Metastasis to the penis in a patient with squamous cell carcinoma of the lung with a review of reported cases

Metastasis to the penis is very rare in lung cancer. We describe a patient with squamous cell carcinoma of the lung who developed a metastatic lesion in the penis. A 75-year-old Japanese male visited a local hospital complaining cough and bloody sputum. A chest plain radiograph and computed tomographic (CT) scans of the chest demonstrated a right hilar mass. He was diagnosed with squamous cell carcinoma of the lung at stage IIIB (T4N2M0). Then he was treated with concurrent chemoradiotherapy consisting of cisplatin, docetaxel, and thoracic irradiation, and after the chemoradiotherapy, he achieved a partial response. However, 6 months later, he visited an urologist complaining of firm mass in the penis with slight pain. A biopsy of the corpus cavernosum penis was performed, which provided a histological diagnosis of squamous cell carcinoma. The histology of the specimen was consistent with that of previous lung cancer, so he was considered to have penile metastasis from squamous cell carcinoma of the lung. Radiotherapy was given to the metastatic tumor in the penis. The penile tumor was diminished and the pain was completely relieved. In addition, we review reported cases to investigate the clinical characteristics and appropriate management of this rare involvement.     

Testicular Metastasis in a Case of Squamous Cell Carcinoma of the Lung

Testicular metastases are a rare finding. Typically, a testicular metastasis will present as a complication of progressive disease or as a primary sign of malignancy. Excluding lymphoma and leukemia, prostate cancer is the most common primary site that metastasizes to the testes. Testicular metastases resulting from squamous cell carcinoma of the lung have rarely been reported in previous literature. Here, we report a case of stage IV squamous cell carcinoma of the lung with metastases to the brain and multiple bilateral lung lesions. Following palliative systemic chemotherapy, this patient was found to have a right testicular mass. Pathology reports confirmed that this was a testicular metastasis of squamous cell lung carcinoma origin.Key Words: Testicular cancer, Testicular metastasis, Blood-testis barrier, Squamous cell, Lung cancer, Sanctuary site     

Scalp lesion: a presenting feature of squamous cell carcinoma of lung

We describe a 45-year-old man, heavy smoker, presenting with 6.5 x 5.3 cm painless solitary growth over right temporal region. Chest radiograph showed opacity over left lung abutting mediastinum. Computed tomogram revealed homogenous ill-defined opacity indicative of bronchogenic carcinoma with metastases to right lung, liver and adrenal glands. The carina was involved with tumor along with partial obliteration of the left main bronchus over bronchoscopy; the biopsy confirmed squamous cell carcinoma. The biopsy from scalp lesion and cervical lymph node also established metastatic squamous cell carcinoma. Although cutaneous metastasis with primary lung cancer has been reported, the scalp lesion as a sole presenting feature of underlying quiescent squamous cell lung cancer, which is described here, has not been reported frequently.     

Penile cancer and human papilloma virus (HPV) in a human immunodeficiency virus (HIV)-infected patient

Only a handful of cases of penile carcinoma among human immunodeficiency virus (HIV)-infected males have been reported. This is surprising insofar as other anogenital malignancies associated with human papillomavirus (HPV) are over-represented in HIV-infected men and women. Herein we describe the case of an HIV seropositive 64-year-old Caucasian with a CD4+ T-lymphocyte count of 550 cells/mm³ and an invasive squamous cell cancer of the penis. He underwent radical penectomy to treat cancer initially confined to the penile shaft and glans penis, but ultimately succumbed to complications associated with metastatic disease. HPV type 18 was identified by in situ hybridization and polymerase chain reaction (PCR) studies in the primary tumor and in groin and lung metastasis. We also briefly review current thoughts regarding the epidemiology and pathogenesis of penile cancer, particularly in the setting of HPV and HIV co-infection     

PTPN13和FAK在肺鳞癌中的表达及其临床意义

目的:研究PTPN13和FAK在肺鳞癌中的表达及意义,为建立早期预防、早期诊断、预后预警及个体化治疗的肺鳞癌防治新策略奠定基础.方法:免疫组化法观察PTPN13及FAK在肺鳞癌及癌旁组织中的表达情况.结果:PTPN13表达与肺鳞癌的临床分期、组织分化程度及淋巴结转移呈显著负相关(P<0.05);FAK表达与肺鳞癌的临床分期、组织分化程度及淋巴结转移呈显著正相关(P<0.05);PTPN13和FAK在肺鳞癌组织中的表达呈显著负相关(P<0.05).结论:PTPN13基因是肺鳞癌发生相关的抑癌基因,其抑制肿瘤侵袭转移的生物学功能可能与FAK磷酸化有关.     

