Metástasis tumor a tumor en pulmón: reporte de tres casos y revisión de la literatura / Tumor-to-tumor metastasis in the lung: report of three cases and review of the literature

Las metástasis tumor a tumor (MTT) corresponden a un evento poco frecuente en el cual se presenta metástasis de un tumor primario a otro tumor primario, bien sea benigno o maligno. El carcinoma de pulmón es un receptor poco habitual, pero uno de los donantes más frecuentes. En el presente articulo presentamos tres casos de MTT como órgano receptor el pulmón: el primero, de una mujer con antecedente de carcinoma papilar de tiroides y carcinoma ductal in situ de la mama, con presencia de MTT y carcinoma papilar de tiroides a un adenocarcinoma primario pulmonar. El segundo caso, es una mujer con MTT de carcinoma ductal de mama a un adenocarcinoma primario pulmonar. Y el tercero, de un MTT de un carcinoma ductal de mama a un hamartoma pulmonar. En los tres casos, fue fundamental la correlación clínico-patológica y los estudios complementarios de inmunohistoquímica.

Tumor-to-tumor metastases (TTM) correspond to a rare event in which a primary tumor metastasizes to another primary tumor, whether benign or malignant. Lung carcinoma is an unusual recipient, but one of the most frequent donors. In this article, we present three cases of TTM to the lung: the first one is of a woman with a history of papillary thyroid carcinoma and ductal carcinoma in situ of the breast, with the presence of TTM and papillary thyroid carcinoma to a primary adenocarcinoma of the lung. The second case is of a woman with TTM from ductal carcinoma of the breast to a primary pulmonary adenocarcinoma, and the third is TTM from a breast ductal carcinoma to a pulmonary hamartoma. In all three cases, the clinical-pathological connection and complementary immunohistochemical studies were essential

Caso Clínico: Metástasis Tumoral a Tumor- Un Raro Fenómeno / Clinical Case: Tumor to Tumor Metastasis - A Rare Phenomenon

Introducción: La metástasis tumor a tumor es muy rara con menos de 50 casos descritos en la literatura. Este artículo informa de un caso de metástasis de cáncer de mama en un tumor renal de células claras. Caso clínico: El caso corresponde a una mujer de 61 años de edad con antecedente de cáncer de mama, libre de enfermedad por 23 años. Por control, se solicita Tomografía computarizada (TC) simple y contrastada observándose a nivel de pelvis renal izquierda imagen nodular hipercaptante heterogénea de 2.4 cm, de bordes definidos, no infiltrante a tejidos adyacentes. Evolución: por localización de lesión, la paciente fue sometida a nefrectomía radical izquierda. El examen patológico demostró un carcinoma de mama metastásico de 3 mm, mal definido, dentro de un carcinoma de células renales claras de 2,5x2x2cm. Desenlace: continúa en seguimiento por consulta externa de oncología clínica. Conclusión: Este caso pone de relieve la importancia de los antecedentes previos de neoplasia maligna de un paciente, así como del muestreo adecuado de las neoplasias renales

Introduction: Tumor to tumor metastasis is very rare with less than 50 cases described in the literature. This article reports a case of breast cancer metastasis in a clear cell renal tumor. Clinical case: The case corresponds to a 61-year-old woman with a history of breast cancer, disease free for 23 years. For control, simple and contrasted computed tomography (CT) is requested, observing at the level of the left renal pelvis, a heterogeneous hypercapting nodular image of 2.4 cm, with defined edges, not infiltrating adjacenttissues. Evolution: Due to the location of the lesion, the patient was subjected to left radical nephrectomy. The pathological examination showed a poorly defined 3 mm metastatic breast carcinoma within a clear renal cell carcinoma of 2.5x2x2cm. Outcome: the patient continues to be followed by an outpatient clinic for clinical oncology. Conclusion: This case highlights the importance of a patient's previous history of malignancy, as well as adequate sampling of renal neoplasms

Effect of simultaneous integrated boost intensity-modulated radiation therapy in the treatment of multiple metastasis tumor of brain / 新乡医学院学报

