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A rare case of metastatic sigmoid adenocarcinoma to the ureter.

ABSTRACT: Colorectal cancer is a very common disease process, as is ureteral obstruction, but the two are typically mutually exclusive. The case report presented details a 35-year-old male with left sided flank pain and hydroureteronephrosis caused by metastatic spread of previously diagnosed and treated sigmoid adenocarcinoma. About two years previously, he had been diagnosed with Stage IV, T4a sigmoid colon cancer with liver metastasis and had resection of his primary tumor as well as metastatic sites and several rounds of chemotherapy. This case is an example of the different ways that cancer can grow, evading detection by spreading in atypical patterns.

SUBMITTER: Peifer D

PROVIDER: S-EPMC6669371 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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A rare case of metastatic sigmoid adenocarcinoma to the ureter.

Peifer David D Rohloff Matthew M Maatman Thomas T

Urology case reports 20190724

Colorectal cancer is a very common disease process, as is ureteral obstruction, but the two are typically mutually exclusive. The case report presented details a 35-year-old male with left sided flank pain and hydroureteronephrosis caused by metastatic spread of previously diagnosed and treated sigmoid adenocarcinoma. About two years previously, he had been diagnosed with Stage IV, T4a sigmoid colon cancer with liver metastasis and had resection of his primary tumor as well as metastatic sites a ...[more]

PMID: 31388493

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Project description:BackgroundSweet's syndrome is a rare inflammatory disease of unknown etiology, and its relationship with tumors is unknown at present. Sweet's syndrome in patients with solid tumors, especially adenocarcinoma of the lung, is extremely rare. At present, only 1 case of an operative patient has been reported in the literature. Diagnosing lung cancer with Sweet's syndrome is not easy, when there is a fever with an unknown cause and erythemas, especially when the erythemas do not disappear after antibiotic treatment, a skin biopsy is much important. Although the exact mechanism of the disease and its link to lung cancer are unknown, our case shows that the active surgical treatment of the primary disease and appropriate glucocorticoid therapy are effective means.Case descriptionWe report the first case of a patient with Sweet's syndrome and lung adenocarcinoma with a decrease in peripheral whole blood cells. A 66-year-old male patient presented, who had been suffering from a fever for >10 days and had multiple tender erythemas, erythemas were mainly on the limbs and upper chest. He was treated with a variety of antibiotics, but his symptoms did not improve significantly. The routine blood tests results show a decline in peripheral blood cells, a chest computed tomography (CT) examination showed a space occupying lesion in the middle lobe of the right lung, which was considered peripheral lung cancer. Sweet's syndrome was diagnosed after a skin biopsy, a pathological examination showed that a large number of neutrophils were infiltrating. The patient then underwent video-assisted thoracoscopic lobectomy associated with the systematic dissection of the mediastinal lymph node, and glucocorticoids were administered. After the operation, the tender erythemas and fever disappeared, at the 1-month follow-up, the chest CT showed no obvious tumor recurrence or metastasis.ConclusionsTo the best of our knowledge, this is the first report of Sweet's syndrome in a patient with lung adenocarcinoma with 3 cell lines reduced. The active surgical treatment of the primary disease and appropriate glucocorticoid therapy proved to be an effective treatment for this syndrome.

Project description:BackgroundCancers of unknown primary origin (CUPs) are reported to be the 3-4th most common causes of cancer death. Recent years have seen advances in mutational analysis and genomics profiling. These advances could improve accuracy of diagnosis of CUPs and might improve the prognosis of patients with CUPs.Case presentationA 76-year old male with an adenocarcinoma of unknown primary origin in the lung presented with another tumor of the palate mucosa. The tumor cells in the pleural effusion were all negative for immunohistochemical markers (TTF-1 and Napsin A) and lung-specific oncogenic driver alterations (EGFR mutation and ALK translocation). The tumor of the palate mucosa was likewise identified as an adenocarcinoma, and the cells showed cytological similarities with the tumor cells in the pleural effusion; TTF-1, Napsin A, EGFR mutation and ALK translocation were all negative. This result suggested that origins of the tumors of the palate mucosa and in the lung were the same, even though the origin had not yet been determined. Next, we addressed whether the tumor of the palate mucosa was a primary tumor or not. Secretory carcinoma (SC), which is a common type of minor salivary gland tumor (MSGT), was suspected; however, mammaglobin was negative and ETV6-NTRK3 (EN) fusion was not observed. Other MSGTs were excluded based on histological and immunohistochemical findings. Furthermore, an additional examination demonstrated an oncogenic KRAS mutation at codon 12 (p.G12D) in both palate tumor and in pleural effusion. KRAS mutation is known to exist in one-third of lung adenocarcinomas (LUADs), but quite rare in MSGTs. The possibility of metastasis from other organs was considered unlikely from the results of endoscopic and imaging studies. This result indicated that the primary site of the CUP was indeed the lung, and that the tumor of the palate mucosa was a metastasis of the LUAD.ConclusionsA tumor of the palate mucosa that showed diagnostic difficulties was determined to be a metastatic LUAD by genomic alterations and histopathological findings.

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A rare case of metastatic sigmoid adenocarcinoma to the ureter.

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A rare case of metastatic sigmoid adenocarcinoma to the ureter.

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