PTPN13和FAK在肺鳞癌中的表达及其临床意义

目的：研究PTPN13和FAK在肺鳞癌中的表达及意义,为建立早期预防、早期诊断、预后预警及个体化治疗的肺鳞癌防治新策略奠定基础。方法：免疫组化法观察PTPN13及FAK在肺鳞癌及癌旁组织中的表达情况。结果：PTPN13表达与肺鳞癌的临床分期、组织分化程度及淋巴结转移呈显著负相关（P〈0.05）;FAK表达与肺鳞癌的临床分期、组织分化程度及淋巴结转移呈显著正相关（P〈0.05）;PTPN13和FAK在肺鳞癌组织中的表达呈显著负相关（P〈0.05）。结论：PTPN13基因是肺鳞癌发生相关的抑癌基因,其抑制肿瘤侵袭转移的生物学功能可能与FAK磷酸化有关。     

肺鳞状细胞癌预后相关影响因素研究进展

肺鳞状细胞癌在肺癌中所占比例为20%~30%,每年在全世界造成约40万人死亡。肺鳞状细胞癌患者的预后较差,这是因为患者确诊时常常已经发展到了晚期。影响肺鳞状细胞癌预后的因素有很多,例如性别和吸烟。本研究就自身因素(吸烟情况、性别、年龄、BMI、并发症)、肿瘤因素(亚部位、转移情况)和治疗因素对肺鳞状细胞癌预后的影响做一综述。     

Northern印迹杂交分析nm23基因在人肺癌中的表达研究

目的探讨ｎｍ２３基因表达在人肺癌中的作用。方法通过Ｎｏｒｔｈｅｒｎ印迹杂交,检测４０例人肺癌组织和１９例非癌肺组织的ｎｍ２３Ｈ１和ｎｍ２３Ｈ２ｍＲＮＡ表达,采用地高辛标记和检测系统显示杂交信号,并分析ｍＲＮＡ表达与肺癌临床特征的关系。结果低分化鳞癌的ｎｍ２３Ｈ２ｍＲＮＡ表达较中高分化鳞癌显著降低（Ｐ＜０．０１）,小细胞肺癌的ｎｍ２３Ｈ１和ｎｍ２３Ｈ２ｍＲＮＡ表达较肺鳞癌明显降低。但在有或无淋巴结转移的原发癌灶组织间,以及肺癌的临床分期间,ｎｍ２３基因ｍＲＮＡ表达差异无显著性（Ｐ＞０．０５）。结论ｎｍ２３基因ｍＲＮＡ表达与肺癌的组织分化有关,未发现其在肺癌中的癌转移抑制作用。     

A case of long-term survival with stage IV small cell lung cancer and early-stage central-type squamous cell lung cancer treated by photodynamic therapy

The present report is on a 67-year-old man with stage IV small cell lung cancer and early-stage centrally located squamous cell cancer of the lung. He was diagnosed as small cell lung cancer with multiple metastasis to the ipsilateral lung and was found to have a central-type early-stage squamous cell cancer by bronchoscope. After obtaining a complete response to the small cell lung cancer with chemotherapy and radiotherapy, photodynamic therapy was applied to the squamous cell carcinoma, resulting in complete disappearance of the tumor. Recurrence of small cell cancer occurred at the ipsilateral lung and this patient died of small cell cancer 8 years after initiation of treatment. Post mortem examination confirmed complete disappearance of squamous cell cancer treated by photodynamic therapy. This is a rare case of long-term survival with stage IV small cell lung cancer and early-stage central-type squamous cell lung cancer successfully treated by photodynamic therapy.     

