Pulmonary Metastases from an Undifferentiated Embryonal Sarcoma of the Liver: A Case Report and Review

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare malignant hepatic tumor that occurs primarily in children. Only a limited number of cases have been reported in the literature due to low incidence of one per million, and reports of metastatic lesion of UESL are even rarer. We hereby describe the case of a 13-year-old male who presented with a palpable mass with imaging findings suggestive of a large complex tumor in the right lobe of the liver. He underwent extended right hepatectomy followed by adjuvant chemotherapy. The tumor was confirmed to be UESL by postoperative pathology and immunohistochemical staining analysis. Four years later, surveillance imaging revealed a small lung nodule in the left lower lobe. Complete removal of the lung tumor by wedge resection was performed, and a histological diagnosis of metastatic UESL was made. The patient also received postoperative adjuvant chemotherapy and is currently in a good general condition and tumor-free in the present eight-month period. This case is presented with emphasis on clinicopathological and immunohistochemical findings of the primary UESL and lung metastases with the aim of collecting more data and expanding our understanding of this rare malignancy.

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Different Patterns of Pneumothorax in Patients With Soft Tissue Tumors Treated With Pazopanib

10.21203/rs.3.rs-115852/v1 ◽

2020 ◽

Author(s):

Hisaki Aiba ◽

Hiroaki Kimura ◽

Satoshi Yamada ◽

Hideki Okamoto ◽

Katsuhiro Hayashi ◽

...

Keyword(s):

Risk Factors ◽

Soft Tissue ◽

Time Course ◽

Lung Tumor ◽

Lung Metastases ◽

Metastatic Lesion ◽

Soft Tissue Tumors ◽

Visceral Pleura ◽

Metastatic Lung Tumor ◽

Central Type

Abstract Background: To investigate the patterns of pneumothorax in pazopanib treatment, focusing on the positional relationship between the visceral pleura and metastatic lung tumor. Methods: We examined 20 patients with advanced soft tissue tumor who developed lung metastases before pazopanib treatment during 2012–2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; central type, > 5 mm from the pleura. We investigated the rates of pneumothorax and the risk factors. Results: Overall, 5 patients experienced pneumothorax (3 subpleural and 2 central type). Cavitation preceded pneumothorax in 80% of the patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in a shorter term in those with the subpleural type. Conversely, a more gradual increase in cavity and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after the initiation of pazopanib and previous intervention before pazopanib including ablation or surgery. The locations of metastatic lesion were not risk factor for the occurrence of pneumothorax.Conclusion: Pneumothorax is an adverse event of pazopanib treatment. Therefore, attention must be paid to the predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions on the lungs. Moreover, as the subpleural pneumothorax tends to occur earlier than the central type, the different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.

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Apatinib treatment is effective for metastatic malignant phyllodes tumors of the breast: a case report

BMC Women s Health ◽

10.1186/s12905-021-01359-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaolu Wang ◽

Li Xie ◽

Wenjing Hu ◽

Jing Yan ◽

Xiaoping Qian ◽

...

Keyword(s):

Partial Response ◽

Lung Metastases ◽

Lung Nodule ◽

Pelvic Mass ◽

Phyllodes Tumor ◽

Leg Pain ◽

Therapeutic Effects ◽

Palpable Mass ◽

Malignant Phyllodes Tumor ◽

Phyllodes Tumors

Abstract Background We report a rare case of malignant phyllodes tumors (MPT) with partial response to apatinib. Case presentation A 26-year-old woman had a palpable mass in her right breast for over a year. After resection, pathology indicated malignant phyllodes tumor. Eleven months after surgery, she underwent reoperation for a lung nodule, which demonstrated lung metastasis. She refused chemotherapy and was rehospitalized six months later due to leg pain. Pelvic mass biopsy revealed metastatic malignant phyllodes tumor. After concurrent chemoradiotherapy of the pelvic mass, multiple lung metastases emerged. Subsequent treatment with apatinib 500 mg/day resulted in a reduction in mass size and partial response. She survived for more than 8 months. Conclusion The present case showed the potential therapeutic effects of apatinib in patients with MPT.

