scholarly journals Tumour-to-tumour metastasis: breast carcinoma to an olfactory neuroblastoma

2020 ◽  
Vol 102 (6) ◽  
pp. e118-e121 ◽  
Author(s):  
A Bashyam ◽  
V Grammatopoulou ◽  
T Crook ◽  
S Di Palma ◽  
VS Sunkaraneni
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Head And Neck ◽  
Skull Base ◽  
Primary Tumour ◽  
Distant Metastases ◽  
Olfactory Neuroblastoma ◽  
Endoscopic Polypectomy ◽  
Tumour Metastasis ◽  
Nasal Symptoms

Tumour-to-tumour metastasis is a rare phenomenon. It occurs when a primary tumour is a recipient of a separate tumour within the same individual. We present a case of a 66-year-old woman with known breast cancer who presented with one-sided nasal symptoms. Examination and imaging revealed a unilateral polyp arising from the skull base. She underwent endoscopic polypectomy with the histology demonstrating tumour-to-tumour metastasis from a breast carcinoma to an olfactory neuroblastoma, a rare sinonasal tumour. Clinicians should be cautious of distant metastases in any patient presenting with head and neck symptoms and a known primary tumour. This is the first documented case of this type.

scholarly journals Survey of UK practice for management of breast cancer metastases to the neck

2012 ◽  
Vol 94 (7) ◽  
pp. 484-489 ◽  
Author(s):  
B Bisase ◽  
C Kerawala
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Current Practice ◽  
Stage Iv ◽  
Evidence Base ◽  
Cervical Metastases ◽  
Stage Iv Disease ◽  
The Uk

INTRODUCTION Cervical metastases from breast carcinoma are rare and their management is controversial. Between 1987 and 2002 the American Joint Committee on Cancer (AJCC) staged patients with supraclavicular fossa nodal disease as M1 but the subsequent demonstration that patients with regional stage IV disease had better outcomes than visceral stage IV disease led to a reclassification of the former to stage IIIC in 2003. The literature remains inconsistent regarding the fate of these patients. Despite the attendant morbidity of treatment and lack of knowledge regarding long-term survival, we hypothesised that current practice varies in the UK and a unified approach does not exist. The aim of this study was therefore to determine current practice and opinion of both head and neck specialists and breast cancer clinicians in the UK. METHODS Questionnaires were disseminated to 185 head and neck surgeons, breast surgeons and their oncology counterparts. These outlined a clinical scenario of a patient with a history of T3 primary breast cancer presenting with cervical and supraclavicular nodal metastases, with opinion being sought regarding the significance of this status and the individual’s practical approach to the problem. The extent of any proposed neck dissection was also explored. RESULTS Of the 117 respondents, a noticeable variation in opinion was evident. Contrary to the current AJCC staging, 61% of clinicians felt that both level V and III metastases represented stage IV disease. There was a tendency towards aggressive surgical treatment with a third recommending comprehensive neck dissection despite a lack of evidence base. A disparity was noted between adjuvant treatments offered and the final pN stage. CONCLUSIONS This study suggests that at present there is widespread inconsistency in the management of breast carcinoma cervical metastases in the UK. There is a need to unify practice with an evidence base in order to improve informed multidisciplinary decision making and, ultimately, patient care. This study goes some way to supporting multicentre collaboration in order to achieve that aim.

Concordance of histology type between synchronous and metachronous contralateral breast carcinoma: Is there susceptibility for breast cancer of particular histology?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21030-e21030
Author(s):  
Zorica Tomasevic ◽  
Dusica Gavrilovic ◽  
Zoran Tomasevic ◽  
Daniela Kolarevic
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Statistical Difference ◽  
Lobular Carcinoma ◽  
Progesterone Receptors ◽  
Distant Metastases ◽  
Tumor Grade ◽  
Contralateral Breast ◽  
Molecular Characteristics ◽  
Significant Difference

