;15(5):655-656
No abstract available.
Adenocarcinoma/*complications/*diagnosis/pathology
;
Aged, 80 and over
;
Colonoscopy
;
Ethanol/therapeutic use
;
Female
;
Gallbladder Neoplasms/*complications/*diagnosis/pathology
;
Humans
;
Intestinal Obstruction/*etiology
;
Liver Neoplasms/complications/drug therapy/secondary
;
Tomography, X-Ray Computed
5.Multiple malignancies in a female patient with common variable immunodeficiency syndrome.
Milena TODOROVIC ; Bela BALINT ; Bosko ANDJELIC ; Biljana MIHALJEVIC
Singapore medical journal 2014;55(10):e162-4
We herein present the case of a 55-year-old woman with a previous history of malignancies--uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.
Adenocarcinoma
;
etiology
;
Carcinoma, Basal Cell
;
etiology
;
Common Variable Immunodeficiency
;
complications
;
diagnosis
;
therapy
;
Fatal Outcome
;
Female
;
Humans
;
Lymphoma, Large B-Cell, Diffuse
;
etiology
;
Middle Aged
;
Neoplasms, Multiple Primary
;
etiology
;
pathology
;
therapy
;
Respiratory Tract Infections
;
etiology
;
Skin Neoplasms
;
etiology
;
Uterine Neoplasms
;
etiology
6.A case of membranoproliferative glomerulonephritis associated with metastatic colon cancer.
Jung Hwa RYU ; Soon Sup CHUNG ; Dong Ryeol RYU ; Seung Jung KIM ; Duk Hee KANG ; Sun Hee SUNG ; Kyu Bok CHOI
The Korean Journal of Internal Medicine 2013;28(2):254-257
No abstract available.
Adenocarcinoma/*secondary/surgery
;
Chemotherapy, Adjuvant
;
Colectomy
;
Glomerulonephritis, Membranoproliferative/diagnosis/*etiology/therapy
;
Hepatectomy
;
Humans
;
Liver Neoplasms/*secondary/surgery
;
Male
;
Middle Aged
;
Paraneoplastic Syndromes/diagnosis/*etiology/therapy
;
Renal Dialysis
;
Renal Insufficiency/etiology
;
Sigmoid Neoplasms/*pathology/surgery
;
Treatment Outcome
7.Metastatic Common Bile Duct Cancer from Pulmonary Adenocarcinoma Presenting as Obstructive Jaundice.
In Hye CHA ; Jin Nam KIM ; You Sun KIM ; Soo Hyung RYU ; Jeong Seop MOON ; Hye Kyung LEE
The Korean Journal of Gastroenterology 2013;61(1):50-53
We report an extremely rare case of metastatic common bile duct cancer from pulmonary adenocarcinoma presenting as obstructive jaundice. The patient was a 76-year-old male, who presented with generalized weakness and right upper quadrant pain. Plain chest X-ray noted multiple small nodules in both lung fields. Abdominal computed tomography scan showed a stricture of the mid common bile duct along with ductal wall enhancement. Endoscopic retrograde cholangiography revealed a concentric, abrupt narrowing of the mid-common bile duct suggestive of primary bile duct cancer. However, pathology comfirmed metastatic common bile duct cancer arising from pulmonary adenocarcinoma with immunohistochemical study with thyroid transcriptional factor-1 (TTF-1).
Adenocarcinoma/*diagnosis/pathology/radiography
;
Aged
;
Brain Neoplasms/radiography/secondary
;
Bronchoscopy
;
Cholangiopancreatography, Endoscopic Retrograde
;
Common Bile Duct Neoplasms/*diagnosis/secondary
;
DNA-Binding Proteins/metabolism
;
Humans
;
Immunohistochemistry
;
Jaundice, Obstructive/*etiology
;
Lung Neoplasms/*diagnosis/pathology/radiography
;
Male
;
Positron-Emission Tomography
;
Tomography, X-Ray Computed
8.The advancement of predictive diagnosis and molecular mechanism in multiple primary lung cancer.
Lan YUAN ; Lun-Xu LIU ; Guo-Wei CHE
Chinese Journal of Cancer 2010;29(5):575-578
Due to the advanced diagnostic technique and better understanding for multiple primary lung cancers (MPLC), the increasing incidence of MPLC has been reported. Very often, MPLC are misdiagnosed as metastasis because of lacking efficient molecular biomarkers for prediction and diagnosis. Studies on the molecular mechanism for tumorgenesis and progression of MPLC may therefore facilitate the discovery of biomarkers for disease diagnosis and prognosis, so that an individual and rational treatment can be achieved. We tried to further our understanding and improve the diagnostic skill for MPLC by reviewing the current status and the latest advancement of molecular markers related to MPLC.
Adenocarcinoma
;
pathology
;
Biomarkers, Tumor
;
analysis
;
Carcinoma, Non-Small-Cell Lung
;
drug therapy
;
radiotherapy
;
Carcinoma, Small Cell
;
pathology
;
Carcinoma, Squamous Cell
;
pathology
;
Chromosome Deletion
;
DNA Damage
;
Genes, Tumor Suppressor
;
Humans
;
Incidence
;
Lung Neoplasms
;
diagnosis
;
epidemiology
;
etiology
;
genetics
;
Neoplasms, Multiple Primary
;
diagnosis
;
epidemiology
;
etiology
;
genetics
;
Smoking
;
adverse effects
10.Adenocarcinoma in Ileal Pouch after Proctocolectomy for Familial Adenomatous Polyposis: Report of A Case.
Seung Hyun LEE ; Byung Kwon AHN ; Hee Kyung CHANG ; Sung Uhn BAEK
Journal of Korean Medical Science 2009;24(5):985-988
Restorative proctocolectomy with ileal pouch-anal anastomosis is one of the surgical treatments of choice for patients with familial adenomatous polyposis. Although the risk of cancer developing in an ileal pouch is not yet clear, a few cases of adenocarcinoma arising in an ileal pouch have been reported. We report a case of adenocarcinoma in ileal pouch after proctocolectomy with ileal pouch-anal anastomosis. A 56-yr-old woman was diagnosed as having familial adenomatous polyposis. Total colectomy with ileorectal anastomosis was performed. Six years later, she underwent completion-proctectomy with ileal J pouch-anal anastomosis including anorectal mucosectomy for rectal cancer. After 7 yr, she presented with anal spotting. Endoscopic biopsies revealed adenocarcinoma at the ileal pouch. Resection of the ileal pouch and permanent ileostomy were performed. The risk of cancer in an ileal pouch and its prevention with regular surveillance must be emphasized.
Adenocarcinoma/*diagnosis/etiology/pathology
;
Adenomatous Polyposis Coli/complications/diagnosis/*surgery
;
Colonic Pouches/*pathology
;
Colorectal Neoplasms/*diagnosis/etiology/pathology
;
Female
;
Humans
;
Middle Aged
;
*Proctocolectomy, Restorative
;
Tomography, X-Ray Computed

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