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Late Lung Metastasis in a Patient with a Clear Cell Chondrosarcoma: An Indication for a Life-Long Follow-Up?

Case Reports in Oncological Medicine ◽

10.1155/2021/7205649 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Paulien West ◽

Celine Jacobs ◽

Michael Saerens ◽

David Creytens ◽

Gwen Sys ◽

...

Keyword(s):

Lung Metastasis ◽

Clear Cell ◽

Wedge Resection ◽

Lung Nodule ◽

Complete Removal ◽

Good Health ◽

Ct Guided ◽

Clear Cell Chondrosarcoma ◽

Lung Lobe

Background. Clear cell chondrosarcoma (CCCS) is a rare subtype of chondrosarcoma and comprises between 1.6% and 2.5% of all chondrosarcoma. They are known to be chemo- and radiotherapy resistant; surgical resection is therefore the therapy of choice. Methods. We present a 63-year-old woman with a progressive lung nodule 20 years after initial diagnosis and treatment of a clear cell chondrosarcoma of the right os naviculare. Results. On serial CT scans of the chest, an asymptomatic, slowly growing nodule in the left upper lung lobe was detected. CT-guided transthoracic biopsy of this nodule confirmed the diagnosis of a chondrosarcoma lung metastasis. Video-assisted thoracoscopic wedge resection was performed with complete removal of the nodule. The patient recovered well from surgery and remains in good health during further follow-up. Conclusion. Given the tendency of clear cell chondrosarcoma to recur and metastasize after extended periods of time, a long-term, possibly life-long follow-up and clinical surveillance is advisable in these patients.

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Pathological complete response after afatinib treatment of stage IV oligometastatic adenocarcinoma of the lung: the role of pulmonary surgery

Surgical Case Reports ◽

10.1186/s40792-019-0741-3 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Ping-Chung Tsai ◽

Yi-Chen Yeh ◽

Chien-Sheng Huang ◽

Chao-Hua Chiu

Keyword(s):

Lung Cancer ◽

Lung Tumor ◽

Mediastinal Lymph Node ◽

Bone Lesion ◽

Lung Nodule ◽

Tumor Resection ◽

Lower Lobe ◽

Lumbar Vertebra ◽

Whole Body ◽

Pathology Report

Abstract Background Some oligometastatic lung cancer patients, after induction systemic chemotherapy or tyrosine kinases inhibitor treatment, followed by aggressive radical consolidative treatment, have improved overall survival. Unfortunately, clinical criteria cannot assess such patients. Case presentation We hereby reported the case of a 55-year-old female with lower back pain and bilateral lower leg numbness for months and who had an osteolytic bone lesion over the third lumbar vertebra. In February 2017, a third lumbar vertebra biopsy showed metastatic adenocarcinoma, compatible with lung origin (thyroid transcription factor-1 positive [TTF-1], L858R mutation positive). Complete imaging of the right lower lobe (RLL) showed a spiculated mass of about 3.4 × 2.2 cm, and a trans-bronchoscopic lung biopsy revealed non-small cell carcinoma of lung origin (positive for TTF-1 and negative for p40). Tentative diagnosis was RLL adenocarcinoma, cT2aN0M1b, with bone metastasis at L3. The epidermal growth factor receptor-tyrosine kinase inhibitor afatinib was prescribed beginning April 2017. A November 2018 follow-up CT scan showed regression in the RLL lung mass. A whole-body positron emission tomography-computed tomography showed RLL lung nodule with faint uptake and mildly increased uptake in the L3 vertebra. After providing informed consent, the patient received uniportal video-assisted thoracoscopic RLL lobectomy and radical mediastinal lymph node dissection on December 25, 2018. The final pathology report was fibrotic scar with no residual tumor cells, compatible with post-treatment status, ypT0N0. Curative intent radiotherapy was also applied to the L3 vertebra after the operation. The patient is still alive for more than 32 months after initially diagnosed with metastatic lung adenocarcinoma. Conclusions Our case provides additional data to support that tissue assessment through primary lung tumor resection after systemic treatment of oligometastic lung cancer by minimally invasive surgery can reveal the treatment effect and potentially provide a surrogate endpoint in further clinical trials.

