Hypercalcaemia due to ovarian small cell carcinoma of the hypercalcaemic type

A 37-year-old woman presented with a few days’ history of lower abdominal pain and an incidental finding of hypercalcaemia. A thorough workup ensued, and the cause was found to be an exceptionally rare ovarian tumour—ovarian small cell carcinoma of the hypercalcaemic type. Acute treatment of hypercalcaemia consisted of aggressive intravenous fluids and bisphosphonates. She underwent surgery to remove the tumour and is currently receiving systemic platinum/etoposide chemotherapy combination to be followed by pelvic radiotherapy. This case highlights the wide range of differential diagnosis for hypercalcaemia and the importance of a stepwise and thorough approach during investigations. We discuss the pathophysiology of malignancy-related hypercalcaemia, focusing especially on parathyroid hormone-related peptide-associated hypercalcaemia.

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Metastatic small cell carcinoma of the lung with prominent spindle cell morphology and hemangiopericytoma-like vascular pattern: A sarcoma mimicker

SAGE Open Medical Case Reports ◽

10.1177/2050313x20981177 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2098117

Author(s):

Esra Nsour ◽

Ali Al Khader ◽

Bushra Al-Tarawneh

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Spindle Cell ◽

Small Cell ◽

Nerve Sheath Tumor ◽

Vascular Pattern ◽

Nerve Sheath ◽

History Of ◽

Wall Mass ◽

Aggressive Clinical Behavior

Small cell carcinoma is a malignant neuroendocrine tumor with aggressive clinical behavior. Histologically, the tumor is characterized by the proliferation of small, round, blue cells. Here, we present the case of a 50-year-old man with a 1-month history of enlarging chest wall mass. Microscopic examination of the lesion revealed a highly cellular neoplasm composed of closely packed, atypical spindle cells with scant cytoplasm, inconspicuous nucleoli, and brisk mitotic activity. The hemangiopericytoma-like vascular pattern was prominent. Areas showing a fibrosarcoma-like fascicular pattern were also observed. The tumor was immunohistochemically positive for TTF1, synaptophysin, and chromogranin, confirming small cell carcinoma. Further investigations revealed a lung origin and widespread metastases. The tumor in this case closely mimicked synovial sarcoma or malignant peripheral nerve sheath tumor. Small cell carcinoma demonstrates a hemangiopericytoma-like pattern that can mimic sarcoma histologically. This is a serious pitfall that can significantly affect the speed of diagnosis and management.

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Small cell carcinoma of the lung: an incidental finding on routine cardiac imaging

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ejechocard/jep117 ◽

2009 ◽

Vol 11 (1) ◽

pp. 82-84 ◽

Cited By ~ 2

Author(s):

Mehreen A. Qureshi ◽

Lynne L. Johnson ◽

Rebecca T. Hahn ◽

Sabahat Bokhari

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Cardiac Imaging ◽

Incidental Finding ◽

Small Cell

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Bilateral Testicular Metastases of Pulmonary Small Cell Carcinoma: a Rare Incidental Finding following Orchiectomy for Prostatic Carcinoma

British Journal of Urology ◽

10.1111/j.1464-410x.1989.tb05960.x ◽

1989 ◽

Vol 63 (5) ◽

pp. 552-552 ◽

Cited By ~ 2

Author(s):

A. STEIN ◽

Y. SOYA ◽

M. LURIE ◽

A. LURIE

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Prostatic Carcinoma ◽

Incidental Finding ◽

Small Cell ◽

Testicular Metastases

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Primary Small Cell Carcinoma of the Hypopharynx: A Case Report of a Rare Tumor

Case Reports in Otolaryngology ◽

10.1155/2015/934926 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ali Bayram ◽

Ebru Akay ◽

Sema S. Göksu ◽

İbrahim Özcan

Keyword(s):

Case Report ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Systemic Chemotherapy ◽

Metastatic Potential ◽

Pyriform Sinus ◽

Small Cell ◽

Rare Tumor ◽

History Of ◽

The Right

Introduction. Primary hypopharynx involvement of small cell carcinoma is very rare and very few cases have been reported in the literature. Here, we report a case of primary small cell carcinoma of the hypopharynx in a male patient.Case Report. A 50-year-old man presented with a 6-month history of sore throat and swellings in the right side of the neck. Direct laryngoscopy and biopsy revealed small cell carcinoma of the hypopharynx located in the right pyriform sinus.Discussion. Small cell carcinoma of the hypopharynx has no clear treatment modality due to the rarity of the disease. Systemic chemotherapy and radiotherapy should have priority among the therapy regimens because of the high metastatic potential of the tumor.

