scholarly journals Heterotopic ossification in lymph node metastasis after rectal cancer resection: a case report and literature review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hideki Nagano ◽  
Tamotsu Togawa ◽  
Takeshi Watanabe ◽  
Kenji Ohnishi ◽  
Toshihisa Kimura ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Lymph Node ◽  
Heterotopic Ossification ◽  
Tumor Cells ◽  
Digestive Tract ◽  
Histological Examination ◽  
Metastatic Lesion ◽  
Axillary Lymph ◽  
The Brain

Abstract Background Heterotopic ossification (HO) is the formation of osseous tissue outside the skeleton. HO in malignant tumors of the digestive tract is extremely rare, as is ossification in metastatic lesions from HO-negative digestive tract tumors. Regarding the pathogenesis of HO, two theories have been proposed. The first is that the osteoblastic metaplasia of tumor cells (driven by the epithelial-mesenchymal transition, EMT) results in HO, and the second is that factors secreted by cancer cells lead to the metaplasia of stromal pluripotent cells into osteoblasts. However, the osteogenic mechanisms remain unclear. Case presentation An 83-year-old Japanese woman underwent low anterior rectal resection for rectal cancer before presentation at our institution, in June 2018. The final diagnosis was stage IIB rectal adenocarcinoma (T4aN0M0). Histological examination did not reveal HO in the primary tumor. Thirteen months after the operation, a solitary metastatic lesion in the brain 20 mm in size and a solitary metastatic lesion in a right axillary lymph node 20 mm in size were diagnosed. The patient was treated with gamma-knife therapy for the brain metastasis. One month later, she was referred to our institution. She underwent lymph node resection. Histological examination revealed that most portions of the affected lymph node were occupied by metastatic tumor cells and that central necrosis and four small ossified lesions without an osteoblast-like cell rim were present in the peripheral region. Immunohistochemical analysis showed tumor cells positive for BMP-2, osteonectin, osteocalcin, AE1/AE3, TGF-β1, Gli2, Smad2/3, and CDX2 and negative for nestin, CD56, and CK7. Conclusion This is the first English case report of HO in a metachronous metastatic lymph node after the curative resection of HO-negative rectal cancer. Unlike HO lesions in past reports, the HO lesion did not show peripheral osteoblast-like cells, and the immunohistochemical findings indicated that the present case resulted from the EMT.

Sentinel Node Biopsy: Interpretation and Management of Patients With Immunohistochemistry-Positive Sentinel Nodes and Those With Micrometastases

2008 ◽  
Vol 26 (5) ◽  
pp. 698-702 ◽  
Author(s):  
Emiel J.T. Rutgers
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Sentinel Node ◽  
Tumor Cells ◽  
Clinical Decision Making ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Isolated Tumor Cells ◽  
Sentinel Nodes ◽  
Node Metastasis

The sentinel node procedure is an adequate tool to identify lymph node metastasis in breast cancer. Sentinel nodes are generally examined with greater attention mainly to exclude, as reliably as possible, lymph node metastasis. To achieve this, many protocols are used, resulting in different rates of micrometastasis or isolated tumor cells encountered. Since the prognostic significance of isolated tumor cells or micrometastasis in the sentinel nodes, and the risk of further axillary lymph node involvement in patients with isolated tumor cells, is uncertain and at most limited, these findings may pose difficulties for clinicians in clinical decision making. Protocols that identify lymph node metastasis, from which the clinical relevance is known, are warranted. Unnecessary lymph node dissections should be avoided.

scholarly journals Axillary Lymph Node Metastasis of Colon Cancer—Case Report and Literature Review

2014 ◽  
Vol 03 (12) ◽  
pp. 669-673
Author(s):  
Helena Devesa ◽  
Luísa Pereira ◽  
Álvaro Gonçalves ◽  
Telma Brito ◽  
Teresa Almeida ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Literature Review ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Cancer Case ◽  
Axillary Lymph ◽  
Node Metastasis

Right Axillary Lymph Node Visualization by Bipedal Lymphography: A Case Report

Radiology ◽  
1976 ◽  
Vol 121 (1) ◽  
pp. 69-70 ◽  
Author(s):  
Hisashi Ohtake ◽  
Masaru Oikawa ◽  
Tetsuhiro Syoh
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Axillary Lymph