Claudin-7与Slug在肺鳞癌和腺癌中的表达及其临床意义

背景与目的 Claudins是紧密连接的骨架蛋白,Claudin-7是Claudins家族成员之一。本研究旨在观察Claudin-7和Slug在肺鳞癌和腺癌中的表达及其与临床病理因素的关系,并探讨Claudin-7和Slug的相互关系。方法采用免疫组织化学SP法检测101例原发性肺鳞癌、腺癌组织中Claudin-7和Slug的表达,同时应用Westernblot检测30例新鲜肺癌组织及其配对的癌旁组织中Claudin-7和Slug的表达情况。结果 Claudin-7在肺癌中的表达明显低于正常肺组织,并且与分化程度和淋巴结转移有关(P<0.05),Slug在肺癌中的表达明显高于正常肺组织,除与分化程度和淋巴结转移有关外,还与TNM分期有关(P<0.05),肺鳞癌、腺癌中Claudin-7与Slug的表达具有负相关性(r=-0.566,8)。结论肺鳞癌、腺癌中Claudin-7的低表达与Slug的高表达可能是肺组织恶性转变和转移的有关标志物之一。     

食管鳞癌患者远处转移部位与预后的相关性及生存分析

目的:探讨食管鳞癌患者远处转移部位与预后的相关性及生存分析。方法:从SEER数据库中提取2010年至2015年共439例食管鳞癌伴远处转移患者的临床资料,回顾性分析比较食管鳞癌远处转移部位与预后的相关性,通过χ2检验比较两组变量的差异,采用Kaplan-Meier法绘制生存曲线,Log-rank检验进行单因素分析,COX回归进行多因素分析。结果:肺转移、骨+肺转移、肝+肺转移患者预后较好;骨转移、脑转移、骨+脑转移、骨+脑+肝+肺转移患者预后较差。单因素分析显示:年龄、原发灶部位、T分期、手术情况、多器官转移情况与食管鳞癌远处转移患者的预后有关（P＜0.05）;多因素分析显示:年龄、手术情况与多器官转移情况是影响食管鳞癌远处转移患者总生存时间（OS）的独立危险因素。结论:食管鳞癌伴远处转移的患者整体预后较差,但年龄在60~69岁区间、接受手术治疗与较好的预后相关。仅单器官转移的食管鳞癌患者中,骨转移、脑转移患者预后较差;合并多器官转移的患者中,骨+脑转移、骨+脑+肝+肺转移患者预后较差。     

肺鳞癌骨转移因素分析

目的:分析肺癌诊断因素与肺鳞癌全身骨显像骨转移之间的关系。方法:回顾性分析185例肺鳞癌患者的全身骨显像及肺癌有关的肿瘤标志物,以全身骨显像为诊断骨转移的金标准。单因素方差分析和ROC工作曲线下面积比较,得出肺癌肿瘤标志物与肺鳞癌全身骨显像骨转移之间的关系。结果:单因素方差分析结果:NSE、CEA、ProGRP、ALP,均P＞0.05,差异无统计学意义,与骨转移无关;CYFRA21-1、SCC、CA125,均P＜0.05,差异有统计学意义,与骨转移有关;ROC受试者工作曲线结果:CEA(AUC=0.542,P=0.395)、ProGRP(AUC=0.577,P=0.116)、ALP(AUC=0.506,P=0.900),AUC均近于0.5,诊断准确性不高,且其P＞0.05,差异无统计学意义;CYFRA21-1(AUC=0.687,P=0.000)、NSE(AUC=0.679,P=0.000)、SCC(AUC=0.638,P=0.005)、CA125（AUC=0.660,P=0.001）,AUC近于0.7,诊断准确性较高,均P＜0.05,差异有统计学意义,与骨转移有关。结论:CEA、ProGRP、ALP与骨转移无关,不具有对肺鳞癌骨转移的预测和诊断意义;CA125、CTFRA21-1、NSE、SCC与骨转移有关,对肺鳞癌骨转移具有预测和诊断意义。     

Shift in the IgG subclass distribution in patients with lung cancer.

