垂体转移癌的临床诊治

目的:通过1例肺癌垂体转移病例报道,回顾分析本院另1例影像学诊断为垂体转移癌的病例,并复习相关文献,总结垂体转移癌的临床特点.方法:分析2例垂体转移癌的临床资料,整理复习近期国内外关于垂体转移癌的相关文献.结果:垂体转移癌患者临床表现多为尿崩、头痛、视物模糊等眼部症状,病情通常进展较快.影像学表现为鞍区骑跨鞍隔生长而呈“哑铃状”浸润性肿瘤.结论:患者出现垂体异常增大或伴有垂体病变的临床症状时,首先要考虑垂体转移,垂体转移癌病人预后极差.     

肝细胞癌垂体转移1例并文献复习

垂体转移癌是指颅内或颅外的恶性肿瘤转移至垂体区域,包括垂体前后叶、垂体硬膜、蛛网膜、鞍膈等,是十分罕见的颅内恶性肿瘤。可发生以乳腺癌、肺癌及甲状腺癌[1]转移,肝癌转移至垂体腺,国内未见报道.现将我院收治的1例报道如下,结     

乳腺癌子宫转移一例并文献复习

乳腺癌的远处转移好发于骨、肺、肝，乳腺癌子宫转移则非常少见，这给临床鉴别诊断子宫原发肿瘤及乳腺转移癌带来了困难。本文报道郑州大学第一附属医院2011年11月收治的1例乳腺癌子宫转移，从病理及免疫组化方面进行分析，并复习国内外相关文献。     

乳腺浸润性导管癌胃转移一例并文献复习

乳腺癌为女性第一常见恶性肿瘤,常见的转移部位为淋巴结、肺、骨骼和肝[1]。乳腺癌胃转移较为罕见,已有文献报道的是小叶癌,导管癌极其少见[2-4]。乳腺癌胃转移的诊断及治疗尚缺乏大量临床数据研究。笔者报道1例乳腺浸润性导管癌术后3年胃转移的患者,并复习相关文献,综合讨论乳腺癌胃转移的临床病理特征、诊断方法及治疗和预后。     

BRMS1蛋白在乳腺癌组织中的表达及临床意义

[目的]分析BRMS1表达与乳腺癌临床病理因素之间的关系,探讨BRMS1蛋白在乳腺癌转移中可能存在的作用机制及意义。[方法]采用免疫组织化学方法检测63例乳腺癌组织标本中BRMS1蛋白的表达,随机抽取相应的癌旁组织32例及乳腺良性病变组织29例作为对照组,结合临床病理资料进行分析。[结果]BRMS1在乳腺癌组织中阳性率为36/63（57.1%）,癌旁组织中阳性率为29/32（90.6%）,乳腺良性病变组织中阳性率为100.0%（29/29）,乳腺癌组织中BRMS1表达率显著低于癌旁组织和乳腺良性病变组织。BRMS1表达与年龄、肿瘤大小、病理分型无关,与淋巴结转移、临床病理分期有关。[结论]BRMS1蛋白在乳腺癌组织中表达下调,其表达下调可能与乳腺癌的侵袭转移相关。     

宫颈鳞状细胞癌乳腺转移3例报道并文献复习

目的:探讨宫颈鳞状细胞癌乳腺转移的临床病理特征,以期提高对该病的认识。方法:回顾性分析我院3例宫颈鳞状细胞癌乳腺转移患者的临床资料、影像学特征、病理学特征及预后,并复习国内外相关文献。结果:宫颈鳞状细胞癌乳腺转移非常罕见,本文报道3例患者以乳腺肿块就诊,影像学检查无法与原发性乳腺癌相鉴别,通过肿块病理学检查及免疫组化染色确诊为宫颈鳞状细胞癌转移。虽经积极的抗肿瘤综合治疗,但患者生存期仍然极短。结论:乳腺转移性鳞状细胞癌极易误诊为原发性乳腺癌,需结合病史、组织形态学特征及免疫表型等进行诊断和鉴别诊断,避免误诊。宫颈鳞状细胞癌患者一旦出现乳腺转移,生存期短、预后差。     

