The thyroid gland is a rare site of clinically detectable tumor metastasis and kidneys are frequently the site of the parent malignancy. In the present review on thyroid metastases from renal cell carcinoma, cases were searched on PubMed by entering the strings: “renal carcinoma [or“hypernephroma”] AND thyroid metastasis/metastases”. Thus, we retrieved a total of 111 cases that were published between 1964 and 2007, a total that became 113 by adding two patients observed by us. The female to male ratio was 1.35:1. The primary renal cancer was almost always unilateral (90%) (with no significant side preference) and only rarely bilateral (9% in men, 4% in women), whereas bilaterality of thyroid metastases was relatively more frequent (28%). Thyroid metastasis from renal cancer was commonly single with a unique node that appears solid and hypoechoic at ultrasonography, approximately 9 years after nephrectomy. Concordance of lateralization was insignificantly greater for the right kidney/right thyroid lobe pattern (54%) than for the left kidney/left thyroid lobe pattern (40%), regardless of gender. Finally, survival was longer for women. Thyroid metastases, even if rare in the clinical practice, must be considered in the differential diagnosis of a thyroid nodule, particularly in patients who have a history of malignancies.
Abstract. Somatostatin anti-proliferative and anti-angiogenic activities, together with the expression of somatostatin receptors (sstrs), account for the use of somatostatin analogues in the treatment of human tumours. In the present study, sstr2A immunohistochemical expression was analyzed in grade II and III meningiomas and was compared with that revealed in grade I meningiomas. Thirty-five formalin-fixed paraffinembedded meningiomas, comprising 13 grade I, 19 grade II and 3 grade III tumours, according to the WHO 2007 classification, were submitted to immunohistochemical assays for sstr2A. Moreover, in the same cohort of tumours, the immunoexpression of CD105, a specific marker for neoangiogenesis, as well as the Ki-67 labelling index (LI), reflecting the proliferative activity of the meningiomas, were recorded. Sstr2A immunoreaction was evidenced in 26/35 cases and was localized at the cytoplasm and the plasma membrane in 12 and in 14 cases, respectively. Specifically, a positive staining was found in 7/13 grade I, in 16/19 grade II and in 3/3 grade III tumours, thus demonstrating that sstr2A is frequently expressed in high grade meningiomas. A significantly higher microvessel density (MVD), assessed by CD105 immunostaining and Ki-67 LI were evidenced in high grade meningiomas. A significant correlation was recorded between sstr2A expression and a high MVD of the meningiomas. The existence of a correlation between sstr2A expression and the entity of neo-angiogenesis provides the basis for the use of somatostatin analogue-based therapies in the treatment of meningiomas.
According to the ToGA trial, HER2 has been shown to be predictive for the success of treatment with trastuzumab in advanced gastric cancer (AGC). A number of studies have analyzed HER-2/neu overexpression in gastric carcinoma and identified the rate of HER2 positivity to be markedly varied. To date, the prevalence of HER2 overexpression in Sicilian people with AGC is unknown. Therefore, in the present study, a retrospective immunohistochemical analysis of HER2 was performed in a cohort of 304 AGC samples that were obtained from the archives of 10 Sicilian anatomopathological diagnostic units in order to verify the positive rate of HER2-positive cases. Furthermore, the characteristics of histotype, grade, stage and Ki-67 expression were also analyzed. HER2 overexpression was encountered in 17.43% of all the gastric adenocarcinomas, which was consistent with the results that have been reported elsewhere in the literature. A progressive increase in HER2 overexpression was observed, from the poorly cohesive histotype to the tubular adenocarcinomas and gastric hepatoid adenocarcinomas. HER2 overexpression was significantly associated with a high grade, advanced stage and high Ki-67 labeling index. Further investigations performed jointly by pathologists and oncologists within the geographical area of the present study should confirm that the association of trastuzumab with chemotherapy results in an improvement of survival in patients with AGC.
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