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Retroperitoneal fibrous tumor recurring as lung metastases after 10 years: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01209-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kozue Matsuishi ◽

Kojiro Eto ◽

Atsushi Morito ◽

Hirokazu Hamasaki ◽

Keisuke Morita ◽

...

Keyword(s):

Case Report ◽

Solitary Fibrous Tumor ◽

Distant Metastasis ◽

Curative Resection ◽

Lung Metastases ◽

Lung Resection ◽

Left Lung ◽

Metastatic Lesion ◽

Case Presentation ◽

Fibrous Tumor

Abstract Background Solitary fibrous tumor (SFT) is a relatively rare mesenchymal tumor that mainly affects adults. Its prognosis is good after curative resection, but distant recurrences after 10 years or longer have been reported. Recurrent SFT usually arises as a local lesion; distant metastasis is rarely reported. Here, we report lung metastases that recurred a decade after excising a retroperitoneal primary SFT. Case presentation A 44-year-old woman had an SFT resected from her right retroperitoneum at our hospital. Ten years later, at age 54, she underwent a lung resection after CT showed three suspected metastases in her left lung. All three were histologically diagnosed as lung metastases from the retroperitoneal SFT. However, whereas the primary SFT had 1–2 mitotic cells/10 high power fields (HPF), the metastatic lesion increased malignancy, at 50/10 HPF. Conclusion Patients who have had resected SFTs should be carefully followed up, as malignancy may change in distant metastasis, as in this case.

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Clinicopathological characteristics and impact on efficacy of three versus six months of adjuvant chemotherapy in early-onset colon cancer: ACHIEVE and ACHIEVE-2 trials.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.60 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 60-60

Author(s):

Eiji Oki ◽

Masahito Kotaka ◽

Dai Manaka ◽

Manabu Shiozawa ◽

Yasuhiro Sakamoto ◽

...

Keyword(s):

Colon Cancer ◽

High Risk ◽

Adjuvant Chemotherapy ◽

Early Onset ◽

Lung Metastases ◽

Age Groups ◽

Disease Free Survival ◽

Clinicopathological Characteristics ◽

Related Data ◽

Incidence And Mortality

60 Background: Colorectal cancer (CRC) incidence and mortality have decreased since the 1970s but several data such as the SEER CRC registry show that the incidence of early onset colon cancer (eoCC, age 20-49) and RC keep increasing. There is limited results suggesting eoCC may have different behaviors compared to traditional CC (tCC, age ≥ 50). Methods: Individual patient data of 1,805 high-risk stage II/III colon cancer (CC) patients (pts) as the modified ITT population in ACHIEVE and ACHIEVE-2 trials were investigated. Clinicopathological features and treatment-related data were assessed by age group. Disease-free survival (DFS) was assessed by Kaplan-Meier curves and Cox multivariable models adjusted by trials, regimen, T and N. Results: Of the 1,805 pts, eoCC were 155 pts (8.6%). Using 5% difference between age groups as clinically meaningful cutoff, eoCC had similar gender (female, 52 vs 48%), PS (PS = 1, 1 vs 4%), risk group (high-risk, 43 vs 42%) and T stage (T4, 30 vs 30%) as tCC, while eoCC were less likely right-sided colon primary (32 vs 39%), had N1 disease (48 vs 54%), and treated by FOLFOX (16 vs 23%). Overall, eoCC significantly had a worse DFS than tCC (3y-DFS, 75 vs 82%; Adjusted Hazard Ratio = 1.40: 95% Confidence Interval, 1.00-1.95: p= 0.0478); in addition, similar DFS were observed among tCC pts (age 50-69 vs >70). eoCC experienced less neutropenia, thrombocytopenia and stomatitis, but had more diarrhea, nausea and/or vomiting. There were 38 and 297 pts with an initial relapse in eoCC and tCC, respectively. Of those, peritoneal metastases were more frequently seen in eoCC (n = 13, 34%) than in tCC (n = 63, 21%) (p = 0.097), whereas liver and lung metastases were similar between the two groups. Impact on DFS of 3 versus 6 months of adjuvant chemotherapy in eoCC (3y-DFS, 75% vs 76%) is similar to that in tCC (83% vs 81%). Conclusions: eoCC had unique characteristics; the difference in DFS between eoCC and tCC were potentially due to a different metastatic spread. eoCC had a different adverse event profile compared to tCC. No impact on DFS of treatment duration in eoCC was suggested. Clinical trial information: UMIN000013036.

