Penile metastasis from rectal carcinoma

We are presenting a 65-year old patient with metastatic carcinoma of the penis which was discovered 19 months after abdomino-perineal resection for rectal cancer (Duke A). There was also metastasis in the perineum and one rib. Penile biopsy and cavernosography were carried out and established the metastatic nature. The patient declined further therapy and died 5 months after diagnosis.     

Breast metastasis from rectal carcinoma: A case report and review of the literature

BackgroundMetastasis from extramammary primary tumor to breast is extremely rare.Case SummaryA 59-year-old woman with 1-year history of rectal cancer presented with asymptomatic breast mass. At 16 months after the diagnosis of rectal mucinous adenocarcinoma, a breast mass was confirmed by ultrasonography and identified by pathology and immunohistochemistry as a metastasis from the rectal cancer. Treatments included chemotherapy (6 cycles: 300 mg irinotecan on day 1, 4.5 mg raltitrexed on day 2, 450 mg bevacizumab on day 3), radiotherapy, and surgical resection. Two years of follow-up examinations (6-months intervals) showed no evidence of recurrence or novel distant metastasis.ConclusionBreast metastasis from rectal carcinoma is a rare secondary malignancy. Final diagnosis can be established by histopathology and immunohistochemistry.     

Simultaneous laparoscopic excision for rectal carcinoma and synchronous hepatic metastasis

Background  Rectal carcinoma patients are often accompanied by hepatic metastasis. The aim of this study was to evaluate the therapeutic efficacy of simultaneous laparoscopic excision for rectal carcinoma with synchronous hepatic metastasis.

Methods  A total of 41 patients with rectal carcinoma and synchronous hepatic metastasis detected by CT scan were included in this study. Among them, 23 patients underwent laparoscopic surgery and 18 patients underwent traditional open surgery to simultaneously remove the rectal tumor and hepatic metastasis lesions. All patients received postoperative adjuvant chemotherapy. All the patients were followed up from 36 to 72 months (mean 45.3 months).

Results  All the operations were performed successfully and no patient was turned to open surgery in laparoscopic group. The mean blood loss, the mean postoperative hospital stay, the mean blood transfusion and the mean intestinal functional recovery time showed a significant difference between the two groups (P <0.05). The 1-, 3- and 5-year survival rates were 82.6%, 43.5% and 8.6% in the laparoscopic group, without significant difference compared with the open group (77.8%, 38.9% and 0) (P >0.05).

Conclusions  Simultaneous laparoscopic excision for rectal carcinoma and synchronous hepatic metastasis is safe and effective with similar survival achieved by the traditional open abdominal surgery.

     

直肠癌直肠系膜转移相关因素的临床研究

目的探讨直肠癌系膜淋巴结转移的规律及与临床病理特征的关系。方法回顾性分析2006年1月至2009年6月在我院以全直肠系膜切除（Total mesorectal excision,TME）原则行直肠癌根治术的47例直肠癌临床资料,采用卡方检验、非参数秩和检验及Logistic多因素回归分析,了解其淋巴结转移与临床病理之间的关系。结果患者的性别、年龄,肿瘤大小、部位、侵犯肠管周径,术前CEA表达水平与直肠系膜淋巴结转移无明显关系（P〉0.05）。肿瘤的分化程度、浸润深度与直肠系膜淋巴结转移相关,低分化肿瘤的直肠系膜转移阳性率明显高于高、中分化组（P〈0.05）。多因素回归分析显示肿瘤的分化程度与直肠系膜的淋巴结转移相关。结论直肠癌直肠系膜淋巴结转移与肿瘤的分化程度相关。     

Gut metastasis from breast carcinoma

Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone, and the brain. Metastases to the gastrointestinal tract are rare with patients presenting with small-bowel perforation, intestinal obstruction, and gastrointestinal bleeding. Here we report a case of a Saudi female presenting with invasive lobular carcinoma and ileo-cecal junction metastasis.     

Appendicular metastasis from carcinoma cervix

A young lady who was treated for early squamous cell carcinoma of cervix presented with perforated appendicitis. Appendicectomy was done and the histopathology was reported as metastatic squamous cell carcinoma. Squamous cell carcinoma of the cervix metastasizing to the appendix is extremely rare and we previously unreported.     

Unusual scalp metastasis from follicular thyroid carcinoma

Metastatic tumors presenting as soft tissue lesions are relatively rare, and can be the source of diagnostic confusion both clinically and histopathologically. We present a case of an 82-year-old woman with complaints of painless swelling in the right temporo-occipital junction for 3 months, and with unusual scalp metastasis of thyroid follicular carcinoma. Use of histopathological examinations are significant for determining the tumor type, and arriving at the exact and correct diagnosis.     

Left ventricular metastasis from a primary lung carcinoma

The most common tumors associated with cardiac metastases are lung carcinoma and melanoma.1 Although the cardiac involvement of lung cancer is common(lung cancer usually directly invades into the pericardium and/or left/right atrium),the primary lung cancer accompanied with metastasis to the left ventricle is extremely rare.     