e21030 Background: Contra-lateral breast cancer (CBC) is considered to be the most frequent new malignancy after primary breast cancer (PBC) However, there are few reports whether the histology and other major molecular characteristics differs between PBC and CBC. The aim of this paper is toevaluate and compare PBC/CBC histology according to the time to CBC development. Also, age at CBC and major molecular characteristics (tumor grade, estrogen/progesterone receptors, HER2) have been analyzed. Methods: A cohort of 113 patients with CBC, without distant metastases, has been prospectively registered during 28 months. Patients are divided in 2 groups according to the time of CBC diagnose: 1. Synchronous, if the CBC (S-CBC) was diagnosed either simultaneously or within 6 months after PBC; 2. Metachronous (M-CBC) if CBC was diagnosed > 6 months after PBC. Results: Results are presented in Table 1. Median age was calculated at the time of CBC diagnose. Patient with S-CBC are median 7 years older than patients with M- CBC that is statistically significant difference (p-0.007) S-CBC is more likely to be of the same histological type (76%) than M-CBC (56%) (p 0.006) In the whole analyzed group, and each subgroup separately, lobular carcinoma is registered in higher percentage (41%) than expected (~20%) For all other analyzed BC characteristics, statistical difference was not confirmed, however ~ 25% of specimens were not available for testing. Conclusions: Although it is still unclear what could be the clinical significance of these findings, genetic susceptibility to particular histology type of BC might be reasonably speculated. [Table: see text]

scholarly journals Phylogenetic analysis of metastatic progression in breast cancer using somatic mutations and copy number aberrations

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
David Brown ◽  
Dominiek Smeets ◽  
Borbála Székely ◽  
Denis Larsimont ◽  
A. Marcell Szász ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Copy Number ◽  
Somatic Mutations ◽  
Primary Tumour ◽  
Distant Metastases ◽  
Molecular Techniques ◽  
Metastatic Progression ◽  
Number Of Patients ◽  
Cancer Dissemination

Abstract Several studies using genome-wide molecular techniques have reported various degrees of genetic heterogeneity between primary tumours and their distant metastases. However, it has been difficult to discern patterns of dissemination owing to the limited number of patients and available metastases. Here, we use phylogenetic techniques on data generated using whole-exome sequencing and copy number profiling of primary and multiple-matched metastatic tumours from ten autopsied patients to infer the evolutionary history of breast cancer progression. We observed two modes of disease progression. In some patients, all distant metastases cluster on a branch separate from their primary lesion. Clonal frequency analyses of somatic mutations show that the metastases have a monoclonal origin and descend from a common ‘metastatic precursor’. Alternatively, multiple metastatic lesions are seeded from different clones present within the primary tumour. We further show that a metastasis can be horizontally cross-seeded. These findings provide insights into breast cancer dissemination.

Distant metastases in terminal head and neck cancer patients

1997 ◽  
Vol 111 (5) ◽  
pp. 454-458 ◽  
Author(s):  
Yoav P. Talmi ◽  
Daniel Cotlear ◽  
Alexander Waller ◽  
Zeev Horowitz ◽  
Abraham Adunski ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Primary Tumour ◽  
Cell Cancer ◽  
Distant Metastases ◽  
Clinical Series

AbstractWith improved control of cancer above the clavicles, distant metastases (DM) are frequently more seen and are becoming a more common cause of morbidity and mortality. The present study defined the incidence of distant metastases in a cohort of terminal head and neck cancer patients (HNCP) and compared it to current reported data. The incidence of distant metastases in relation to the primary tumour was evaluated and their impact on survival was assessed. A retrospective survey of patient charts was made, based on the hospice database and original referring hospital charts. Data of 59 patients admitted to the hospice were evaluated. The incidence and location of locoregional and distant disease were studied and effects on survival analyzed.The overall survival from diagnosis to demise was 42.7 months. Thyroid cancer was seen in 20.3 per cent of cases and squamous cell cancer was seen in 59.3 per cent. Distant metastases were found in 83 per cent and 48.6 per cent of patients respectively. Laryngeal cancer patients had a 54.5 per cent incidence of distant metastases. Locoregional disease was seen in 47 per cent of cases and 35.7 per cent of them had distant metastases while a 64.3 per cent incidence of distant metastases was found in cases without locoregional disease. Mean survival was 47.3 months with distant metastases vs 36.5 months without metastases. The difference was not statistically significant.The incidence of distant metastases in squamous cell cancer in terminalHNCP was 48.6 per cent. This is the highest reported incidence of metastases in a clinical series. Patients without locoregional disease had almost a two-fold incidence of metastases. Survival was not affected by metastases in this series.

