scholarly journals A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Koji Shindo ◽  
Kenoki Ohuchida ◽  
Taiki Moriyama ◽  
Fumio Kinoshita ◽  
Yutaka Koga ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gastric Cancer ◽  
Rare Case ◽  
Metastatic Cancer ◽  
Gastric Tumor ◽  
Pathological Examination ◽  
Poorly Differentiated Adenocarcinoma ◽  
Primary Gastric Cancer ◽  
Poorly Differentiated ◽  
Metastatic Gastric Tumor

Abstract Background Metastatic cancer to the stomach is relatively rare. Prostate-specific antigen (PSA) is a reliable biomarker used in the screening and management of patients with prostate cancer. However, it is difficult to definitively diagnose a PSA-negative metastatic gastric tumor of prostate cancer because the cancer sometimes resembles primary gastric cancer in clinical images. It is also difficult to distinguish metastatic cancer from primary cancer even in the pathological examination of biopsy samples when the lesion is poorly differentiated adenocarcinoma. There is a possibility that the characteristics of the cancer are changed during treatment such as chemotherapy or radiation therapy. Therefore, careful consideration is required for surgical indication. Case presentation A 60-year-old male underwent radical prostatectomy and subsequent radiation therapy for advanced prostate cancer (pT3N1M0) 10 years previously, and hormone therapy was started for metachronous multiple bone metastasis 10 months before. Upper gastrointestinal endoscopy revealed an irregular depressed lesion with a convergence of folds at the greater curvature of the upper gastric body. Biopsy showed poorly differentiated adenocarcinoma that was negative for PSA upon immunohistochemistry. He had high serum carcinoembryonic antigen (CEA) (946.1 ng/ml) and carbohydrate antigen 19-9 (CA19-9) (465.1 U/ml) levels with no elevation of PSA (0.152 ng/ml). The tumor was diagnosed as primary gastric cancer based on the clinical imaging and pathological examination of the biopsy sample including the PSA staining. Based on the diagnosis, laparoscopic proximal gastrectomy with lymphadenectomy was performed. However, pathological examination of the resected specimen revealed poorly differentiated adenocarcinoma that was positive for other prostate markers such as androgen receptor. Thus, the patient was diagnosed with metastasized prostate cancer to the stomach. Conclusions We report a case of metastatic gastric cancer of prostate cancer 10 years after radical prostatectomy. In the present case, it was difficult to diagnose a metastatic gastric tumor of prostate cancer preoperatively, because of its resemblance to primary gastric cancer without PSA expression and no serum PSA elevation. Although a rare case entity, it is important to consider the possibility of a metastatic gastric tumor when the surgical indication is determined in cases with another co-existing cancer.

scholarly journals HISTOPATHOLOGICALANALYSIS OF INCIDENTAL PROSTATE CARCINOMA IN TRANSURETHRAL RESECTION OF PROSTATE SPECIMENS: A FIVE-YEAR RETROSPECTIVE STUDY

2020 ◽  
pp. 79-80
Author(s):  
Alfy Ann George ◽  
Anitha Das P.H ◽  
I. Praseeda ◽  
Baby Mathew
Keyword(s):  
Prostate Cancer ◽  
Retrospective Study ◽  
Prostate Carcinoma ◽  
Transurethral Resection ◽  
Retrospective Review ◽  
Transurethral Resection Of Prostate ◽  
Incidental Prostate Cancer ◽  
Poorly Differentiated Adenocarcinoma ◽  
Detailed Review ◽  
Poorly Differentiated

Aim: To identify the rate of incidental prostate cancer in patients undergone Transurethral resection of prostate(TURP) over a period of 5 years in our center. Methods: A Retrospective review was conducted using Histopathological department database on all TURP specimens over a period of 5 years from January 2015 to December 2019. Results: Out of 570 cases of TURP during our study period, 1.9% had incidental prostate cancer. Most of these positive cases had a Gleasons score of 10, which represent poorly differentiated Adenocarcinoma. Conclusion: The value of pathologic review of TURP specimens is limited but a detailed review helps to reduce under detection of prostate cancer.

scholarly journals A Case of Poorly Differentiated Adenocarcinoma with Signet Ring Cell Carcinoma of the Duodenal Bulb: A Case Report

2017 ◽  
Vol 102 (3-4) ◽  
pp. 141-144 ◽  
Author(s):  
Kosuke Hirano ◽  
Yukinori Yamagata ◽  
Teppei Tatsuoka ◽  
Yawara Kubota ◽  
Kazuyuki Saito ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Rare Case ◽  
Case Reports ◽  
Duodenal Bulb ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Poorly Differentiated Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Ring Cell

