Change from triple negative type to triple positive type: A case report of discordance of re-biopsy from primary breast cancer

Mapping Intimacies ◽

10.36879/jcmi.20.000126 ◽

2020 ◽

pp. 1-5

Keyword(s):

Primary Tumor ◽

Triple Negative ◽

Lobular Carcinoma ◽

Rare Event ◽

Metastatic Tumor ◽

Complete Response ◽

Current Treatment ◽

Positive Type ◽

Impact On Treatment ◽

The Right

The patient was a 60-year-old woman who had visited a clinic with the chief complaint of a mass in the right breast prior to being referred to our hospital. Breast examination revealed the presence of a 3-cm hard elastic mass in the C region of the right breast. Computed tomography (CT) further indicated metastases to the liver and lungs. Upon needle biopsy of the primary tumor, the patient was diagnosed with triple-negative (ER (-), PgR (-), HER2 (-)) invasive lobular carcinoma. Chemotherapy was successful in achieving a transient partial response (PR); however, the tumor later advanced to a progressive disease (PD) after five cycles of oral fluoropyrimidine derivative therapy (S-1). Re-biopsy of the primary tumor revealed that the tumor was triple-positive (ER (+), PgR (+), HER2 (+)). The patient was subsequently treated with anti-HER2 therapy and has since achieved complete response (CR). Although biological changes sometimes occur from the primary to the metastatic tumor, changes in the primary tumor itself during the course of treatment is a rare event. Furthermore, the transition from triple-negative to triple-positive status is very uncommon. Re-biopsy rarely changes the biological characteristics of a tumor; however, biological changes can have a significant impact on treatment if they do occur. Thus, it is important to perform a re-biopsy if the current treatment results in PD.

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Intracranial and Orbital Metastasis of Hepatocellular Carcinoma: Report of Two Cases

Neurosurgery ◽

10.1227/00006123-199005000-00021 ◽

1990 ◽

Vol 26 (5) ◽

pp. 863-866 ◽

Cited By ~ 22

Author(s):

Shinichiro Wakisaka ◽

Manabu Tashiro ◽

Shinichi Nakano ◽

Toshihiro Kita ◽

Hiroto Kisanuki ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Primary Tumor ◽

Relevant Literature ◽

Occipital Lobe ◽

Metastatic Tumor ◽

Orbital Tumors ◽

Primary Hepatoma ◽

Orbital Metastasis ◽

Left Orbit ◽

The Right

Abstract Two cases of rare intracranial and orbital metastasis of hepatocellular carcinoma are presented. A 61-year-old woman was found to have a metastatic tumor in the right temporo-occipital lobe 1 year after undergoing treatment for a primary hepatoma. An osteolytic tumor was removed from the left orbit of a 58-year-old man and the primary tumor, a hepatoma, was discovered postoperatively. The intracranial and orbital tumors were verified to be hepatocellular carcinoma. Both patients died within 1 year of surgery. The relevant literature is briefly reviewed.

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EFFICACY OF 90Y-RADIOEMBOLIZATION IN METASTATIC COLORECTAL CANCER DEPENDING ON THE PRIMARY TUMOR SIDE

Digestive Diseases ◽

10.1159/000512744 ◽

2020 ◽

Author(s):

Philipp Schindler ◽

Max Masthoff ◽

Fabian Harders ◽

Hartmut Schmidt ◽

Lars Stegger ◽

...

Keyword(s):

