Metastatic bladder tumor disseminated lymphogenously from gastric cancer: a case report

A 59-year-old man was referred to our clinic with a complaint of frequent urination, voiding pain, and macroscopic hematuria. He had undergone total gastrectomy for mucinous adenocarcinoma, 21 months earlier. Pelvic computed tomography revealed a thick bladder wall all around. There were no other metastatic sites except for paraaortic lymph nodes. Transurethral resection of the bladder tumor was performed. The specimen showed signet ring cell carcinoma and revealed the same pathological findings as the primary gastric cancer. We diagnosed him with metastastic bladder tumor lymphogenously disseminated from gastric cancer. Such lymphogenous metastases from gastric cancer at the entire bladder wall without other apparent lesions have rarely been reported in the Japanese literature.     

Metastatic tumor of the epididymis from pancreatic carcinoma: a case report]

A 58-year-old male who complained of painful left scrotal swelling consulted a local clinic in August 1998. Because his symptoms did not improve after antibiotic therapy, he was transferred and admitted to Jyouhoku City Hospital on September 14, 1998. Pelvic computed tomography (CT) was performed, and revealed left epididymitis. However, antibiotic treatment did not improve the condition. Then, because carcinoma of the epididymis was suspected, left inguinal orchiectomy was performed. We found a tumor in the spermatic cord and another tumor in the epididymis. The pathological diagnosis was adenocarcinoma, and metastatic carcinoma from the digestive tract was suspected. Therefore, examinations were performed to detect the primary cancer. CT and magnetic resonance imaging (MRI) demonstrated an invasive irregular tumor from the pancreas to the left kidney. Irregular mucosa was observed by gastrointestinal fiberscopy. A biopsy was performed and the pathological diagnosis was adenocarcinoma. Based on these findings, the patient was diagnosed as having a metastatic tumor of the epididymis and spermatic cord caused by pancreatic carcinoma. This is the 3rd case of adenocarcinoma of the pancreas that presented as an epididymal nodule, and this is the 12th case of adenocarcinoma of the pancreas that presented as a spermatic cord nodule.     

Metastatic renal tumor originating from esophageal carcinoma: a case report

A 46-year-old woman with a past history of esophageal carcinoma was hospitalized with the chief complaint of right abdominal pain. Enhanced computed tomography (CT) and selective renal angiography suggested a metastatic renal tumor. Right nephrectomy was performed. Histological examination revealed a renal tumor originated from esophageal squamous cell carcinoma. Metastatic renal tumors are frequently observed at autopsy, but clinically they are extremely uncommon. Thirty-four clinical cases of metastatic renal tumors reported in the Japanese literature during these 20 years are discussed including the present case.     

A case of metastatic urinary bladder tumor from gastric carcinoma]

We report a case of metastatic bladder tumor from gastric carcinoma. A 55-year old male patient was referred to our urological clinic with a complaint of frequent urination and voiding pain. He had undergone total gastrectomy for poorly differentiated adenocarcinoma, signet-ring cell type, 9 months earlier. Computed tomographic scan revealed a thick bladder and rectum wall all around. Punch biopsies from vesical and rectal wall revealed metastatic adenocarcinoma, signet-ring cell type. There were no other metastatic sites. Systemic chemotherapy was done with a combination of mitomycin-C, 5-fluorouracil and cytosine arabinoside. This chemotherapy was effective and complete remission was obtained at bladder and rectum. Six months after chemotherapy, peritoneal recurrence developed and he died 9 months after chemotherapy. However no recurrence of bladder tumor was detected. This was a quite rare case of metastatic bladder tumor characterized by good response to systemic chemotherapy.     

Metastatic renal tumor originating from esophageal carcinoma: a case report

A 61-year-old male, who had undergone operation of esophageal carcinoma 11 months earlier, was admitted for left flank pain and high fever. Intravenous pyelography showed a space occupying lesion in the upper half of the left kidney. Computed tomographic scan showed an irregular low density area in the upper half of the left kidney. Angiograms revealed a hypovascular mass with encasement vessels in the same site. Left nephrectomy and paraaortic lymph node biopsy was performed. Pathological examination revealed a metastatic squamous carcinoma from the esophageal carcinoma. Chemotherapy was conducted, but he died 2 months later. Autopsy revealed recurrence in the retroperitoneum, and no metastasis in the right kidney. The literature on secondary renal tumor is reviewed.     

Metastatic brain tumor originating from urachal carcinoma: case report

The authors presented a patient with metastatic brain tumor originating from urachal carcinoma. A 64-year-old female was admitted to our hospital with complaints of memory disturbance, indifference and apathy of 3 months duration. Head CT and MRI on admission showed a round mass with perifocal edema in the right frontal lobe. After administration of Gd-DTPA, the mass lesion showed ringed enhancement effect. Pelvic MRI scan revealed a bladder tumor, which was diagnosed as urachal carcinoma. The brain lesion was suspected to have metasta sized metastatic from urachal carcinoma, and was excised by craniotomy. Histology of the brain tumor was identical to that of urachal carcinoma. Postoperatively the patient received local radiation therapy, but died of multiple metastasis to lung and local recurrence, 18 months later. Urachal carcinoma is an extremely rare tumor, comprising 0.17-0.34% of all bladder tumors. Though this rare tumor carries a poor prognosis, it may be effective for longer survival of a patient to treat the metastatic brain lesion with surgery and radiation.     