Lung cancer patients have been reported to have generalized immune dysfunction of the cell-mediated immune response. In contrast, little is known about the humoral immune function in these patients. Therefore, we examined the IgG subclass distribution (IgG1-lgG4) in 67 lung cancer patients (23 adenocarcinoma, 29 squamous cell carcinoma, 15 small cell carcinoma), 13 patients with inflammatory lung diseases, seven patients with pulmonary metastasis and 23 healthy controls using a commercial available ELISA. We found a significant increase in the percentage of IgG1 in adenocarcinoma, compared with squamous cell and small cell lung carcinoma (P < 0.05). Small cell lung cancer patients showed an increase in IgG2, IgG3 and IgG4 compared with all other groups (P < 0.05, respectively). IgG1/lgG2, IgG1/lgG3 and IgG1/lgG4 ratios in adenocarcinoma were higher than in small cell lung cancer (P < 0.05). In the squamous cell carcinoma there was no difference in IgG subclass distribution compared to controls. Our study demonstrates that the different histological subtypes of lung carcinoma influence the IgG subclass distribution. Whether this phenomenon is the result of a direct influence on B-cell activity by the tumor needs further investigation.     

Paraneoplastic Syndromes of Hypercalcemia and Leukocytosis Associated with Colonic Metastases from Squamous Cell Carcinoma of the Lung： a Case Report

Lung cancer is the most common cancer-related death in both men and women in the world. Approximately 25% of all cancer deaths are attributable to lung carcinoma. Moreover, about one-half of patients with lung cancer have metastases at the time of initial diagnosis, most frequently of lymph nodes, adrenals, liver, bone and brain.     

Liver metastasis at the time of initial diagnosis of lung cancer

In order to evaluate clinicopathological features associated with liver metastases from lung cancer, we reviewed our experience of lung cancer patients seen in our division. Of the 1073 lung cancer patients diagnosed between October 1976 and May 2002, 62 (5.8%) patients had liver metastasis. The incidence of liver metastasis was 17.5% in small-cell lung cancer (SCLC) patients, whereas the incidence in non-small-cell lung cancer patients was 3.8%. Of the 62 patients, 17 had sole liver metastasis, and the remaining 45 had synchronous spread to the liver and one or more other organs. Six of 12 squamous cell carcinoma patients and 10 of 28 SCLC patients had sole liver metastasis. However, 19 of 20 adenocarcinoma patients showed liver metastasis with one or more other organs. In morphological liver metastasis, 26 of the 28 SCLC patients had multiple nodules, whereas 16 of the 34 non-small-cell lung cancer patients had a solitary liver nodule (p = 0.0006). Liver is a possible site of extrathoracic spread of disease for some patients with lung cancer, especially with SCLC. When the histological types are squamous cell carcinoma or SCLC, it would also be considered likely that an isolated liver mass represents a metastasis even though there is no metastatic disease elsewhere.     

IGF1R和IGFBP3在肺鳞癌中的表达及其临床意义

目的:检测IGF1R、IGFBP3在肺鳞癌组织中的表达,并探讨其在肺鳞癌发生发展中的作用及其临床意义。方法:用免疫组化二步法检测246例肺鳞癌术后组织与40例癌旁正常组织中IGF1R、IGFBP3的表达情况,并分析二者的相关性及与临床病理特征和预后的关系。结果:IGF1R在肺鳞癌组织中的阳性表达明显高于癌旁正常组织,其表达率分别为54.07%、32.5%,IGFBP3在肺鳞癌组织中的阳性表达明显低于癌旁正常组织,其表达率分别为61.79%、87.5%,差异具有统计学意义（P＜0.05）。IGF1R的表达与淋巴结转移正相关（P＜0.05）,IGFBP3的表达与肺癌的TNM分期、淋巴结转移负相关（P＜0.01）,而与其他临床病理参数无关（P＞0.05）。IGF1R阳性表达组患者生存期明显短于IGF1R阴性表达组患者,IGFBP3阳性表达组患者生存期明显长于IGFBP3阴性表达组患者,差异有统计学意义（P分别为<0.001和=0.001）。Cox单因素分析显示TNM分期、淋巴结转移、IGF1R及IGFBP3的表达均与预后相关,将TNM分期、淋巴结转移、IGF1R及IGFBP3的表达进行Cox回归多因素分析,结果显示TNM分期、IGF1R及IGFBP3的表达均为肺鳞癌患者的独立预后因子。IGF1R、IGFBP3在肺鳞癌组织中表达呈负相关（r=-0.204,P＜0.001）。结论:IGF1R、IGFBP3参与了肺鳞癌的发生、发展,并且二者均为肺鳞癌的独立预后因子。有望成为分子靶向治疗的新靶点。     