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Malignant Melanoma With Neuroendocrine Differentiation: A Case Report and Literature Review

Frontiers in Oncology ◽

10.3389/fonc.2021.763992 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jason Cham ◽

Ayal Shavit ◽

Aren Ebrahimi ◽

Miguel Viray ◽

Paul Gibbs ◽

...

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Neuroendocrine Differentiation ◽

Small Cell ◽

Brown Pigment ◽

Molecular Testing ◽

Lung Mass ◽

Diagnostic Uncertainty ◽

Wide Range ◽

Microscopic Morphology

BackgroundMelanoma has a wide range of histologic variants and cytomorphologic features that make its diagnosis challenging. Melanoma can also rarely have neuroendocrine markers adding further diagnostic uncertainty particularly given that unrelated tumor types, such as prostate cancer, can also display focal neuroendocrine differentiations.Case presentationOur patient is a 74-year-old Caucasian man found to have a lung mass. Initial biopsy revealed typical microscopic morphology and neuroendocrine differentiation consistent with small cell carcinoma. Despite standard chemoradiation treatment, the patient continued to progress with new metastasis in the brain, liver and bone. Subsequent chest wall biopsy revealed golden-brown pigment associated with melanin. Further tumor immunohistochemistry revealed extensive neuroendocrine differentiation with CD56, synaptophysin, and INSM1, as well as strong immunoreactivity for melanocyte markers including SOX10, S100, PRAME, and MITF, consistent with metastatic melanoma with neuroendocrine differentiation. Genomic testing revealed increased tumor mutational burden and alterations in NF1, BRAF, CDKN2A/B, TERT. The patient was transitioned to checkpoint inhibitor therapy with nivolumab and ipilimumab and had resolution of his intracranial mass and decrease in size of other metastatic lesions.ConclusionOften the combination of anatomic findings such as a lung mass, typical microscopic morphology, and confirmation of neuroendocrine differentiation correctly identifies a patient with small cell carcinoma. However, in a patient who fails to respond to treatment, a broader immunohistochemical workup along with molecular testing with additional tissue may be warranted.

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Rare case of metastatic small cell carcinoma of the nasopharynx to the pancreas

BMJ Case Reports ◽

10.1136/bcr-2020-235054 ◽

2020 ◽

Vol 13 (6) ◽

pp. e235054 ◽

Cited By ~ 1

Author(s):

Jonathan Teinor ◽

Lara Groshek ◽

Jin He

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Primary Tumour ◽

Treatment Options ◽

Needle Aspiration ◽

Concurrent Chemotherapy ◽

Small Cell ◽

Tissue Mass ◽

Positron Emission ◽

History Of

We present a 49-year-old woman with a history of an unresectable nasopharyngeal small cell carcinoma (SCC) who was treated with concurrent chemotherapy and radiation therapy. On surveillance positron emission tomography scan 14 months after diagnosis, her primary tumour appeared stable, but there was fludeoxyglucose uptake in the pancreas. A CT scan demonstrated a 3.4×2.1 cm ill-defined soft tissue mass at the tail of the pancreas, which was concerning for adenocarcinoma. However, further workup including endoscopic ultrasound and fine needle aspiration confirmed the mass to be a metastasis from her nasopharyngeal SCC. Because there have been no previously reported cases of a metastatic small cell carcinoma to the pancreas, there are no data about prognosis. Thus treatment options were tailored to the patient. Distal pancreatectomy, splenectomy and cholecystectomy were performed. The patient recovered from surgery without complication.

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Extrapulmonary small cell carcinoma of the external auditory canal: a case report and review of the literature

Journal of International Medical Research ◽

10.1177/0300060520946517 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094651

Author(s):

