scholarly journals Radiographically Occult Carcinomatous Spread of Breast Cancer to the Liver: A Challenging Case

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Trish Millard ◽  
Akriti Gupta ◽  
Christiana Brenin ◽  
Paul Marshall ◽  
Patrick Dillon

Metastatic carcinomatosis to the liver is a pattern of malignant infiltration that tends to provoke hepatic fibrosis. It is a rare complication of multiple solid tumor types and often seen in the absence of discrete tumor mass in the liver. We report a case of a 69-year-old woman with metastatic ductal carcinoma of the breast who presented with rising serum tumor markers and mildly cirrhotic contour of the liver on a CT scan. An early diagnosis of occult spread to the liver was made by means of a percutaneous liver biopsy showing desmoplastic response to invasive breast cancer cells found diffusely in the liver. This case highlights a rare pattern of metastatic spread of breast cancer as well as predisposing and prognostic features.

2022 ◽  
pp. 7-7
Author(s):  
Miroslav Mitrovic ◽  
Milan Jovanovic ◽  
Mihailo Bezmarevic ◽  
Bosko Milev ◽  
Darko Mirkovic

Introduction. Arteriovenous fistula is one of the complications that can occur during percutaneous liver biopsy. Hepatic arterio-venous fistula with chronic bleeding from the puncture site on the skin is extremly rare complication following percutaneous liver biopsy. Case report. The case represents a 35-year-old woman with secondary anemia caused by chronic bleeding at the site of a granuloma caused by a previous liver biopsy done 7 years ago. The patient was examined and treated for several years due to anemic syndrome. The pathological communication between the right hepatic vein, the anterior sectional branch of the portal vein and the posterior arterial sectional branch was detected on a CT scan, and proven by fistulography. Due to the failed embolization, a laparotomy was performed, where a tumor mass was found in the VI and VII segment of the liver, which communicates with the skin. Tumor mass was removed by atypical resection of VI and VII liver segments. Due to hemorrhage, re-exploration was performed, where bleeding was found from the surface of the resected liver parenchyma. Two weeks after the last operation, the patient was released for home treatment. Conclusion. Although percutaneous liver biopsy is a safe procedure, the complication in the form of bleeding occurs in less than 25% of cases and with spontaneous cessation. In our presentation, there was a complicated intrahepatic arteriovenous-portal fistula with the formation of communication with the puncture site on the skin. This is the first case of complications of this type after percutaneous liver biopsy.


Author(s):  
Musa Azhar ◽  
Syed Abdul Mannan Hamdani ◽  
Jhanzeb Iftikhar ◽  
Waqas Ahmad ◽  
Sajid Mushtaq ◽  
...  

Breast cancer is the commonest cancer among females and has a high propensity to metastasize, but gynaecological organs are rarely affected. We report a case where invasive ductal carcinoma of the breast metastasized to the uterus after initial management with curative intent. Our patient was on tamoxifen, which can cause endometrial hyperplasia and lead to a challenge in eventual diagnosis.


2014 ◽  
Vol 29 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Motoyoshi Endo ◽  
Yutaka Yamamoto ◽  
Masahiro Nakano ◽  
Tetsuro Masuda ◽  
Haruki Odagiri ◽  
...  

Introduction Breast cancer is a leading cause of cancer-related death in women worldwide, and its metastasis is a major cause of disease mortality. Therefore, identification of the mechanisms underlying breast cancer metastasis is crucial for the development of therapeutic and diagnostic strategies. Our recent study of immunodeficient female mice transplanted with MDA-MB231 breast cancer cells demonstrated that tumor cell-derived angiopoietin-like protein 2 (ANGPTL2) accelerates metastasis through both increasing tumor cell migration in an autocrine/paracrine manner, and enhancing tumor angiogenesis. To determine whether ANGPTL2 contributes to its clinical pathogenesis, we asked whether serum ANGPTL2 levels reflect the clinical features of breast cancer progression. Methods We monitored the levels of secreted ANGPTL2 in supernatants of cultured proliferating MDA-MB231 cells. We also determined whether the circulating ANGPTL2 levels were positively correlated with cancer progression in an in vivo breast cancer xenograft model using MDA-MB231 cells. Finally, we investigated whether serum ANGPTL2 levels were associated with clinical features in breast cancer patients. Results Both in vitro and in vivo experiments showed that the levels of ANGPTL2 secreted from breast cancer cells increased with cell proliferation and cancer progression. Serum ANGPTL2 levels in patients with metastatic breast cancer were significantly higher than those in healthy subjects or in patients with ductal carcinoma in situ or non-metastatic invasive ductal carcinoma. Serum ANGPTL2 levels in patients negative for estrogen receptors and progesterone receptors, particularly triple-negative cases, reflected histological grades. Conclusions These findings suggest that serum ANGPTL2 levels in breast cancer patients could represent a potential marker of breast cancer metastasis.