肝细胞癌骶骨转移1例报告并文献复习

肝癌位居世界常见恶性肿瘤第6位,其死亡率居第3位,绝大多数为肝细胞癌(HCC)。近年来,肝癌诊断和治疗策略有所改善,患者生存时间得到延长,但5年生存率仍较低(16%),若发生肝外转移,生存率仅为4%[1-2]。有文献报道,HCC肝外转移发生率为15%~17%[3],除转移至肺、淋巴结、肾等,还可转移至皮下组织及骨骼肌肉系统[4]。在脊柱转移瘤中,骶骨转移瘤较胸椎(60%~80%)、腰椎(15%~30%)、颈椎(10%~15%)转移瘤发生率低[5-6]。肝癌骶骨转移发生率低,在局部呈多灶性、小片状、巨块状、虫蚀样改变,常累及骶孔,常见溶骨性破坏,破坏区无钙化,边缘不清晰。肿瘤若累及骶神经,可表现为运动感觉障碍及腱反射异常。本院2018年9月收治HCC骶骨转移患者1例,本研究组根据其临床表现,影像学、实验室及病理学检查并结合文献复习,探讨骶骨转移瘤的诊断,骶骨解剖结构、生物力学与手术治疗的关系及临床疗效评价,现报告如下。     

Metastatic sternal tumor from thyroid papillary carcinoma; report of a case

A 68-year-old male was referred to our department for treatment of a metastatic sternal tumor in the manubrium sterni. Primary lesion was papillary carcinoma of the left lobe of the thyroid gland. Total thyroidectomy, cervical lymph node dissection, resection of manubrium sterni with concomitant resection of bilateral clavicles, 1st ribs and 2nd ribs, and chest wall reconstruction using Marlex Mesh were performed on January 29, 2001. Considering relatively good prognosis and good response to multimodality therapy, surgical resection of sternal metastatic lesion from differentiated thyroid cancer seems to be a choice of therapy as a part of multimodality approach, including surgery, radioiodine and external radiation therapy, to thyroid cancer with systemic spread.     

Metastatic renal tumor of esophageal carcinoma: report of a case

In August 1987, a 66-year-old man was hospitalized because of macrohematuria and right flank pain. He had undergone resection of middle and lower part of the esophagus with esophagogastrostomy for esophageal carcinoma on April 16, 1984. Computed tomography revealed a solid, irregular, low density area in the upper pole of the right kidney and the right lobe of the liver. Arteriography showed a hypovascular mass in the upper pole of the right kidney, and several small tumor stains in the liver. At cystoscopic examination, the urinary bladder was normal and blood flowing from bilateral ureters was not seen. Cytological study of urine sediment disclosed squamous cell carcinoma. The patient was treated with systemic chemotherapy, but not improved. He died 6 months later, and the autopsy demonstrated widespread metastasis in various organs including the right kidney and liver. No recurrence was found in the residual esophagus. The kidney is the sixth organ of metastasis following the lung, liver, bone, adrenal, peritoneum and mesenterium. Although metastasis to the kidney is relatively common in autopsy, it is uncommon to be manifest clinically.     

Metastatic adrenal carcinoma suspected as a primary tumor: a case report

A 62-year-old man was admitted with chief complaints of fever and general fatigue. Enhanced computed tomography revealed a tumor (5 cm in diameter) in the right suprarenal space, and the right renoportal lymph nodes were swollen. An abdominal TI-weighted MR image showed a low-intensity tumor measuring 4.5 x 5.5 x 6.0 cm. Chest computed tomography revealed two tumors. One was 1.5 cm, on the hilum of left lung, the other was 1 cm in the S6 lung field near the pleura. These findings strongly indicated primary adrenal carcinoma and lung metastasis. Right adrenalectomy was performed. Histological examination of this tumor revealed diffuse tumor cells with irregular nuclei, and it was diagnosed as poorly differentiated adenocarcinoma. There was no possibility of primary adrenal carcinoma. The primary site of the tumor was suspected to be the left lung.     

Metastatic ureteral tumor: a case report

Among the secondary ureteral tumors, there have been a few true metastases to the ureters. We report a case of metastatic ureteral tumor from the pancreas, and review and discuss 60 cases collected from the Japanese literature.     

A case of metastatic urinary bladder tumor from a gastric remnant carcinoma

We report a case of a metastatic urinary bladder tumor from gastric remnant carcinoma. On August 23, 1984, a 70-year-old-woman visited us with the complaint of dysuria. She had undergone gastrectomy for gastric ulcer 25 years earlier. Cystoscopy revealed a non-stalk tumor in the dome of the bladder and the examination of the upper gastro-intestinal tract revealed gastric remnant carcinoma. We treated her with adriamycin, cis-diamminedichloroplatinum and mitomycin C but unfortunately she died of cachexia two weeks later. An autopsy revealed that the urinary bladder tumor was a signet ring cell carcinoma, metastasized from gastric remnant carcinoma.     

Metastatic penile tumor from lower pharynx: a case report

Metastatic tumor of the penis is uncommon and only 95 cases have been reported in Japan. A 70-year-old man, who had squamous cell carcinoma of the lower pharynx, complained of urethral induration. Biopsy was performed and pathological diagnosis was metastatic tumor of penis originating from the lower pharynx. Although partial response in tumor size was noted by irradiation therapy, the patient died of multiple metastases in the 4th month after the diagnosis. This case is the first report of metastatic penile tumor originating from the lower pharynx.     

Metastatic intrapelvic tumor from esophageal cancer: a case report

We report a case of a metastatic intrapelvic tumor arising from esophageal cancer. The patient, a 74-year-old man, visited our hospital with the chief complaint of gross hematuria. Magnetic resonance imaging and cystoscopy revealed a huge intrapelvic tumor which invaded the bladder, rectum, sigmoid colon and left ilium. The patient underwent total pelvic evisceration with ileal conduit and colostomy. Pathologic diagnosis of the intrapelvic tumor was moderately differentiated squamous cell carcinoma. Preoperatively, gastrointestinal fiberscopy revealed an esophageal tumor, and biopsy showed moderately differentiated squamous cell carcinoma. Finally, the intrapelvic tumor was diagnosed as metastatic tumor from esophageal cancer.     

Metastatic penile tumor from lung cancer: a case report

A 70-year-old man, who had squamous cell carcinoma of lung, complained of urethral pain. Physical examination revealed an induration of the bulbous urethra and a month later corpora cavernosa were involved. Biopsy was performed and pathological diagnosis was metastatic penile tumor originating from squamous cell carcinoma of lung. Several days after the biopsy the patient died of pleuritis carcinomatosa. Metastatic penile tumor is a rare disease and only 87 cases have been reported in Japan. We review the literature on metastatic penile tumors.     

直肠腺癌合并转移性巨大卵巢癌一例报告

病例：女，30岁。因下腹胀痛伴腹泻、便血1月余入院。入院查体：腹隆，腹正中可及巨大包块，质硬无压痛。肛指检查：截石位于直肠前壁9—12点距肛门约8cm处可触及一菜花状肿块，质硬，触之出血。实验室检查：血红蛋白83g／L，大便隐血（＋＋＋＋）；     

Metastatic tumor of renal pelvis and ureter from prostatic cancer: a case report]

An 86-year-old man was admitted to our hospital with a complaint of gross hematuria. Urological examination revealed right hydronephrosis and poorly differentiated adenocarcinoma of the prostate with bone metastases. Abdominal computed tomographic scan and retrograde pyelography showed thickening of the ureteral wall with irregular stenosis in the right upper ureter. Right nephroureterectomy demonstrated diffuse lymphatic infiltration of PSA-positive cancer cells in the submucosa and muscle layer of the ureter as well as renal pelvis. This is the 6th reported case of metastatic ureteral tumor from prostate cancer in the Japanese literature.     

Metastatic renal tumor originating from thyroid cancer: a case report

A 82-year-old female was referred to our department for close examination and treatment of a right renal tumor incidentally found by computed tomography. Her past history included partial thyroidectomy for follicular thyroid carcinoma 20 years earlier. Enhanced computed tomography showed a hypervascular mass with a diameter of 3 cm at the lower pole of the right kidney. We carried out radical nephrectomy for diagnosis of renal cell carcinoma. Pathological findings revealed a metastatic renal tumor of follicular thyroid carcinoma. It is rare to find metastatic renal tumors arising from thyroid carcinoma in clinical practice. Thirty cases have been reported in the Japanese literature.     

Pseudosarcomatous fibromyxoid tumor of the urinary bladder: a case report]

A 41-year-old man was referred to our clinic for gross hematuria. Cystoscopy revealed a 6 x 5 x 5 cm wide-based tumor located at the dome of the bladder. Pathological diagnosis of the biopsy was pseudosarcomatous fibromyxoid tumor. Microscopically this tumor was composed of spindle cells and myxoid stroma, and immunohistochemical and ultrastructural studies showed benign characteristics of this tumor. Therefore partial cystectomy was performed. It is important to recognize the histological characteristics of this essentially benign condition so that total cystectomy can be avoided.     

Small cell carcinoma of the urinary bladder: a case report]

We report a case of small cell carcinoma of the urinary bladder. A 60-year-old man with microscopic hematuria was referred to our hospital. Cystoscopy revealed a sessile tumor on the left lateral wall of the urinary bladder. The patient underwent transurethral resection of the bladder tumor (TUR-Bt). Because of muscle invasion (pT2), total cystectomy was recommended, but was not performed because the patient would not give consent for the operation. Six months after TUR-Bt, invasive bladder tumor recurred and total cystectomy was performed. Pathological examination of the operative specimen revealed small cell carcinoma. Adjuvant combined therapy of irradiation and chemotherapy (nedaplatin and etoposide) was ineffective. Metastases to retroperitoneal lymph nodes, lung and liver were detected soon after the adjuvant therapy. The patient died 15 months after his first visit to our hospital.