PRIMARY UNDIFFERENTIATED PLEOMORPHIC SARCOMA OF BREAST IN A 24 YEAR FEMALE : A CASE REPORT

2021 ◽  
pp. 57-58
Author(s):  
Sona Pathak ◽  
Manoj Kumar Paswan ◽  
Arpana ShailalyTirkey ◽  
Joyeeta Mandal
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Histopathological Examination ◽  
Axillary Lymph ◽  
High Grade ◽  
Node Dissection ◽  
Total Mastectomy ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Pleomorphic Sarcoma ◽  
Adolescents And Adults

Undifferentiated pleomorphic sarcoma constitutes less than 5 % of all sarcomas in adults and has been rarely seen in the breast and is dened as a group of pleomorphic, high-grade sarcomas in which any attempt to disclose their line of differentiation has failed . Most undifferentiated pleomorphic sarcomas(UPS) have occurred in their sixth and seventh decades of life and very rarely in adolescents and adults. We report a case of 24 year old female presented with painless lump in right breast and rapidly increasing in size for last 5 months. Iinitial diagnosis was made as sarcoma breast on the basis of physical and radiological examination. After that total mastectomy was done without axillary lymph node dissection, as lymphatic spread is very rare. But without histopathological examination and most importantly IHC-panel, it is impossible to make a denitive diagnosis of UPS breast.

Simultaneous Immunohistochemical Detection of Tumor Cells in Lymph Nodes and Bone Marrow Aspirates in Breast Cancer and Its Correlation With Other Prognostic Factors

2001 ◽  
Vol 19 (4) ◽  
pp. 960-971 ◽  
Author(s):  
Bernd Gerber ◽  
Annette Krause ◽  
Heiner Müller ◽  
Dagmar Richter ◽  
Toralf Reimer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

PURPOSE: We studied the prognostic and predictive value of immunohistochemically detected occult tumor cells (OTCs) in lymph nodes and bone marrow aspirates obtained from node-negative breast cancer patients. All were classified as distant metastases-free using conventional staging methods. PATIENTS AND METHODS: A total of 484 patients with pT1-2N0M0 breast cancer and 70 with pT1-2N1M0 breast cancer and a single affected lymph node participated in our trial. Ipsilateral axillary lymph nodes and intraoperatively aspirated bone marrow were examined. All samples were examined for OTCs using monoclonal antibodies to cytokeratins 8, 18, 19. Immunohistological findings were correlated with other prognostic factors. The mean follow-up was 54 ± 24 months. RESULTS: OTCs were detected in 180 (37.2%) of 484 pT1-2N0M0 patients: in the bone marrow of 126 patients (26.0%), in the lymph nodes of 31 patients (6.4%), and in bone marrow and lymph nodes of 23 (4.8%) patients. Of the 70 patients with pT1-2N1MO breast cancer and a single involved lymph node, OTCs were identified in the bone marrow of 26 (37.1%). The ability to detect tumor cells increased with the following tumor features: larger size, poor differentiation, and higher proliferation. Tumors of patients with OTCs more frequently demonstrated lymph node invasion, blood vessel invasion, higher urokinase-type plasminogen activator levels, and increased PAI-1 concentrations. Patients with detected OTCs showed reduced disease-free survival (DFS) and overall survival (OAS) rates that were comparable to those observed in patients who had one positive lymph node. Multivariate analysis of prognostic factors revealed that OTCs, histological grading, and tumor size are significant predictors of DFS; OTCs and grading of OAS. CONCLUSION: OTCs detected by simultaneous immunohistochemical analysis of axillary lymph nodes and bone marrow demonstrate independent metastatic pathways. Although OTCs were significantly more frequent in patients with other unfavorable prognostic factors, they were confirmed as an independent prognostic factor for pT1-2N0M0, R0 breast cancer patients.

Isoechoic axillary lymph node metastases of mucinous carcinoma of the Breast: A case report

Breast Cancer ◽  
2006 ◽  
Vol 13 (4) ◽  
pp. 382-385 ◽  
Author(s):  
Kumiko Kamitani ◽  
Minoru Ono ◽  
Satoshi Toyoshima ◽  
Shoshu Mitsuyama ◽  
Keisei Anan ◽  
...  
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Lymph Node ◽  
Mucinous Carcinoma ◽  
Axillary Lymph ◽  
Carcinoma Of The Breast ◽  
Axillary Lymph Node Metastases ◽  
Node Metastases
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