Objective To investigate the clinical effect of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)and whole brain radiation therapy (WBRT) plus sequential boost conformal radiation therapy (SBCRT) in the treatment of multiple metastasis tumor of brain.Methods A total of 98 patients with multiple metastasis tumor of brain in the Radiation Oncology Center of the First Affiliated Hospital of Xinxiang Medical University from August 2014 to July 2015 were divided into observation group (n =60) and control group (n =38) according to the treatment plan.The patients in the observation group were treated with SIB-IMRT,the whole brain planned target dose was 2 Gy every time,and the target dose of the metastatic target volume was 3 Gy every time for 20 times (5 times weekly).The patients in the control group received WBRT plus SBCRT,the WBRT dose was 3 Gy every time for 10 times(5 times weekly),then the metastatic tumor target area was treated with SBCRT,the prescribed dose was 3 Gy every time for 10 times.All patients were followed up from the end of treatment to December 2016.The effective rate,disease control rate and one-year survival rate were compared between the two groups.Results The patients in the two groups were successfully treated with radiotherapy.Ninety patients were followed up,eight patients were lost to follow-up,the follow-up rate was 91.8％ (90/98).The effective rate,disease control rate and oneyear survival rate in the observation group were significantly higher than those in the control group (x2 =5.371,4.352,6.002;P ＜ 0.05).The median progression free survival time in the observation group was significantly longer than that in the control group (x2 =6.537,P ＜ 0.05).There were no significant differences in the incidence of bone marrow suppression,digestive system reaction and nervous system damage between the two groups (x2 =1.821,2.032,3.782;P ＞ 0.05).Conclusion SIB-IMRT can improve the effective rate,disease control rate and one-year survival rate of patients with multiple metastasis tumor of brain.

Tumor de Krukenberg del ovario asociado a teratoma maduro / Krukenberg tumor of the ovary associated with mature teratoma

Se reporta un caso excepcional de tumor de Krukenberg ovárico bilateral asociado a teratoma maduro encontrado en una mujer de 54 años. La ecografía mostró al lado derecho tumor ovárico sólido de 55 mm y al lado izquierdo tumor quístico de 125 mm. Se realizó histerectomía total, salpingooforectomía bilateral, resección del epiplón mayor y muestras peritoneales. Al tercer día postcirugía, la paciente presentó signos de tromboembolismo pulmonar masivo y aunque recibió terapia anticoagulante falleció al quinto día postoperatorio. El estudio histológico mostró infiltración masiva de carcinoma de células en anillo positivas para citoqueratina en ambos ovarios. El ovario derecho mostró la forma sólida clásica del tumor de Krukenberg mientras que el ovario izquierdo correspondió a un quiste dermoide con infiltración tumoral de carcinoma de células en anillo en la pared.

An exceptional case of bilateral Krukenberg tumor of the ovary associated with mature teratoma presented in a 54 years old patient is reported. The ultrasound showed a 55 mm solid right ovarian tumor and a 125 mm left cystic ovarian tumor. Hysterectomy and bilateral salpingoophorectomy was performed including omental resection and peritoneal biopsies. Massive pulmonary embolism was detected in the third day after the surgery. Even anticoagulant therapy was established the patient died in the fifth postoperative day. The histological study revealed massive infiltration of signet ring cell carcinoma with positive expression for cytokeratin in both ovaries. The right ovary showed the classical solid form of the tumor. The left ovary was a dermoid cyst with signet ring cell carcinoma infiltrating the cystic wall.

Research progress on peritumoral edema-related molecular biology factors of the metastasis tumor of brain / 中国肿瘤临床

Peritumoral edema (PTE) of the metastasis tumor of brain (MTB) refers to the abnormal increase of moisture in the surrounding cerebral parenchyma of the brain tumor. The mechanism of PTE occurrence of MTB is complicated, and the influencing factors are diverse. PTE is one of the key factors that affect patient survival and cure. Researchers from China and overseas believe that it may be related to the expression of the vascular endothelial growth factor (VEGF) or VEGF receptor, aquaporin-4 (AQP-4), matrix metalloproteinase-9, interleukin-6, hypoxia inducible factor-1a, and other molecular biology factors. Studies of these molecular biologi-cal factors provide objective scientific evidence for the prevention, control, monitoring, treatment, and prognosis of PTE of metasta-sized brain tumor. In addition to the traditional dehydration therapy of PTE, the use of PTE-related molecular biological factors pro-vides a new approach for the treatment. AQP-4 agonists or antagonists and VEGF receptor antagonists also have good therapeutic poten-tials. In this paper, the authors reviewed the PTE-related molecular biological factors of MTB.