scholarly journals Breast Cancer Metastases to the Head and Neck: Case Series and Literature Review

2017 ◽  
Vol 96 (3) ◽  
pp. E21-E24 ◽  
Author(s):  
Jeremiah C. Tracy ◽  
Nicholas R. Mildenhall ◽  
Richard O. Wein ◽  
Miriam A. O'Leary
Keyword(s):  
Breast Cancer ◽  
Head And Neck ◽  
Case Series ◽  
Metastatic Breast ◽  
Distant Metastases ◽  
Jugular Foramen ◽  
Breast Cancer Metastases ◽  
Cancer Metastases ◽  
Bony Metastases ◽  
Patient Prognosis

Breast cancer is the most common cancer in women and is the second most common cause of cancer-related death. Despite the relatively high prevalence of this disease, breast cancer manifestations in the head and neck are relatively rare. Supraclavicular lymphadenopathy and bony metastases to the mandible and maxilla are the most common manifestation of breast cancer in the head and neck. Head and neck metastases are the first presentation of distant disease in approximately one-third of cases. The prognosis of breast cancer with distant metastases to the head and neck is generally poor, and the management of these lesions is controversial. Overall extent of disease and individual patient prognosis must guide treatment decisions. Atypical cases including maxillary sinus mass, jugular foramen mass, and dermal metastases are presented. Metastatic breast cancer is a rare diagnosis in the head and neck, yet metastatic disease from an infraclavicular primary deserves inclusion on any comprehensive differential diagnosis list. In women, breast carcinoma is the most common infraclavicular primary to metastasize to the head and neck.

scholarly journals Pituitary Tumor-Transforming Gene 1 Is Expressed in Primary Ductal Breast Carcinoma, Lymph Node Infiltration, and Distant Metastases

2013 ◽  
Vol 35 ◽  
pp. 267-272 ◽  
Author(s):  
Fabio Grizzi ◽  
Sonia Di Biccari ◽  
Barbara Fiamengo ◽  
Sanja Štifter ◽  
Piergiuseppe Colombo
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Breast Carcinoma ◽  
Cancer Cells ◽  
Pituitary Tumor ◽  
Breast Cancer Cells ◽  
Distant Metastases ◽  
Pituitary Tumor Transforming Gene ◽  
Ductal Breast Carcinoma ◽  
Transforming Gene

Despite the advances that have been made in the fields of molecular and cell biology, there is still considerable debate explaining how the breast cancer cells progress through carcinogenesis and acquire their metastatic ability. The lack of preventive methods and effective therapies underlines the pressing need to identify new biomarkers that can aid early diagnosis and may be targets for effective therapeutic strategies. In this study we explore the pituitary tumor-transforming gene 1 (PTTG1) expression in primary ductal breast carcinoma, lymph node infiltration, and distant metastases. Three human cell lines, 184B5 derived from normal mammary epithelium, HCC70 from a primary ductal carcinoma, and MDA-MB-361 from a breast metastasis, were used for quantifying PTTG1 mRNA expression. The PTTG1 immunohistochemical expression was carried out on specimens taken from eight patients with invasive ductal breast cancer who underwent surgical treatment and followup for five years retrospectively selected. The study demonstrated that PTTG1 is expressed gradually in primary ductal breast carcinoma, lymph node infiltration, and distant metastases. Our findings suggest that the immunohistochemical evaluation of PTTG1 expression might be a powerful biomarker of recognition and quantification of the breast cancer cells in routine pathological specimens and a potential target for developing an effective immunotherapeutic strategy for primary and metastatic breast cancer.

scholarly journals CXCR4-CXCL12 axis and distant metastatic outgrowth in head and neck malignancy