基因异常表达在判断垂体腺瘤侵袭性中的作用

有关垂体腺瘤侵袭性的研究很多,肿瘤相关基因的异常表达揭示垂体腺瘤侵袭性的一个重要方面。癌基因、抑癌基因的表达与垂体腺瘤侵袭性相关。通过对肿瘤相关基因的研究,有助于我们进一步了解垂体腺瘤侵袭性的产生机制,为临床治疗垂体腺瘤提供帮助。     

垂体转移癌一例并文献复习

 目的　探讨垂体转移癌的临床特点。方法　报告1例甲状腺乳头状癌垂体转移病例,并结合文献就垂体转移癌的临床特点及误诊原因进行分析。结果　垂体转移癌是十分罕见的疾病,甲状腺乳头状癌转移至垂体腺,国内鲜见报道,临床上极易误诊。结论　垂体转移癌术前诊断困难,预后取决于原发肿瘤,一般较差。     

微血管计数与乳腺癌临床病理因素及预后的关系

乳腺癌的生长、侵袭与转移依赖于血管形成。我们用Ⅷ因子相关抗原对癌组织中新生血管进行免疫组化染色 ,探讨微血管计数 (ＭＶＣ)与乳腺癌侵袭、转移及预后的关系。一、材料与方法1 临床材料 :收集 1986～ 1988年间辽宁省肿瘤医院乳腺科收治的女性乳腺癌 5 6例 ,年龄 2 9～ 72岁 (平均年龄 46 .2岁 )。手术方式为简化根治术或标准根治术。术前未经任何治疗 ,术后均行化疗 ,17例行术后放疗。术后病理均为侵袭性非特殊型癌。组织学分级 :1级 2 2例 ,2级 17例 ,3级 17例。临床病理分期 :Ⅰ期 8例 ,Ⅱ期 40例 ,Ⅲ期 8例。 5 6例无失访 ,最长随访…     

垂体转移瘤的临床与MR表现

目的：探讨垂体转移瘤的临床和MR表现。方法：收集垂体转移瘤20例，对其MR表现和临床资料进行回顾分析。结果：原发肿瘤包括乳腺癌5例，肺癌14例，结肠癌1例。主要临床表现有尿崩症（10例）、垂体前叶功能减退（2例）、头痛（4例）和视力下降（5例）等鞍区占位症状。转移灶位于垂体柄和（或）垂体后叶，呈浸润性生长，T1WI呈等、略低或等低不均匀信号，T2WI呈等、略高或等高混杂信号。结论：垂体转移瘤的临床和MR表现有一定特征，正确认识这些特征对临床诊断和治疗具有重要意义。     

Symptomatic metastases to the pituitary infundibulum resulting from primary breast cancer

Metastatic spread into the brain is not infrequently seen in association with epithelial neoplasms such as lung and breast cancer, among others. In the majority of cases such spread entails a poor prognosis. Metastasic spread to the pituitary gland, specifically to the area of the infundibulum is, however, a more rare presentation. Most reported cases of metastatic disease to the pituitary are confined to the posterior lobe, probably related to the richer blood supply as compared to the anterior counterpart. The detection of pituitary metastasis is further complicated by the lack of specific associated symptomatology or definite radiologic diagnostic findings. We here describe the different clinical presentations of two patients with symptomatic pituitary stalk metastasis resulting from primary breast cancer; we also provide a systematic review of the literature.     