2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ramy Mansour ◽  
Justin Miller

Percutaneous Liver Biopsy is an often-required procedure for the evaluation of multiple liver diseases. The complications are rare but well reported. Here we present a case of a 60-year-old overweight female who underwent liver biopsy for elevated alkaline phosphatase. She developed acute pancreatitis secondary to hemobilia, with atypical signs and symptoms, following the biopsy. She never had the classic triad of RUQ pain, jaundice, and upper GI hemorrhage. There were also multiple negative imaging studies, thus complicating the presentation. She was successfully treated with ERCP, sphincterotomy, balloon sweep, and stent placement. Angiography and transcatheter embolization were not required.


Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1325 ◽  
Author(s):  
Patrice M. Witschen ◽  
Thomas S. Chaffee ◽  
Nicholas J. Brady ◽  
Danielle N. Huggins ◽  
Todd P. Knutson ◽  
...  

Cancer has been conceptualized as a chronic wound with a predominance of tumor promoting inflammation. Given the accumulating evidence that the microenvironment supports tumor growth, we investigated hyaluronan (HA)-CD44 interactions within breast cancer cells, to determine whether this axis directly impacts the formation of an inflammatory microenvironment. Our results demonstrate that breast cancer cells synthesize and fragment HA and express CD44 on the cell surface. Using RNA sequencing approaches, we found that loss of CD44 in breast cancer cells altered the expression of cytokine-related genes. Specifically, we found that production of the chemokine CCL2 by breast cancer cells was significantly decreased after depletion of either CD44 or HA. In vivo, we found that CD44 deletion in breast cancer cells resulted in a delay in tumor formation and localized progression. This finding was accompanied by a decrease in infiltrating CD206+ macrophages, which are typically associated with tumor promoting functions. Importantly, our laboratory results were supported by human breast cancer patient data, where increased HAS2 expression was significantly associated with a tumor promoting inflammatory gene signature. Because high levels of HA deposition within many tumor types yields a poorer prognosis, our results emphasize that HA-CD44 interactions potentially have broad implications across multiple cancers.


2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096930
Author(s):  
Jie Zheng ◽  
Jingjing Yu ◽  
Tao Zhou

Ductal carcinoma in situ (DCIS) with microinvasion (DCIS-MI) is defined as the extension of cancer cells beyond the basement membrane into adjacent tissue with no focus larger than 1 mm or a maximum diameter of less than 1 mm for multiple invasive foci. DCIS-MI constitutes approximately 1% of all breast cancer cases and 5% to 10% of cases of DCIS. The current literature is controversial concerning the clinical prognostic features and management of DCIS-MI. This narrative review described recently reported literature regarding the characteristics, diagnosis, treatment, and prognosis of DCIS-MI.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Salih Samo ◽  
Muhammed Sherid ◽  
Husein Husein ◽  
Samian Sulaiman ◽  
Jeffrey V. Brower ◽  
...  

True metastatic involvement of the colon is rare. Colonic metastases occur most commonly secondary to peritoneal metastases from intra-abdominal malignancies. Breast cancer is the most common malignancy that metastasizes hematogenously to the colon. Colonic metastatic disease mimics primary colonic tumors in its presentation. Colonic metastatic involvement is a poor prognostic sign, and the pathologist should be informed about the history of the primary breast cancer when examining the pathologic specimens. In this paper, we report a case of an ileocecal mass found to be histologically consistent with metastatic ductal breast cancer, and then we review the literature about breast cancer metastases to the gastrointestinal tract in general and colon in particular.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 853-853 ◽  
Author(s):  
Lindsey A Miles ◽  
Nagyung Baik ◽  
Stan Krajewski ◽  
Robert J Parmer ◽  
Barbara M Mueller