2020 ◽  
Author(s):  
Yin Li ◽  
Leila Bahadori ◽  
Kristin Fritsche ◽  
Percy Knolle ◽  
Achim Krüger ◽  
...  
Keyword(s):  
Head And Neck ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Primary Tumour ◽  
Distant Metastases ◽  
Treatment Protocols ◽  
Neck Malignancy ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Primary Tumour Site

Abstract Background: To analyze whether distant metastatic outgrowth in different head and neck malignancies (HNM) underlies the CXCR4-CXCL12 axis as overriding molecular mechanism. Methods: Clinic-pathological data of 1,250 HNM was included. HNM were collected due to different capability to exhibit distant metastasis comprising basal cell, squamous cell, and adenoid-cystic carcinoma as well as melanoma. MMP2/9, TIMP1/2, CXCR4, and CXCL12 immunohistochemistry was done in 190 randomly selected specimens.Results: Immunohistochemistry visualized a significant increase in MMP2/9, TIMP1/2, CXCR4, and CXCL12 protein expression following the clinical occurrence of distant metastasis. CXCR4, CXCL12, and TIMP2-expression significantly increases with number of affected organs by distant metastasis. Cox regression demonstrated CXCR4-overexpression and advanced T-status being independent risk factors of distant metastasis associated death.Conclusion: The CXCR4-CXCL12 axis is associated with the occurrence of distant metastases in different HNM. The increased risk of distant metastasis associated death was identified at primary tumour site and, therefore, potentially influences further treatment protocols.

scholarly journals Expression of Biomarkers Estrogen Receptor, Progesterone Receptor, HER2 in Primary Breast Tumour and Synchronous Metastatic Axillary Lymph Node

2021 ◽  
Author(s):  
Priyanka Mondal ◽  
Satyadev Rana ◽  
Mautoshi Saha ◽  
Sayan Kundu ◽  
Jayati Chakraborty
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Breast Carcinoma ◽  
Axillary Lymph Node ◽  
Metastatic Lymph Node ◽  
Primary Tumour ◽  
Her2 Status ◽  
Axillary Lymph ◽  
Her2 Positive ◽  
Metastatic Lymph

Introduction: Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor Receptor 2 (HER2) status are routinely used to guide treatment decision for breast cancer. Treatment protocol in breast cancer is currently based on biomarker characteristic of primary tumour. But this biomarker status may change as the tumour progresses from primary to synchronous metastatic lymph node. Hence, it is important to know the biomarker status of these synchronous metastatic lymph nodes as it may serve as an important tool to guide management, evaluate prognosis and to anticipate the possibility of recurrent risk of primary invasive breast cancer. Aim: To study the expression of ER, PR, HER2 status in primary breast carcinoma and synchronous metastatic lymph node and to evaluate concordance and discordance between them. Materials and Methods: This study was observational, retrospective and prospective study conducted over a period of one and half years from February 2015 to October 2016 at ESI-PGIMSR, Maniktala, Kolkata, India, where 50 cases of breast carcinoma with positive axillary lymph node metastasis were studied. Haematoxylin and Eosin (H&E) sections were reviewed and representative paraffin blocks were selected. Immunostains were performed and scoring was done following standard protocols. Standard statistical methods were applied for analysis of data using chi-square test and kappa statistics and data was analysed using Statistical Package for the Social Sciences (SPSS) version 6.1.3 software. Results: Out of 50 cases the mean age of the patients was 50.56±10.5 years. Amongst ER and PR status, 24 out of 50 (48%) and 18 out of 50 (36%) were ER and PR positive respectively. HER2 positive cases were 48% i.e., 24 out of 50 cases. The overall discordance rates of ER, PR and HER2 was found to be 10%, 8%, 18%, respectively. The discordance rates of ER positive and ER negative cases were 4.2% and 15.4%, respectively. The discordance rates of PR positive and PR negative cases were 5.6% and 9.4% respectively, whereas 29.2% of HER2 positive cases were discordant in lymph node metastases. Conclusion: There was discordance between ER, PR, HER2 status of primary tumour and metastatic lymph node. Hence, assessment of these biomarker status in axillary lymph node metastases may be considered along with primary tumour in breast carcinoma work-up.

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