Clinical evaluation of high viscosity bone cement in percutaneous vertebroplasty / 重庆医学

Objective To investigate the effect of high viscosity bone cement in percutaneous vertebroplasty to treat osteoporotic vertebral compression fracture(OVCF) and veterbral metastasis tumor(VMT) .Methods 102 cases of OVCF(OVCF group) and 16 cases of VMT(VMT group) in our hospital from March 2010 to December 2012 were performed percutaneous vertebroplasty under local anesthesia ,through the vertebral pedicle approach by conducting puncture at bilateral vertebral pedicle into the vertebra , 3-6 mL high viscosity bone cement was injected to each vertebra .The pain intensity was detected by the McGill pain questionnaire score before operation ,on postoperative 3 d ,1 month and 6 -18 months last follow-up .The preoperative and postoperative MPQ scores were statistically analyzed .Results Postoperative patients′s back pain was significantly alleviated or disappeared .Compared with before operation ,the MPQ scores on postoperative 3 d ,in 1 month and 6 -18 months last follow-up in the OVCF group and the VMT group were significantly decreased(P<0 .05) .The postoperative CT scanning revealed that the cement leakage rates in the OVCF group and the VM T group were 11 .76% and 6 .25% respectively .But no complications of bone cement toxicity ,pulmo-nary embolism ,infection and nerve damage occurred .Conclusion High viscosity bone cement injection has the advantages of strongly controllable injection due to high viscosity ,low bone cement leakage and high surgical safety ,which is suitable for the treatment of OVCF and VM T .

Retrospective analysis of ~(89)Sr metastron treating 83 cases of multiple osseous metastasis tumor / 第三军医大学学报

Objective To evaluate the therapeutic effect and side effects of 89Sr metastron on treating multiple osseous metastasis tumor. Methods The total 83 patients had been treated by intravenously injecting 89Sr metastron at a dose of 2.22 MBq/kg. Results Among 83 cases, 31.3% of them got complete remission, 37.3% moderate remission, and 18.1% slight remission. The total effective rate was 86.7%. The side effects were mild, and only white blood cells and platelets transiently fell by 20%. Conclusion Internal radiotherapy with 89Sr metastron is the good alternative in treating multiple osseous metastasis tumor.

Treatment of Secondary Metastatic Hepatocarcinoma / 中国医师杂志

Objective To explore the values of various surgical techniques in the treatment of secondary hepatocarcinoma.Methods One hundred thirty-four patients with secondary hepatocarcinoma were respectively divided into three groups,hepatectomy(group Ⅰ), other surgical treatments(group Ⅱ) and chemotherapy or/and interventional therapy(group Ⅲ). Retrospective analysis was performed to all patients above mentioned.The three groups were compared each other for survival rate.Results The survival rate among three groups was significantly different.There was a higher survival rate in hepatectomy group.Conclusions Hepatectomy is the most effective method to cure secondary hepatocarcinoma.

Clinical study of paclitaxel combined with cisplatin in treatment of pulmonary metastasis tumor / 重庆医科大学学报

Objective:To evaluate the effect and toxic side-effect of paclitaxel combined with cisplatin(TP regiment) chemotherapy in treatment of pulmonary metastasis tumor.Methods:Forty tumor patients with pulmonary metastasis accepted chemotherapy by paclitaxel 135mg/m~2 infusion intravenous on d1,and cisplatin 25mg/m~2 daily on d2～4.Each treatment cycle was four weeks.Each patient received more than 2 courses of treatment.Results:In 40 patients,7 were with complete response (17.5%)and 18 were with partial response(45%),the complete remission and partial remission(CR+PR)was 62.5%;The disease kept stable in 11 case(27.5%)and progressed in 4 case(10%).The median time to tumor progression was 6.0months, and the median actuarial survival was10.0 months.The most common toxic side-effects were myelosuppression and alopecia. Conclusion:The combined chemotherapy of paclitaxel and cisplatin is good short-term efficacy in treatment of pulmonary metastasis tumor.The toxic side-effects are tolerable and mild.