Hepatocellular carcinoma metastasis in the pituitary gland: case report and review of the literature

Symptomatic pituitary metastases are uncommon and have been reported mainly in autopsy series. Although all types of malignancies can metastasize to the pituitary gland, a review of the literature has indicated that lung and breast carcinomas are the most frequent primary tumors while hepatocellular carcinoma metastasis has only recently been described.A 59-year-old man with abdominal pain and fever was admitted to our hospital. Hepatosplenomegaly was present without signs of ascites. Laboratory tests showed only abnormal hepatic biochemistry while the radiological studies revealed a solid mass occupying the left hepatic lobe. The patient underwent excision of the left hepatic lobe and was closely followed-up. Six months later he readmitted with headache and visual disturbances. MRI revealed a solid mass in the sella region pressing the optic chiasma. Transsphenoidal excision of the pituitary mass was followed and the histological examination of the tumor was compatible with hepatocellular carcinoma.Symptomatic pituitary metastases are uncommon and may be difficult to differentiate from pituitary adenomas. The present case emphasizes on the capricious nature of hepatocellular carcinoma and on the importance of the individualized therapeutic approach.     

Blocking tumor growth, invasion, and metastasis by maspin in a syngeneic breast cancer model

Maspin is a unique serine protease inhibitor of which the down-regulation is associated with the development of breast cancers. In vitro, recombinant maspin inhibits tumor cell migration and invasion. Overexpression of maspin in transgenic mice is protective against tumor progression. Additionally, maspin acts as an angiogenesis inhibitor in rat cornea model and in a xenograft tumor model. To additionally prove that maspin is directly involved in the suppression of tumor growth and metastasis, we tested maspin in a new syngeneic mammary tumor model, TM40D. This model involves the implantation of TM40D mammary tumor cells orthotopically to the mammary gland; tumors grew within the gland and then become invasive and metastatic to other organs. Here we demonstrate that TM40D cells in implanted mammary glands are highly invasive. Overall, a 75% rate of invasion and metastasis was observed in this model. However, both primary tumor growth and metastasis were significantly blocked in TM40D cells that overexpress maspin as a consequence of plasmid or retrovirus infection. Maspin-transfected tumors tended to have tumor encapsulation and less necrosis, which were associated with better prognosis and lower invasiveness. Thus, maspin can block primary tumor growth as well as invasion and metastasis. These data support the concept that maspin has a strong protective role against tumor progression.     

Panhypopituitarism in a patient with breast cancer

BACKGROUND: Malaise and fatigue are common symptoms of advanced malignant disease. Nevertheless, a specific cause--requiring specified treatment--for this symptom should be ruled out. We report on a patient with a complex endocrine dysfunction that developed due to a tiny metastasis of a breast carcinoma in the pituitary stalk. CASE REPORT: A 46- year-old woman presented with general ill feeling 3 years after operation for a breast carcinoma. She was diagnosed to have hepatic and peritoneal metastases and malignant pleural effusion. For the application of chemotherapy, an i.v.-port system in the right brachiocephalic vein was inserted. In the postoperative period, an emergency situation developed due to demasked cortisol deficiency and hypernatremia. Careful laboratory investigations revealed hypofunction of the anterior lobe of the pituitary gland and diabetes insipidus centralis. By MRI imaging of the parasellar region, a 4 x 5 mm metastatic lesion in the pituitary stalk was found--notable only in knowledge of the clinical diagnosis. The patient's condition and quality of life improved markedly with hormone replacement therapy. CONCLUSION: Metastatic cancer may present as endocrine disease, either by release of hormone-like substances or by tumorous destruction of endocrine structures. Metastases of solid tumors to the pituitary gland are often asymptomatic or present with diabetes insipidus. The presentation with a hypofunction of the anterior and posterior lobe of the pituitary gland is a rare event. It is recommended to consider endocrine dysfunction as potential cause of 'malaise' in a cancer patient.     

Clinicopathologic review of 88 cases of carcinoma metastatic to the putuitary gland.