Abstract Abstract 853 The ability of tumor cells to bind plasminogen is highly correlated with their invasive and metastatic potential. Here we evaluate cell surface plasminogen binding in human breast cancer. In a xenograft model for aggressive, triple-negative human breast cancer, tumor cells harvested from orthotopic mammary fat pad (mfp) tumors of the invasive human breast cancer line, MDA-MB-231, exhibit dramatic increases in tumor growth and lung and lymph node metastases, compared to parental cells. The breast cancer cells isolated from the mfp have been designated as 231mfp cells. Although the levels of most secreted proteins are similar, the plasminogen activators, urokinase-type plasminogen activator (uPA) and tissue type plasminogen activator (tPA) are highly upregulated in 231mfp cells, compared with MDA-MB-231 parental cells, suggesting a role for the plasminogen activation system in the differences in growth and metastasis between these two cell lines (Jessani et al., Proc Natl Acad Sci USA 101:13756, 2004). Further evaluation of the plasminogen activation system in this model revealed that plasminogen bound to both 231mfp and MDA-MB-231 cells and plasminogen binding was specifically inhibited by the lysine analog, ε-aminocaproic acid (EACA). 231mfp cells exhibited a 3-fold greater capacity for plasminogen compared to MDA-MB-231 cells: Quantitative FACS analysis yielded a Bmax of 3.8 ± 0.5 × 105 plasminogen binding sites with a Kd of 1.2 μM for the 231 mfp cells and a Bmax of 1.2 ± 0.3 × 105 binding sites with a Kd of 1.5 μM for the parental cells. We recently discovered a novel cell surface receptor for plasminogen, Plg-RKT (Andronicos et al., Blood 115:1319, 2010). Plg-RKT enhances enzymatic activation of plasminogen to plasmin and localizes and spatially orients plasmin on the cell surface. We compared cell-surface expression of Plg-RKT on 231mfp and MDA-MB-231 cells using a specific monoclonal antibody raised against the C-terminus of human Plg-RKT, termed mAb7H1. In FACS analysis with mAB7H1, expression of Plg-RKT was markedly (5-fold) higher on 231mfp cells, compared to the parental cells. These data were confirmed in Western blotting. To further determine expression of Plg-RKT in breast cancer, human tissues were stained with anti-Plg-RKT antibodies. We found very high expression of Plg-RKT in human invasive ductal carcinoma and ductal carcinoma in situ and minimal expression in normal breast ducts and lobules in control subjects. We considered whether Plg-RKT expressed on breast cancer cells can a therapeutic target and we tested the ability of anti-Plg-RKT mAb7H1 to inhibit lung metastasis of 231mfp cells in immune deficient mice. Mice were injected into the tail vein with cells either mixed with mAb7H1 or with buffer control. The antibody-treated group received a second dose of mAb7H1 24 hr later. Four weeks after tumor cell injection, mice were sacrificed and tumor foci on the lungs were compared between the two groups. Anti-Plg-RKT mAb7H1 markedly reduced the number of 231mfp lung metastases per mouse: mean number of lung foci in the mAb7H1 treated group was 109 (± 47.8) and in the vehicle-treated control group 270.4 (± 61.7), probability of no difference between the groups by t-test P<0.05. The size distribution of the individual foci was not different between the groups. These data demonstrate that anti-Plg-RKT mAb7H1 has activity in the mouse model of metastatic breast cancer and suggest that it interferes with an early step in the establishment of lung metastases. In summary, the highly metastatic 231mfp breast cancer cells have increased plasminogen binding capacity and increased expression of the plasminogen receptor, Plg-RKT, compared to parental MDA-MB-231 cells. Plg-RKT was highly expressed in human breast cancer tissue but not in normal mammary glands. Furthermore, anti-Plg-RKT mAb inhibited establishment of lung metastases in a model of human breast cancer. Therefore, the presence of Plg-RKT on breast cancer cells may represent a new control point in the establishment of breast cancer metastases. Disclosures: No relevant conflicts of interest to declare.


Author(s):  
Ida Pucci-Minafra ◽  
Gianluca Di Cara ◽  
Rosa Musso ◽  
Patrizia Cancemi ◽  
Nadia Ninfa Albanese ◽  
...  

The present investigation has been conducted on one hundred tissue fragments of breast cancer, collected and immediately cryopreserved following the surgical resection. The fragments were selected from patients with invasive ductal carcinoma of the breast, the most common and potentially aggressive type of mammary cancer, with the objective to increase the knowledge of breast cancer molecular markers, useful for diagnostic and prognostic categorization of patients, in assessing post-surgical therapeutic regimes. The proteomic screening, by 2D-IPG and mass spectrometry, allowed us to identify two main classes of protein clusters: proteins expressed ubiquitously at high levels in all patients, and proteins expressed sporadically among the same patients. Within the group of ubiquitous proteins, glycolytic enzymes and proteins with anti-apoptotic activity were predominant. Among the sporadic ones, proteins involved in cell motility, molecular chaperones and proteins involved in the detoxification appeared prevalent. The data of the present study indicates that the primary tumor growth is generally supported by two concurrent pathways: the inhibition of apoptosis and the stimulation of cellular proliferation. The second phase of the evolution of the tumor can be prematurely scheduled by the occasional presence of proteins involved in cell motility and in the defenses of the oxidative stress. To our knowledge this report on large-scales proteomics of breast cancer is currently a unique approach in the literature that offers the opportunity to evaluate the presence and recurrence of proteins to be used as prognostic indicators and susceptibility to metastasis in patients operated on for invasive ductal carcinoma of the breast.


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