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。     

肺癌~（18）F-FDG-PETCT的SUVmax与淋巴结转移及肺癌肿瘤标志物之间的关系研究

目的：研究肺癌18F-FDG-PETCT的SUVmax（最大标准摄取值）与肺癌淋巴结转移、肺癌肿瘤标志物、肿瘤大小及临床病理类型之间的关系。方法：经病理确认的98例肺癌住院患者,术前一周内均行18F-FDG PET-CT检查肿块大小、SUVmax及肺门或纵隔淋巴结转移情况;并进行肿瘤标志物神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）和细胞角蛋白片（CYFRA21-1）检查,统计学分析检测结果。结果：原发灶SU-Vmax与原发灶大小之间存在相关性（r=0.497,P〈0.05）,与单个肿瘤标志物的值之间无明显相关性。整体分析时肺门或纵隔淋巴结转移组与无转移组的原发灶SUVmax均值之间差异无统计学意义,腺癌肺门或纵隔淋巴结转移组及无转移组的SUVmax均数之间差异有统计学意义（P〈0.05）。鳞癌肺门或纵隔淋巴结转移组及无转移组的SUVmax均数之间差别无统学意义（P=0.721）。肺鳞癌与腺癌SUVmax均值之间比较差异有统计学意义（P=0.001）;细支气肺泡癌与其它腺癌SUVmax均值之间差异有统计学意义（P〈0.05）。结论：在病理类型不明确的情况下原发灶SUVmax的高低并不能预测淋巴结转移的有无,肺腺癌原发灶FDG代谢活性与肺门和（或）纵隔淋巴结转移有关,淋巴结转移率随着肿块SUVmax的增加而增加;肺鳞癌FDG代谢活性与肺门和（或）纵隔淋巴结转移无关。SUVmax与病理类型有关,鳞癌SUVmax较高,腺癌较低,细支气管肺泡癌则更低。     

Membrane proteomic analysis comparing squamous cell lung cancer tissue and tumour-adjacent normal tissue

Lung cancer is the leading cause of cancer-related deaths worldwide. Squamous cell carcinoma is one of the predominant histological subtypes of lung cancer. Detecting lung cancer at an early stage is essential for successful therapy and increasing survival. There are still no satisfactory biomarkers for the early detection of lung cancer. In this study, tumour tissue paired with tumour-adjacent normal bronchial epithelial tissue was obtained from patients with squamous cell lung carcinoma without metastasis. The proteins extracted from the cell membrane were separated by two-dimensional polyacrylamide gel electrophoresis (2-DE) and were analysed with the Image Master two-dimensional platinum software. Twenty-five significantly different protein spots were selected and identified with matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). A total of 19 proteins were successfully identified. Twelve proteins were up-regulated, and seven proteins were down-regulated in the cancerous tissue compared with the tumour-adjacent normal tissue. One up-regulated protein and one down-regulated protein in squamous cell lung carcinoma were verified by Western blot analysis and RT-PCR; the results were consistent with the 2-DE analysis. In conclusion, membrane proteomics identified a number of candidate biomarker proteins that were differentially expressed between squamous cell lung cancer tissue and adjacent normal tissue. These biomarker candidates have the potential to elucidate the underlying pathogenesis of squamous cell lung cancer.     

Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review

Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients.