Metastatic pulmonary adenocarcinoma to placenta and pleural fluid: clinicopathologic findings.

OBJECTIVES: To report the clinicopathologic findings of a pregnant woman with Stage IV adenocarcinoma of the lung with placental metastasis. MATERIALS AND METHODS: Medical records review. RESULTS: A 31-year-old G(2)P(1001) woman was diagnosed with Stage IV metastatic adenocarcinoma of the lung. At 34 weeks' and 2 days' gestation, she went into preterm labor and delivered a live male infant, weighing 2595 grams, with Apgar scores of 9 and 9, respectively. Placental pathology was significant for adenocarcinoma with a solid and acinar pattern, consistent with that from the lung. Her postpartum course was uneventful. She did not receive chemotherapy and expired one month postpartum. To date, the infant is without evidence of disease. CONCLUSIONS: The occurance of lung cancer in pregnancy is rare and a few cases have been reported in literature. Placental metastasis is extremely uncommon in these cases and can lead to fetal involvement by lung tumor. It is important to report all cases of lung cancer occurring in pregnancy with subsequent close clinical surveillance of the infant as all cases have a different clinical picture.

Delayed harvesting of sentinel lymph nodes after previous wide local excision of extremity melanoma.

BACKGROUND: Harvesting the sentinel lymph node (SLN) is important in the management of patients with primary cutaneous melanoma. Selective sentinel lymphadenectomy (SSL) is generally performed at the time of wide local excision (WLE). The aim of our study was to determine whether delayed SSL is useful in detecting micrometastasis to the regional basin in patients with previous WLE of an extremity melanoma. METHODS: Of 203 patients with a primary melanoma site located on the upper or lower extremity seen at the University of California, San Francisco/Mount Zion Melanoma Center from May 17, 1994, to March 23, 1999, 24 patients had a WLE of their extremity melanoma with adequate margins before referral. SSL was performed to assess micrometastasis in the regional lymph node basin after preoperative lymphoscintigraphy. RESULTS: At least 1 SLN was identified in all 24 patients. At a median follow-up of 3 years, two patients showed micrometastasis in the SLNs. One of these two patients developed recurrence, and all remaining patients showed no evidence of disease. CONCLUSIONS: Although it is generally advised that WLE should be performed simultaneously with SSL, delayed SSL after WLE of an extremity melanoma can still provide valuable staging information, which is critical for management of the patient.