Solitary thyroid metastasis from clear-cell renal carcinoma.

A 58-year-old woman underwent nephrectomy because of clear-cell renal carcinoma. Seven years later a solitary thyroid metastasis was detected. She is alive and well 17 months after thyroidectomy. The rarity of this manifestation is well known but its explanation is not clear. The long metastasis-free interval, a characteristic shared by other hormonally dependent neoplasms, has been explained in part by the concept of "dormant cells", which do not undergo division. The stimulus that provokes these cells into division is at present not known.     

Brain metastasis from hepatocellular carcinoma after radical hepatectomy

Brain metastasis from hepatocellular carcinoma (HCC) is a rare, yet perplexing problem in patients with cancer. We report on 5 patients with metastasis of HCC to the brain after radical hepatectomy. Intrahepatic recurrence occurred in 3 patients, and distant metastasis to sites other than the brain was observed in 3 patients (lung, 2; bone, 1). The symptoms for brain metastasis included headache, hemiparesis, and vomiting. Hemorrhage was found in 4 of 5 patients. All patients had a single nodular lesion in the brain. The alpha-fetoprotein levels were more than 10,000 ng/ml in 4 patients. Two patients underwent surgical resection, 1 received cranial irradiation, and 2 were administered corticosteroids. The interval between diagnosis of the primary cancer and detection of brain metastasis ranged from 2 to 54 months. The mean survival period was only 3 months after diagnosis of brain metastasis. All 5 patients died of neurologic causes. Because no effective treatment for brain metastasis from HCC is available, further study is needed.     

Isolated splenic metastasis from carcinoma of the breast

A case of isolated splenic metastasis from carcinoma of the breast in a 54 year old woman, two years after treatment for breast carcinoma, is presented. There was no involvement of other organs like liver, bone, lungs, etc. The patient underwent splenectomy and recovered without any complications. This case is being reported because of the rarity of the lesion.     

直肠癌患者周围淋巴结转移的临床及病理特征分析

目的:总结保留盆腔植物神经的直肠癌扩大根治术中直肠周围各组淋巴结的转移规律,探讨现阶段侧方淋巴结清扫的意义.方法:接受保留盆腔植物神经的直肠癌扩大根治术患者114例,清除淋巴结并行常规病理学方法(HE染色)观察,分析直肠周围淋巴结转移情况.结果:114例患者中有46例发生淋巴结转移,总的淋巴结转移率为40.4%(46/...     

直肠癌中MMP-7和MVD的表达及其与肿瘤转移和预后的相关性研究

目的：探索基质溶解素（MMP-7）、微血管密度（MVD）与直肠癌临床病理的关系及其在肿瘤浸润转移中的作用。方法：应用免疫组织化学SP法检测42例直肠癌组织及18例正常直肠组织（对照组）中MMP-7和MVD的表达情况。结果：直肠癌及对照组中CD34的表达分别为（43．50&;#177;11．80）及（23．83&;#177;4．88）,两组比较,有非常显著性差异（P〈0．01）。临床病理分期中,淋巴结转移阴性组MMP-7阳性表达率为66．7％,淋巴结转移阳性组MMP-7阳性表达率为85．7％,两组比较,有显著性差异（P〈0．05）;同时,淋巴结转移阴性组MVD阳性表达为（36．52&;#177;6．95）,淋巴结转移阳性组MVD阳性表达为（50．48&;#177;11．61）．两组比较,有显著性差异（P〈0．05）。结论：直肠癌MMP-7及MVD均呈高表达,二者可能具有相互促进作用。即MMP-7能促进直肠癌的血管生成,从而使血行转移速度加快;MMP-7及MVD将有可能成为检测直肠癌高危人群的临床新指标,高表达MVD可能预示着直肠癌患者预后不良。     

老年原因不明颈部转移癌的特点和预后

本文通过20例老年和50例中青年原发隐性颈部淋巴结转移癌临床分析对比,发现前者比后者确诊的时间长,转移灶数多,体积大,找到原发灶的例数少,时间长。找到原发灶并治疗者比原发灶不明、单纯治疗转移灶者生存期明显延长,老年组为7.8倍,中青年组为3.4倍。5年生存率分别为8.3％和4.9％。     

腹腔镜直肠癌腹会阴联合切除术的初步体会

目的 探讨腹腔镜行直肠癌腹会阴联合切除的可行性及应用价值。方法 总结8例低位直肠癌病人行腹腔镜腹会阴联合切除术的临床资料。结果 8例均顺利完成手术，术中平均出血150ml，术后1例出现排尿困难。结论 腹腔镜行直肠癌腹会阴联合切除术符合现代外科微创及快速康复理念，只要熟练掌握腹腔镜技术，同样能达到开腹手术的效果。