Duodenal cancers are rare. Histopathologically, most duodenal cancers are adenocarcinoma. Signet ring cell carcinoma (SRCC) is a rare tumor more commonly found in the stomach than at other sites in the digestive tract. SRCC is extremely uncommon in the duodenum, with most of these tumors occurring in the ampulla. Until now, there are few case reports of duodenal cancers with SRCC. To accumulate case reports, we report a rare case of nonampullary duodenal bulb SRCC. A 74-year-old man was admitted to our hospital with melena. Esophagogastroduodenoscopy (EGD) showed a duodenal bulb ulcer. He was treated with a proton pump inhibitor. However, 1 month later, he was readmitted to our hospital with epigastric pain and nausea. A second EGD examination showed an ulcer at the duodenal bulb. Biopsies taken from the ulcer showed SRCC. Distal gastrectomy and duodenal bulb resection were performed. Histologic examination of the specimen showed a type 4 lesion located from the duodenal bulb to the pyloric antrum. The tumor was composed of poorly differentiated adenocarcinoma (por) with SRCC. The distal margin of the duodenal bulb was invaded with tumor. Therefore, pancreatoduodenectomy was performed. One year after the initial operation, he is alive and had no relapse. We described a rare case of por with SRCC of the duodenal bulb. It is important to bear in mind that an ulcer following an abnormal clinical course should be biopsied, and we have to select a suitable operation in cases of duodenal bulb cancer.

scholarly journals A Case of G-CSF–Producing Histiocytic Sarcoma of the Stomach

2015 ◽  
Vol 100 (3) ◽  
pp. 568-573 ◽  
Author(s):  
Toshiharu Hanaoka ◽  
Kazuhiko Jingu ◽  
Toru Tochigi ◽  
Isamu Hoshino ◽  
Takeshi Uematu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Histiocytic Sarcoma ◽  
Granulocyte Colony Stimulating Factor ◽  
Computed Tomography Scan ◽  
Blood Cell Count ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated ◽  
Stimulating Factor ◽  
Hematoxylin Eosin ◽  
Tomography Scan

No reports have been published to date regarding primary gastric granulocyte colony–stimulating factor (G-CSF)–producing histiocytic sarcoma. We encountered a case of primary gastric histiocytic sarcoma that also fulfilled the criteria for a G-CSF–producing tumor. A 75-year-old man was diagnosed with gastric cancer with poorly differentiated adenocarcinoma. The patient's white blood cell count was elevated to 20,700/μL, and the G-CSF level was elevated to 380 pg/mL. A computed tomography scan showed hepatic infiltration; therefore, a preoperative diagnosis of T4 (liver) N2H0M0 cStage IV gastric cancer was made, and surgery was performed. No. 11d lymphatic metastasis was noted, resulting in invasion of the pancreatic tail, and combined resection of the liver, pancreas, and spleen was conducted with complete gastrectomy. The results of hematoxylin-eosin and immunohistochemical staining were subsequently assessed. On discharge, the G-CSF level had fallen to 22.7 pg/mL. Currently, the patient is still alive and has experienced no recurrence approximately 4 years after the operation.

scholarly journals Primary Malignant Melanoma of the Rectum: Report of Two Cases

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Kodai Tomioka ◽  
Hitoshi Ojima ◽  
Makoto Sohda ◽  
Akiko Tanabe ◽  
Yasuyuki Fukai ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Systemic Treatment ◽  
Early Stage ◽  
Immunohistochemical Analysis ◽  
Pathological Examination ◽  
Anorectal Melanoma ◽  
Stage Iiic ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated ◽  
Tumor Node Metastasis Classification

We report two cases of rectal malignant melanomas. The patients were an 84-year-old male and a 66-year-old female who had blood in their stools. They were preoperatively diagnosed with poorly differentiated adenocarcinoma of the rectum. The clinical diagnosis for each was rectal carcinoma at stage IIIc according to the tumor-node-metastasis classification (6th edition), and the patients underwent abdominoperineal resection with dissection of lymph nodes. Pathological examination of the resected specimens revealed a malignant melanoma. Immunohistochemical analysis results were positive for HMB-45 and negative for cytokeratin AE1/AE3, CD45, and synaptophysin. Primary anorectal melanoma is an uncommon and aggressive disease that carries a poor prognosis. Therefore, it is necessary to provide systemic treatment. To improve prognosis, it is important to detect anorectal melanoma at an early stage.

scholarly journals Achalasia Secondary to Submucosal Invasion by Poorly Differentiated Adenocarcinoma of the Cardia, Siewert II: Consideration on Preoperative Workup

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Antonino Agrusa ◽  
Giorgio Romano ◽  
Giuseppe Frazzetta ◽  
Giovanni De Vita ◽  
Daniela Chianetta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Gastroesophageal Junction ◽  
Rare Condition ◽  
Submucosal Invasion ◽  
Poorly Differentiated Adenocarcinoma ◽  
Endoscopic Findings ◽  
Poorly Differentiated ◽  
Secondary Achalasia