Clinical and pathologic features of 88 cases of carcinoma metastatic to the pituitary gland were reviewed.In 61 (69.3%), metastases were localized either in the posterior lobe alone or in the posterior and anterior lobes together; only 12 (13.6%) involved the anterior lobe alone. Diabetes insipidus was present in 6 patients (6.8%), one of whom also had clinical panhypopituitarism due to metastatic tumor and necrosis in the anterior pituitary lobe. Breast and lung were the most frequent primary sites in women and men, respectively. Sixty-four (72.7%) of these glands were grossly normal at necropsy. Metastases to the pituitary gland occur more frequently in the posterior lobe than in the anterior lobe, and my ve reflected clinically by diabetes insipidus in patients with diseminated carcinoma. Clinical panhypopituitarism is a rare accompaniment of anterior lobe involvement.     

Pituitary metastasis from malignant bronchial carcinoid

Metastases from a carcinoid tumor to the pituitary gland have, to our knowledge, not been described. We present a 49-year-old woman diagnosed as having a primary carcinoid tumor arising in the submucosa of a large bronchus who 8 years later presented with multiple metastases including one to the pituitary gland, which was in partial failure of pituitary function. This case illustrates than when confronted with a pituitary tumor resembling an adenoma but negative for pituitary hormones, the possibility of a metastasis from a carcinoid tumor should be considered.     

CD44 crosslinking-mediated matrix metalloproteinase-9 relocation in breast tumor cells leads to enhanced metastasis

CD44 plays a major role in multiple physiological processes, including cell-cell adhesion, cell-substrate interaction, lymphocyte homing, and tumor metastasis. It has been reported that highly expressed CD44 in certain types of tumors is associated with the hematogenic spread of tumor cells. The ability of CD44 to bind hyaluronan has been shown to correlate with tumor cell invasiveness, and it is likely that this ability may enhance tumor cell migration at several points during metastasis. However, the mechanism as to how CD44 stimulates metastasis remains unknown. The human breast tumor cell line, MDA-MB-435s, was used to investigate the effect of antibody-mediated CD44 crosslinking on the cellular level and localization of matrix metalloproteinase-9 (MMP-9). Confocal microscopy and immunocytochemical analyses were performed to demonstrate colocalization of CD44 and MMP-9 after CD44 crosslinking. Furthermore, the CD44-MMP-9 complex was purified by immunoprecipitation. G8 myoblast monolayers were employed to evaluate the invasiveness of human breast tumor cells after CD44 crosslinking in the presence or absence of protease inhibitors. CD44 crosslinking augmented the level of MMP-9 in the membrane of human breast tumor cells and clustering of CD44 serves as an MMP-9 docking molecule allowing MMP-9 to retain its concentrated proteolytic activity on the cell surface. Furthermore, crosslinking of CD44 enhances the ability of breast tumor cells to invade G8 myoblast monolayers and migrate through the basal membranes which was inhibited in the presence of anti-MMP-9 antibody or the MMP inhibitors GM6001 or 1,10-phenanthroline. This study demonstrates for the first time that CD44 crosslinking leads to an enhanced level and relocation of MMP-9 in human breast tumor cells accompanied by increased tumor invasion and metastasis.     

Proto-oncogene ACTR/AIB1 promotes cancer cell invasion by up-regulating specific matrix metalloproteinase expression

Overexpression of ACTR/AIB1 is frequently found in different cancers with distant metastasis. To address its possible involvement in tumor metastasis, we performed invasion assays to examine the effect of ACTR alteration on the invasiveness of breast cancer cells (MDA-MB-231 or T-47D) and found that high levels of ACTR are required for their strong invasiveness. Molecular analysis indicates that ACTR functions as a coactivator of AP-1 to up-regulate the expression of matrix metalloproteinases such as MMP-7 and MMP-10 and reduce cell adhesion to specific extracellular matrix proteins. These novel findings provide a mechanistic link between ACTR and MMPs, and suggest that ACTR may also play an important role in cancer progression by facilitating tumor invasion.