Metastasis to scrotal skin as the initial manifestation in a patient with rectal adenocarcinoma: a rare case report and literature review.
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ABSTRACT:
SUBMITTER: Wu G
PROVIDER: S-EPMC4854111 | biostudies-literature | 2016 May-Jun
REPOSITORIES: biostudies-literature
Publications
Metastasis to scrotal skin as the initial manifestation in a patient with rectal adenocarcinoma: a rare case report and literature review.
Wu Gang G Gu Bao-Jun BJ Nastiuk Kent L KL Gu Jun J Wu Deng-Long DL
Asian journal of andrology 20160501 3
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Project description:BACKGROUND:Colorectal cancer is ranked third among the most commonly diagnosed malignancies and fourth among the leading causes of cancer death in the world. However, only a few case reports are found in the literature regarding skin metastasis originating from rectal cancer, which usually shows widespread disease and poor prognosis. Approximately, 0.8% of the patients will have skin lesion as the first indication of a silent internal malignancy, which is rare. CASE REPORT:We report a complicated case of a 45-year-old male patient who referred to our highly specialized governmental hospital for diversion loop colostomy as well as biopsies of rectal and inguinal skin areas followed by palliative radiation therapy to the pelvis. Histopathological exam of rectal biopsies revealed moderately differentiated rectal adenocarcinoma, while the skin of the right inguinal area showed metastatic cutaneous rectal adenocarcinoma. Unfortunately, palliative radiation therapy was not started as the patient passed away secondary to respiratory failure which ended by cardiopulmonary arrest. CONCLUSION:A patient who is having new or evolving skin lesions with an oncology history should be well investigated as cutaneous metastasis is a strong possibility.
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| S-EPMC11537902 | biostudies-literature
Project description:IntroductionGastrointestinal tract involvement in breast cancer is rarely encountered clinically. Data about this condition is limited and mostly from case reports.Case presentationWe report a case of rectal metastasis originating from breast cancer, which presents after a long-term latency of initial diagnosis. The patient had a history of diagnosis and treatment of stage II triple-negative breast cancer with mastectomy and adjuvant chemotherapy and radiotherapy. She showed no signs of recurrence up to eleven years, then presented with hematochezia and mild constipation. A rectal lesion was found on colonoscopy, which raise the initial suspicion of primary rectal cancer, but surprisingly, immunohistochemistry staining of the rectal specimen confirmed the origin of breast cancer.Clinical discussionBreast cancer with rectal metastasis is very rare. Immunohistochemistry combined with medical history is essential for definitive diagnosis in this situation. Mammaglobin and GCDFP-15, CDX2, CK20, and CK7 help differentiate the origin from the breast or the rectum.ConclusionThough breast cancer metastasizing to the rectum is a rare event, physicians should be aware of this differential diagnosis, even in patients with a remote history of breast cancer.
| S-EPMC9207094 | biostudies-literature
Project description:Posterior perforation of duodenal ulcers is very rare; the infection may spread from the retroperitoneal space to the scrotum. A 75-year-old male presented with painful right scrotal swelling for 2 days associated with fever. During abdominal examination there was abdominal tenderness and scrotal swelling and tenderness. CT scan of the abdomen showed large amount of air collection in the retroperitoneal space extending to the right scrotum with contrast media passing to the retroperitoneum and right scrotum. Laparotomy done and there was a perforation in the posterior wall of the duodenum, suturing done and right scrotal abscess drained.
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Project description:Introduction and significanceCardiac dissemination of gastric adenocarcinoma represents an exceedingly uncommon clinical scenario. To date, there is an absence of documentation concerning the presence of tumor emboli within the cardiac chambers originating from gastric cancer, particularly following a possible transvenous migration.Case presentationThis report delineates the clinical journey of a 60-year-old female diagnosed with inoperable diffuse gastric adenocarcinoma, who developed cardiac metastases.Clinical discussionThe prognostication of isolated cardiac metastasis in oncology patients is fraught with difficulty due to its infrequency and non-specific clinical manifestations. While systematic screening for cardiac metastasis is not part of standard oncological protocols, heightened vigilance is warranted in specific scenarios such as advanced-stage malignancies or in the presence of suggestive cardiac symptomatology, thereby prompting further exploration.ConclusionCardiac metastasis, while infrequent, constitutes a dire clinical entity that must be contemplated in the differential diagnosis of cardiac mass presentations in individuals with a neoplastic history. Prompt recognition and deployment of appropriate diagnostic imaging are pivotal for informed therapeutic decision-making. An integrative, multidisciplinary strategy is imperative for the formulation of an optimal treatment paradigm, encompassing surgical and palliative care options.Key clinical messageCardiac metastasis of gastric adenocarcinoma are extremely rare, however, in gastric cancer cases with cardiopulmonary manifestation should be considered as a probable differential diagnoses.
