Primary lesions that may imitate metastatic tumors histologically: A selective review

Wick, Mark R.

doi:10.1053/j.semdp.2017.11.010

Cited by 11 publications

(5 citation statements)

References 226 publications

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“…Thus, in EBV-negative LECSG, the lack of lymphoid infiltrate would help make this distinction, a challenge if reviewing only core needle samples. Metastatic melanoma is non-cohesive, but will be reactive with various melanocytic markers [67][68][69].…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Carcinoma of Salivary Gland EBV-association in Endemic versus Non-Endemic Patients: A Report of 16 Cases

Whaley

Carlos²,

Bishop

et al. 2020

Head and Neck Pathol

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Lymphoepithelial carcinoma of salivary glands (LECSG) are rare neoplasms, reported in endemic populations (southeastern Chinese) with a strong Epstein-Barr virus (EBV) association. A retrospective series comparing EBV status within an ethnically diverse population (endemic vs. non-endemic patients) has not been reported. Sixteen LECSG were equally distributed between males (n = 8) and females (n = 8) with a median age of 54 years (range 18 to 85 years) at initial diagnosis. Ten patients were white, 4 Asian, and 2 black. The patients typically presented with swelling or mass for an average of 11.6 months. Tumors affected only major salivary glands: parotid (n = 13); submandibular (n = 3). Tumors were an average of 2.9 cm (range 1.5 to 5.8 cm). Nine of 16 (56%) patients had cervical lymph node metastases at presentation. No patients had nasopharyngeal or oropharyngeal tumors. Microscopically, the tumors were widely infiltrative, characterized by large polygonal to spindled cells arranged in a syncytial, lattice-like network in a background of lymphoplasmacytic cells. The neoplastic cells showed an open-vesicular nuclear chromatin to a more basaloid-morphology, the latter showing hyperchromatic nuclei and less cytoplasm, while nearly all of the cases had associated lymphoepithelial lesions/sialadenitis. By in situ hybridization, 8 of 16 cases had a strong, diffuse EBER expression (4 of 4 Asians; 4 of 12 non-Asians), while with immunohistochemistry all cases tested were pan-cytokeratin, CK5/6 and p63 reactive; none of the cases tested were p16 reactive. All patients were managed with wide or radical excision, 4 with concurrent chemoradiation, and 6 with radiation alone. Distant metastasis (lung, brain, and bone) developed in 2 patients. Overall follow-up (mean 3.8 years) revealed 12 patients alive and 2 dead, none with evidence of disease (mean 4.3 years); one white male alive with disease at 1.9 years, and one Asian female dead of disease at 4.2 years; both of these latter patients had Group IV stage disease. High stage (Group IV) patients had a shorter mean survival than lower stage patients: 3.1 versus 4.8 years, respectively. In conclusion, LECSG are uncommon primary neoplasms. Concurrent lymphoepithelial lesions may help suggest a primary tumor. The tumors, irrespective of race or ethnicity, may express EBER. There is an overall good survival, perhaps better for EBV-negative patients and for those with lower stage disease.

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Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Carcinoma of Salivary Gland EBV-association in Endemic versus Non-Endemic Patients: A Report of 16 Cases

Whaley

Carlos²,

Bishop

et al. 2020

Head and Neck Pathol

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“…Most cases of cutaneous metastases are indicative of extensive spreading of the disease and death with worse prognosis [9]. The factor that influences the survival is the time elapsed between diagnosis and the occurrence of the cutaneous metastases.…”

Section: Discussionmentioning

confidence: 99%

Multiple skin metastases in a patient with acute myelomonocytic leukemia

Daye¹

2019

Our Dermatol Online

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Metastatic skin tumors may occur before or at any time before the diagnosis of malignancy. Skin metastases are thought to be indicative of advanced stage malignancy or non-treatment response. Cutaneous metastases are a worse prognostic mark, especially in patients with cancer of the lung, ovary, upper respiratory tract, or upper digestive tract. Acute myelomonocytic leukemia is a malignant-hematopoietic clonal sickness of bone marrow and disrupts production of normal blood cells. Although there are many and various dermatological findings in acute leukemia, they are mostly due to cytopenia and haemostasis disorders and skin metastasis is not frequent. Here, we present a case of skin involvement with a diagnosis of acute myelomonocytic leukemia, which is uncommon in the literature and nodules on the whole body.

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“…It is also compatible with the literature data. A study of 1.227 patients has proven that survival of 5 years is greater in patients with performed resection of the tumour formation in healthy tissue, compared to the definite radiotherapy of the disease [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The disease usually metastasises in the local lymph nodes, but there are also cases of pleural metastases. [ 10 ] Immunohistochemical analysis of a section stained with hematoxylin and eosin indicates tumour cells with infiltrative growth and hyperchromatic nuclei that have been positive for CK20, CD56, chromogranin and synaptophysin [ 11 ]. Survival at 5 years is 51% for local disease and is low as 14% for distant disease, which underscores the aggressive nature of this tumour and challenges in management [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of a Patient with Merkel Cell Skin Carcinoma Using Radiation Therapy - A Case Report

Petrov¹,

Kraleva²,

Kubelka-Sabit³

et al. 2018

Open Access Maced J Med Sci

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BACKGROUND:Merkel cell carcinoma (MCC) is a rare, very aggressive tumour. The pathogenesis remains unclear, but UV radiation, immunosuppression, and the presence of Merkel cell polyomavirus in the tumour genome appear to have a key role. Merkel cell carcinoma is a highly aggressive tumour that often has a lethal end.CAS REPORT:A patient at 93 years of age comes for an examination by a dermatologist due to a rapidly growing nodular tumour growth in the forehead area. A tumour was about 3 cm in size. It had no signs of basal-cell carcinoma, no arborising vascularisation, no pigmentations on dermoscopy. Clinically, an eventual Merkel cell carcinoma was considered for the patient, but other primary skin tumours had to be excluded, as well as the possibility that regarding the patient’s age, it may be a metastatic deposit. A skin biopsy was performed, as well as H-E examination and immunohistochemical analyses (positive CD56, positivity of neuroendocrine markers synaptophysin, chromogranin) which were in favour of Merkel cell carcinoma of the skin. After setting the diagnosis, our patient was treated with therapy which led to a complete withdrawal of a tumour. However, after 3 months the patient had repeated relapse of a tumour at the same site on the forehead and metastases in the retroauricular lymph nodes bilaterally. It shows that the radiotherapy as monotherapy has a great effect on the removal of the tumour formation, but unfortunately, it has no impact on lesion recurrence. It is also compatible with the literature data.CONCLUSION:In many adult patients, as our case suggests, radiotherapy could be a good palliative treatment opportunity that should be considered, as well as a combination of radiation therapy with other oncologic therapeutic options.

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Primary lesions that may imitate metastatic tumors histologically: A selective review

Cited by 11 publications

References 226 publications

Lymphoepithelial Carcinoma of Salivary Gland EBV-association in Endemic versus Non-Endemic Patients: A Report of 16 Cases

Lymphoepithelial Carcinoma of Salivary Gland EBV-association in Endemic versus Non-Endemic Patients: A Report of 16 Cases

Multiple skin metastases in a patient with acute myelomonocytic leukemia

Treatment of a Patient with Merkel Cell Skin Carcinoma Using Radiation Therapy - A Case Report

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