Jianyan Wang ◽

Danqing Liu ◽

Yingdi Meng ◽

Yingyuan Guo ◽

Ming Zhao

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

External Auditory Canal ◽

Small Cell ◽

Purulent Discharge ◽

Surgical Removal ◽

Eyelid Closure ◽

Reasonable Approach ◽

History Of ◽

Extrapulmonary Small Cell Carcinoma

Extrapulmonary small cell carcinoma (EPSCC) affecting the external auditory canal (EAC) is uncommon. We herein report a case involving a 56-year-old man with EPSCC of the EAC who had a 48-year history of recurrent purulent discharge in both ears and a 20-day history of right ear pain and hemorrhage followed by incomplete right eyelid closure and an askew mouth. He underwent surgical removal of middle ear granulation tissue, residual ossicles, and a right EAC mass. Postoperatively, pathomorphological examination combined with immunohistochemical staining supported a diagnosis of small cell carcinoma. Radiation therapy at a dose of 60.06 Gy in 33 daily fractions was completed 1 month after surgery, and synchronous etoposide–cisplatin regimen chemotherapy was performed for two cycles and four sequential cycles. One year postoperatively, magnetic resonance imaging showed no tumor in the ear; however, computed tomography showed multiple liver space-occupying lesions that were considered to indicate liver metastasis. Further chemotherapy was performed, but the patient died 15 months postoperatively. This case indicates that timely and accurate chemoradiotherapy is likely the most reasonable approach to EPSCC of the EAC given the aggressiveness of this tumor.

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Effect of high-dose chemotherapy with autologous stem cell rescue (HDC-aSCR) on outcome in ovarian small-cell carcinoma, hypercalcemic type (SCCOHT): Prospective series from the French Rare Gynecologic Malignant Tumors Network (TMRG).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.6023 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 6023-6023 ◽

Cited By ~ 1

Author(s):

Felix Blanc ◽

Claudia Lefeuvre ◽

Anne Floquet ◽

Dan Chaltiel ◽

Isabelle Laure Ray-Coquard ◽

...

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Performance Status ◽

Diagnostic Delay ◽

Small Cell ◽

High Dose ◽

Rapid Progression ◽

Pelvic Radiotherapy ◽

Event Free Survival ◽

Free Survival

6023 Background: Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a rare and rapidly lethal disease affecting young women with over half dying within 2 years of diagnosis. We previously reported improved outcomes with cytoreductive surgery followed by HDC-aSCR in a prospective study, but these encouraging results needed to be confirmed in an independent and larger cohort. Methods: Between 2008 and 2019, out of 44 patients (pts) diagnosed with centrally confirmed SCCOHT in 16 referent centers of the TMRG network, 38 were treated prospectively according to the French recommendations of the network with complete surgery (primary or after neoadjuvant chemotherapy), 4 to 6 cycles of PAVEP chemotherapy (cisplatin, doxorubicin, vepeside, and cyclophosphamide), and for pts with complete response (CR), HDC-aSCR, followed by pelvic radiotherapy. The 6 patients who could not receive PAVEP (unfit or diagnostic delay) relapsed and died rapidly. The primary endpoint was the event-free survival (EFS) in the intention-to-treat cohort. Results: Median age at diagnosis was 33 years (14-76). 13 pts presented with FIGO stage I, 17 stage III and 6 stage IV, 2 unknown. Median follow-up was 55.5 months. 34 patients achieved CR with CT + surgery and 30 received HDC-aSCR (40%, 47% and 10% with stages I, III and IV diseases respectively) and 21 received also pelvic radiotherapy. Median overall and event-free survival was 36.4 and 15.9 months respectively, and 2-years event-free survival rate was 40% (CI95% 25-56). Median OS was respectively not reached, 18 and 9.6 months for FIGO I, III and IV patients. Among the pts (N = 14) who did not receive HDC-aSCR (rapid progression during or after PAVEP), the 2-yr EFS was 0% compared to 50.5% for the 30 patients receiving HDC. In multivariate analysis, HDC was significantly correlated with better outcomes (p < 0.001). For the 21 patients receiving also pelvic radiotherapy, 57% (12/21) are free of recurrence at 4 years. Grades 3/4 adverse events were frequent (78%) but, in most cases, manageable, although one toxic death (3%) occurred during HDC (fungal septic shock). Conclusions: Treatment of SCCOHT, with intensive multimodal therapy, is associated with a 40% 2-yr event-free survival. However, this protocol is associated with significant toxicity and should be restricted to good performance status patient and expert centers.

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Gastric Small-Cell Carcinoma Found on Esophagogastroduodenoscopy: A Case Report and Literature Review

Case Reports in Oncological Medicine ◽

10.1155/2013/475961 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Natassja Frances ◽

Simon B. Zeichner ◽

Michael Francavilla ◽

Mike Cusnir

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Epigastric Pain ◽

Gastric Wall ◽

Rare Condition ◽

Small Cell ◽

Japanese Male ◽

History Of ◽

Lesser Curvature ◽

Hispanic Male

Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC) most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC) are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC.Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT) of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD) revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation.Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible.

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