Median Survival ◽

Primary Tumor ◽

Progressive Disease ◽

Complete Response ◽

Tumor Burden ◽

Hepatic Tumor ◽

Left Colon ◽

Right Colon ◽

90Y Radioembolization ◽

The Right

Metastatic colorectal cancer (mCRC) is associated with different molecular biology, clinical characteristics and outcome depending on the primary tumor localization. We aimed to evaluate the effectiveness of 90Y-radioembolization (RE) for therapy of colorectal liver metastases depending on the primary tumor side. We performed a retrospective analysis of n=73 patients with mCRC and RE in our university liver center between 2009 and 2018. Patients were stratified according to the primary tumor side (left vs. right hemicolon), treatment response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) at follow-up after 3 months. Kaplan-Meier analysis was performed to analyze survival followed by Cox regression to determine independent prognostic factors for survival. Prior to RE all patients had received systemic therapy, with either stable or progressive disease, but no partial or complete response. In n=22/73 (30.1%) patients the primary tumor side was in the right colon, in n=51/73 (69.9%) patients in the left colon. Hepatic tumor burden was ≤25% in n=36/73 (49.3%) patients and >25% in n=37/73 (50.7%) patients. At 3 months, n=21 (33.8%) patients showed treatment response [n=2 (3.2%) complete response, n=19 (30.6%) partial response], n=13 (21.0%) stable disease, and n=28 (45.2%) progressive disease after RE. The median survival in case of primary tumor side in the left colon was significantly higher than for primary tumors in the right colon (8.7 vs. 6.0 months, p=0.033). The median survival for a hepatic tumor burden ≤25% was significantly higher compared with >25% (13.9 vs. 4.3 months, p<0.001). The median overall survival was 6.1 months. The median survival after RE in hepatic-metastatic CRC depends on the primary tumor side and the pre-procedural hepatic tumor burden.

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Atorvastatin in Treating Patients With Stages IIb-III Triple Negative Breast Cancer Who Did Not Achieve a Pathologic Complete Response After Receiving Neoadjuvant Chemotherapy

Case Medical Research ◽

10.31525/ct1-nct03872388 ◽

2019 ◽

Author(s):

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Pathologic Complete Response ◽

Complete Response

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Stereotactic Body Radiotherapy of a Solitary Metachronous Sphenoid Metastasis from Renal Cell Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000513743 ◽

2021 ◽

pp. 269-273

Author(s):

Charles Marchand Crety ◽

Estelle Vigneau ◽

Camille Invernizzi

Keyword(s):

Renal Cell Cancer ◽

Renal Cell ◽

Stereotactic Body Radiation Therapy ◽

Clinical Presentation ◽

Histopathological Examination ◽

Cell Cancer ◽

Papillary Renal Cell Carcinoma ◽

Complete Response ◽

Resonance Imaging ◽

The Right

Nasosinus metastases from kidney cancer are an unusual clinical presentation although some cases are reported in the literature. Among these cases, sphenoidal metastases are even rarer. Here we report a case of lone sphenoid metastasis in patients with papillary renal cell cancer. Eight months after radical nephrectomy, the patient presented with progressively worsening diplopia. Magnetic resonance imaging showed a mass in the right sphenoid sinus. Histopathological examination of the biopsy sample confirmed diagnosis of sinonasal metastasis from papillary renal cell carcinoma. The patient was declined for surgical management and received stereotactic body radiation therapy. Reassessment MRI at 4 months showed a complete response of the treated sphenoid lesion.

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Cytokeratin 7, GATA3, and SOX-10 is a Comprehensive Panel in Diagnosing Triple Negative Breast Cancer Brain Metastases

International Journal of Surgical Pathology ◽

10.1177/1066896921990717 ◽

2021 ◽

pp. 106689692199071

Author(s):

Eric Statz ◽

Julie M. Jorns

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Metastatic Tumor ◽

Cytokeratin 7 ◽

Breast Cancer Metastases ◽

Her2 Breast Cancer ◽

Cancer Metastases ◽

Breast Cancer Brain Metastasis ◽

The Brain

Following lung cancer, breast cancer is the second most common metastatic tumor to the brain, of which triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2+ (HER2+) breast cancer are the most common subtypes. TNBC does not have standard immunoprofiles and can be difficult to distinguish from other metastases. A tissue microarray was created from 47 patients with breast cancer metastases to the brain and 12 paired breast primaries. Of 47 breast cancer metastases, 24 were HER2+, 14 were TNBC, and 9 were luminal. Forty-five were cytokeratin 7 (CK7) positive, 36 were GATA-binding protein 3 (GATA3) positive, 7 were Sry-related HMg-Box gene 10 (SOX-10) positive, 20 were mammaglobin positive, and 19 were gross cystic disease fluid protein 15 positive. At least one of the CK7, GATA3, or SOX-10 was positive in all TNBC metastases. A panel of CK7, GATA3, and SOX-10 is complementary in the diagnosis of breast cancer brain metastasis. SOX-10 appears to be a specific but not particularly sensitive marker in this context.