Secondary achalasia due to submucosal invasion of cardia by gastric cancer is a rare condition. We report a case of pseudoachalasia, secondary to the involvement of gastroesophageal junction by poorly differentiated gastric cancer, initially mistaken as idiopathic form. We focus on the difficulty to establish differential diagnosis only on the basis of routine exams and we stress the necessity of “second level” instrumental exams; EUS in routine workup in selected patients should be considered. We support that routine workup based on history, clinical presentation, radiological and endoscopic findings, and certainly manometry could be insufficient for a correct differential diagnosis between primary and secondary forms in some patients.

scholarly journals A Case Report of Carbohydrate Antigen 19-9 Producing Advanced Gastric Cancer

2016 ◽  
Vol 5 (2) ◽  
pp. 49
Author(s):  
Konomi Mizuguchi ◽  
Koichi Sato ◽  
Hiroshi Maekawa ◽  
Mutsumi Sakurada ◽  
Hajime Orita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Carbohydrate Antigen ◽  
Cancer Case ◽  
Gastric Cancer Case ◽  
Poorly Differentiated Adenocarcinoma ◽  
Epigastric Discomfort ◽  
Aortic Lymph Node ◽  
Poorly Differentiated ◽  
High Level

<p class="cco-body"><span lang="EN-GB">The gastric cancer producing carbohydrate antigen 19-9 (CA 19-9) is a rare and unknown that characterize informations.</span></p><p class="cco-body"><span lang="EN-GB">74-year-old woman who was admitted with complaints of epigastric discomfort. An advanced cancer was found in her lower gastric region; biopsy of the tumor revealed poorly-differentiated adenocarcinoma. Her serum CA 19-9 was extremely elevated at 2322 U/ml and computed tomography demonstrated enlargement of the para-aortic lymph node; thus the tumor was considered unresectable. The patient received 8 cycles of chemotherapy with S-1/cisplatin, which shrank the para-aortic lymph node dramatically, hence she underwent D2 gastrectomy. Immunohistochemical staining of the resected cancer revealed that a third of the cancer cells were positive for CA 19-9. In addition, her serum CA 19-9 decreased rapidly after surgery and she remains alive without recurrence three years after surgery.</span></p><p class="cco-body"><span lang="EN-GB">We report one high level of CA 19-9 gastric cancer case with dramatically chemosensitive.</span></p>

Gene expression profile of genes-related canceration, invasion, or conversion for metastasis in patients with poorly differentiated adenocarcinoma treated by gastric ESD.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 78-78
Author(s):  
Natsuko Kawanishi ◽  
Mizutomo Azuma ◽  
Atsuko Takeuchi ◽  
Sakiko Yamane ◽  
Akinori Watanabe ◽  
...  
Keyword(s):  
Gene Expression ◽  
Gastric Cancer ◽  
Submucosal Layer ◽  
Gene Expressions ◽  
Poorly Differentiated Adenocarcinoma ◽  
Normal Tissues ◽  
Node Metastasis ◽  
Tumor Tissues ◽  
Mucosal Layer ◽  
Poorly Differentiated

78 Background: We encounter some cases of early gastric cancer treated by endoscopic submucosal dissection (ESD) that are out of the indication criteria after pathologic diagnosis. These cases require additional treatments because of a risk of lymph node metastasis in Japanese Classification. So further prediction factors associated with lymph node metastasis is expected. We are focusing on poorly differentiated adenocarcinomas in early gastric cancer that we treated by ESD and used these tissues to characterize their gene expression profiles related to canceration, invasion or conversion for metastasis. Methods: We examined two cases of intramucosal carcinoma and three of submucosal infiltrating carcinoma histologically diagnosed as poorly differentiated adenocarcinoma after ESD. Those samples are separated five adjacent normal tissues (N), five tumor tissues in mucosal layer (M) and three tumor tissues in submucosal layer (SM) in total 13 lesions. Formalin-fixed, paraffin-embedded tissues were dissected by the laser-captured microdissection technique and were analyzed for targeted 158 gene expressions using a quantitative real-time polymerase chain reaction (PCR) using commercial PCR plate (profile PCR array of genes related to cancer stem cells and epithelial mesenchymal transition). Results: Among genes that elevated in the cancer tissues (M or SM) against the normal tissues, five gene expressions (DKK1, TIMP1, THY1, FN1, COL1A2) were tended to much higher in the submucosal layer compared to the mucosal layer (N < M < SM). When we compared tumor gene expressions in depth of M, three gene expressions (FZD7, ZEB 2, CD 44) are higher in the tumors with submucosal invasion compared to within mucosal layer. Conclusions: Poorly differentiated adenocarcinoma of stomach had high expression level in cancer-related genes even if it was intramucosal tumor. Some of these genes tended to increase as its depth of invasion and the presence of invasion of the SM. It suggested that the biopsy specimen could be a prediction factor of invasion from the surface of gastric cancer, but additional specimens and analysis are necessary to prove these findings.

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