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Ectopic spleen presenting as a slowly enlarging lung nodule in the right lower lobe following gastric pull up operation

BMJ Case Reports ◽

10.1136/bcr-2020-237912 ◽

2021 ◽

Vol 14 (2) ◽

pp. e237912

Author(s):

Anas Alfahad ◽

Rima Hussain ◽

Mamatha Devaraj ◽

Alexandr Svec

Keyword(s):

Case Report ◽

Oesophageal Cancer ◽

Lung Nodule ◽

Lower Lobe ◽

Ct Guided ◽

Ectopic Spleen ◽

Guided Biopsy ◽

Ct Guided Biopsy ◽

The Right ◽

Gastric Pull Up

This is a case report of an elderly man who was investigated at our respiratory clinic for slowly enlarging right lower lobe lung nodule on the background of oesophageal cancer diagnosed more than 11 years ago with gastric pull up. CT guided biopsy confirms the diagnosis of intrathoracic ectopic spleen.

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Uniportal VATS laser resection of the left lower lobe lung nodule

ASVIDE ◽

10.21037/asvide.2017.114 ◽

2017 ◽

Vol 4 ◽

pp. 114-114

Author(s):

Calvin S. H. Ng ◽

Freddie Capili ◽

Ze-Rui Zhao ◽

Peter S. Y. Yu ◽

Jacky Y. K. Ho ◽

...

Keyword(s):

Lung Nodule ◽

Lower Lobe ◽

Left Lower Lobe ◽

Laser Resection

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Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy

Case Reports in Gastrointestinal Medicine ◽

10.1155/2020/4138215 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Hakon Blomstrand ◽

Karin Adolfsson ◽

Per Sandström ◽

Bergthor Björnsson

Keyword(s):

Adjuvant Chemotherapy ◽

Pancreatic Ductal Adenocarcinoma ◽

Palliative Chemotherapy ◽

Lung Metastases ◽

Performance Status ◽

Progression Free Survival ◽

Disease Recurrence ◽

Ductal Adenocarcinoma ◽

Second Line ◽

First Line

Pancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 63-year-old woman with PDAC in the head of the pancreas who was initially successfully treated by pancreaticoduodenectomy followed by adjuvant chemotherapy with gemcitabine. However, disease recurrence with liver and para-aortic lymph node metastases was detected only two months after the completion of adjuvant chemotherapy. First-line palliative chemotherapy with gemcitabine-nab/paclitaxel was commenced. The results were discouraging, with disease progression (liver and lung metastases) detected at the first evaluation; the progression-free survival was just two months (64 days). Surprisingly, the response to second-line palliative chemotherapy with 5-fluorouracil-oxaliplatin was excellent; in combination with the ablation of a liver metastasis, this treatment regimen resulted in a complete radiological response and an 11-month treatment-free interval with a sustained good performance status.

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