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RARE-29. PRIMARY CENTRAL NERVOUS SYSTEM NON-HODGKIN LYMPHOMA IN AN 11-YEAR-OLD BOY: A CASE REPORT

Neuro-Oncology ◽

10.1093/neuonc/noaa222.739 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii448-iii448

Author(s):

Jorge Luis Ramírez-Melo ◽

Regina M Navarro-Martin del Campo ◽

Manuel D Martinez-Albarran ◽

Fernando Sánchez-Zubieta ◽

Ana L Orozco-Alvarado ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Hodgkin Lymphoma ◽

Central Nervous System Lymphoma ◽

Complete Response ◽

High Dose ◽

Illustrative Case ◽

Tumor Biopsy ◽

Non Hodgkin Lymphoma ◽

The Right

Abstract BACKGROUND Primary central nervous system lymphoma (PCNSL) are very rare in children. CLINICAL CASE: An 11-year-old male presented with a 2 months history with myoclonic movements in the upper right limb, and a sudden frontal headache, gait disturbance due to right hemiparesis and an ipsilateral convulsive episode. Upon admission he had critical condition, with hypertensive skull syndrome, Glasgow of 12, Karnofsky 40%, right hemiparesis, swallowing disorder, facial paralysis, and loss of photo motor reflex and unilateral amaurosis. A CT and MRI showed a huge tumor mass in the left tempo-parietal region, infiltrating the white matter and shifting the midline. A Tumor biopsy was done, and reported diffuse small cell non-Hodgkin lymphoma of high-grade, Burkitt type. Systemic lymphoma workup was negative. He received six cycles of chemotherapy based on high dose methotrexate, rituximab and triple intrathecal.After the second cycle an ophthalmologic evaluation was done, and found infiltration to the right retina, for which 6 cycles of intra vitreous chemotherapy with methotrexate were applied, he showed an excellent response, and recovered all his neurological functions except that right hemianopia persist. Control MRI showed partial response at 2nd cycle and complete response after the 4th cycle. No Radiation was performed. CONCLUSION This report highlights the fact that pediatric PCNSL may be effectively treated by a combination of HDMTX and rituximab-based chemoimmunotherapy without irradiation. Lack of awareness of this rare entity may lead to extense resections of brain, and potential permanent secuelae that were avoided in this illustrative case.

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E-Cadherin expression in human tumors: a tissue microarray study on 10,851 tumors

Biomarker Research ◽

10.1186/s40364-021-00299-4 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Eike Burandt ◽

Felix Lübbersmeyer ◽

Natalia Gorbokon ◽

Franziska Büscheck ◽

Andreas M. Luebke ◽

...

Keyword(s):