| S-EPMC11318462 | biostudies-literature
Project description:IntroductionPituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor.MethodsWe present the case of a 58 years-old-man who reported a three-month history of polyuria-polydipsia syndrome, generalized asthenia, panhypopituitarism and bitemporal hemianopsia. Brain-MRI showed a voluminous pituitary mass causing posterior sellar enlargement and compression of the surrounding structures including pituitary stalk, optic chiasm, and optic nerves.ResultsThe patient underwent neurosurgical removal of the mass. Histological examination revealed a poorly differentiated adenocarcinoma of uncertain origin. A total body CT scan showed a mass in the left kidney that was subsequently removed. Histological features were consistent with a clear cell carcinoma. However, endoscopic examination of the digestive tract revealed an ulcerating and infiltrating adenocarcinoma of the gastric cardia. Total body PET/CT scan with 18F-FDG confirmed an isolated area of accumulation in the gastric cardia, with no hyperaccumulation at other sites.ConclusionTo the best of our knowledge, there are no reports of pituitary metastases from gastric cardia adenocarcinoma. Our patient presented with symptoms of sellar involvement and without evidence of other body metastases. Therefore, sudden onset of diabetes insipidus and visual deterioration should lead to the suspicion of a rapidly growing pituitary mass, which may be the presenting manifestation of a primary extracranial adenocarcinoma. Histological investigation of the pituitary mass can guide the diagnostic workup, which must however be complete.
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Project description:Leiomyomas are benign mesenchymal tumors, the overwhelming majority of which are located in the uterus. Rare cases arise in other organs, including the scrotum, pelvis, bladder, and spermatic cord. This report evaluates the case of a 37-year-old man with a history of prior left inguinal hernia repair, who presented with a painless right scrotal mass. He first noticed the mass approximately 1 year prior to his initial visit. Subsequent ultrasound of the scrotum demonstrated a 5-cm circumscribed, hypoechoic, mildly vascular extratesticular mass located within the right hemiscrotum. Based on the initial imaging, the differential diagnosis included lipoma, adenomatoid tumor, papillary cystadenoma, leiomyoma, fibrous pseudotumor, sarcoid granuloma, sarcoma (including liposarcoma, rhabdosarcoma, or leiomyosarcoma), lymphoma, and an extranumerary testis. The mass had circumscribed margins, suggesting an encapsulated lesion, and was completely separate from the testicle on ultrasound. Despite this, testicular malignancy was not entirely excluded as a diagnosis, although it was considered far less likely. The patient was definitively treated with surgical excision of the mass. Pathology of the surgical specimen confirmed diagnosis of leiomyoma, a rare scrotal mass.
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Project description:Huntington's disease (HD) is an autosomal dominant disorder, typically characterized by chorea due to a trinucleotide repeat expansion in the HTT gene, although the clinical manifestations of patients with juvenile HD (JHD) are atypical.A 17-year-old boy with initial presentation of tics attended our clinic and his DNA analysis demonstrated mutation in the HTT gene (49 CAG repeats). After treatment, his symptoms improved. Furthermore, we performed literature review through searching the databases and summarized clinical features in 33 JHD patients.The most prevalent symptoms are ataxia, and two cases reported that tics as initial and prominent manifestation in JHD. Among them, 88% patients carried CAG repeats beyond 60 and most of them have family history. This case here illustrates the variable range of clinical symptoms of JHD and the necessity of testing for the HD mutation in young patients with tics with symptoms unable to be explained by Tourette's syndrome (TS).
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Project description:The thyroid is a rare site for metastasis, occurring in 0.1% of colorectal cases. A 46-year-old man with rectal adenocarcinoma developed an enlarging anterior neck mass and increasing carcinoembryonic antigen 2?years after curative intent treatment. Imaging showed aggressive features with invasion of the larynx, trachea and oesophagus, suspicious for anaplastic thyroid carcinoma. The patient underwent tumour debulking with neck dissection and tracheostomy. Final histopathological review revealed metastatic adenocarcinoma from a colorectal primary. Despite chemotherapy, the patient eventually succumbed to disease progression and complications of his illness. This case demonstrates that recognising rare sites of metastasis may help clinicians effectively institute earlier intervention.
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