Tissue Microarray ◽

Poor Prognosis ◽

Triple Negative ◽

Lobular Carcinoma ◽

Tumor Stage ◽

Advanced Tumor Stage ◽

Carcinoma Of The Breast ◽

Advanced Tumor ◽

Tumor Entities ◽

E Cadherin

Abstract Background The E-Cadherin gene (CDH1, Cadherin 1), located at 16q22.1 encodes for a calcium-dependent membranous glycoprotein with an important role in cellular adhesion and polarity maintenance. Methods To systematically determine E-Cadherin protein expression in normal and cancerous tissues, 14,637 tumor samples from 112 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. Results E-Cadherin was strongly expressed in normal epithelial cells of most organs. From 77 tumor entities derived from cell types normally positive for E-Cadherin, 35 (45.5%) retained at least a weak E-Cadherin immunostaining in ≥99% of cases and 61 (79.2%) in ≥90% of cases. Tumors with the highest rates of E-Cadherin loss included Merkel cell carcinoma, anaplastic thyroid carcinoma, lobular carcinoma of the breast, and sarcomatoid and small cell neuroendocrine carcinomas of the urinary bladder. Reduced E-Cadherin expression was linked to higher grade (p = 0.0009), triple negative receptor status (p = 0.0336), and poor prognosis (p = 0.0466) in invasive breast carcinoma of no special type, triple negative receptor status in lobular carcinoma of the breast (p = 0.0454), advanced pT stage (p = 0.0047) and lymph node metastasis in colorectal cancer (p < 0.0001), and was more common in recurrent than in primary prostate cancer (p < 0.0001). Of 29 tumor entities derived from E-Cadherin negative normal tissues, a weak to strong E-Cadherin staining could be detected in at least 10% of cases in 15 different tumor entities (51.7%). Tumors with the highest frequency of E-Cadherin upregulation included various subtypes of testicular germ cell tumors and renal cell carcinomas (RCC). E-Cadherin upregulation was more commonly seen in malignant than in benign soft tissue tumors (p = 0.0104) and was associated with advanced tumor stage (p = 0.0276) and higher grade (p = 0.0035) in clear cell RCC, and linked to advanced tumor stage (p = 0.0424) and poor prognosis in papillary RCC (p ≤ 0.05). Conclusion E-Cadherin is consistently expressed in various epithelial cancers. Down-regulation or loss of E-Cadherin expression in cancers arising from E-Cadherin positive tissues as well as E-Cadherin neo-expression in cancers arising from E-Cadherin negative tissues is linked to cancer progression and may reflect tumor dedifferentiation.

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PD-L1 Expression after Neoadjuvant Chemotherapy in Triple-Negative Breast Cancers Is Associated with Aggressive Residual Disease, Suggesting a Potential for Immunotherapy

Cancers ◽

10.3390/cancers13040746 ◽

2021 ◽

Vol 13 (4) ◽

pp. 746

Author(s):

Beatriz Grandal ◽

Manon Mangiardi-Veltin ◽

Enora Laas ◽

Marick Laé ◽

Didier Meseure ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Triple Negative ◽

Residual Disease ◽

Checkpoint Inhibitors ◽

Rapid Development ◽

Complete Response ◽

Tumor Burden ◽

Small Subset ◽

Breast Cancers ◽

Residual Cancer Burden

The consequences of neoadjuvant chemotherapy (NAC) for PD-L1 activity in triple-negative breast cancers (TNBC) are not well-understood. This is an important issue as PD-LI might act as a biomarker for immune checkpoint inhibitors’ (ICI) efficacy, at a time where ICI are undergoing rapid development and could be beneficial in patients who do not achieve a pathological complete response. We used immunohistochemistry to assess PD-L1 expression in surgical specimens (E1L3N clone, cutoff for positivity: ≥1%) on both tumor (PD-L1-TC) and immune cells (PD-L1-IC) from a cohort of T1-T3NxM0 TNBCs treated with NAC. PD-L1-TC was detected in 17 cases (19.1%) and PD-L1-IC in 14 cases (15.7%). None of the baseline characteristics of the tumor or the patient were associated with PD-L1 positivity, except for pre-NAC stromal TIL levels, which were higher in post-NAC PD-L1-TC-positive than in negative tumors. PD-L1-TC were significantly associated with a higher residual cancer burden (p = 0.035) and aggressive post-NAC tumor characteristics, whereas PD-L1-IC were not. PD-L1 expression was not associated with relapse-free survival (RFS) (PD-L1-TC, p = 0.25, and PD-L1-IC, p = 0.95) or overall survival (OS) (PD-L1-TC, p = 0.48, and PD-L1-IC, p = 0.58), but high Ki67 levels after NAC were strongly associated with a poor prognosis (RFS, p = 0.0014, and OS, p = 0.001). A small subset of TNBC patients displaying PD-L1 expression in the context of an extensive post-NAC tumor burden could benefit from ICI treatment after standard NAC.

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