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Concurrent diagnosis of pulmonary metastasis of malignant mixed müllerian tumor and small cell lung cancer.

Lee YJ, Jung EJ, Lee SH, Lee YM, Kim B, Choi SJ, Jeong DH, Lee HK - Tuberc Respir Dis (Seoul) (2012)

Bottom Line: Rarely, metastatic cancer can coexist with primary.We experienced a case of concurrent diagnosis of primary small cell lung cancer and pulmonary metastasis of uterine malignant mixed Müllerian tumor (MMMT).We suggest that we have to consider the possible presence of concomitant malignancies of different origins in one organ especially with patients who had a history of malignancy in another organ.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonology, Department of Internal Medicine, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
A patient who has multiple lung masses with a history of malignancy in organs other than the lung is more likely to be diagnosed with metastatic rather than primary lung cancer. Rarely, metastatic cancer can coexist with primary. We experienced a case of concurrent diagnosis of primary small cell lung cancer and pulmonary metastasis of uterine malignant mixed Müllerian tumor (MMMT). The patient was a 52-year-old female with femur fracture and multiple lung masses with a history of an operation for uterine MMMT. The small cell lung cancer was diagnosed by bronchoscopic biopsy. The central lung mass decreased after chemotherapy for small cell lung cancer but multiple peripheral masses increased. A percutaneous biopsy for one of peripheral masses revealed metastatic uterine MMMT. We suggest that we have to consider the possible presence of concomitant malignancies of different origins in one organ especially with patients who had a history of malignancy in another organ.

No MeSH data available.


Related in: MedlinePlus

The computed tomography after two cycles of chemotherapy. (A) The mediastinal mass decreased (arrow). (B) The pleural based mass on left lower lobe increased markedly (arrow). Compare with pictures in Figure 2.
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Figure 5: The computed tomography after two cycles of chemotherapy. (A) The mediastinal mass decreased (arrow). (B) The pleural based mass on left lower lobe increased markedly (arrow). Compare with pictures in Figure 2.

Mentions: She had a history of total hysterectomy for uterine MMMT (Figure 3) one and a half years ago. Multiple pelvic lymph node enlargements were found 6 months later and a recurrence of MMMT was confirmed by surgical biopsy. At that time, there was no small cell carcinoma component in uterine cancer pathologically. No further treatment for MMMT was given to her. Based on her past history, we initially suspected lung and femur metastases of MMMT. The protruding mass lesion on the orifice of the left lower lobe basal segment was found and biopsied by the bronchoscopy. However, the pathologic features of this mass was the typical small cell lung carcinoma (Figure 4) rather than metastatic MMMT from uterus. We assumed that all of these findings are attributable to small cell lung cancer, and we started the treatment accordingly. She was treated with etoposide plus cisplatin. Radiation was delivered to her femur for palliation of pain. After 2 cycles of chemotherapy, most lesions that were located relatively central (mediastinal lymph nodes and the mass around the left lower lobar bronchus) slightly decreased, but the most of peripheral masses increased (Figure 5). In the meantime, she had to undergo hemiarthroplasty of the left hip due to persistent pain. The pathologic finding of femur head was consistent with metastatic adenocarcinoma (Figure 6). It was possible that the metastases of carcinomatous component of MMMT probably appeared in the femur. After these observations, we had the percutaneous needle biopsy for the peripheral lung mass on the left lower lobe which showed rapid growing even after chemotherapy because we suspected the possible presences of both primary and metastatic lung cancers. The pathology revealed the metastasis of sarcomatous component of MMMT (Figure 7). This finding was coincident with the pathology of uterine cancer.


Concurrent diagnosis of pulmonary metastasis of malignant mixed müllerian tumor and small cell lung cancer.

Lee YJ, Jung EJ, Lee SH, Lee YM, Kim B, Choi SJ, Jeong DH, Lee HK - Tuberc Respir Dis (Seoul) (2012)

The computed tomography after two cycles of chemotherapy. (A) The mediastinal mass decreased (arrow). (B) The pleural based mass on left lower lobe increased markedly (arrow). Compare with pictures in Figure 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3475474&req=5

Figure 5: The computed tomography after two cycles of chemotherapy. (A) The mediastinal mass decreased (arrow). (B) The pleural based mass on left lower lobe increased markedly (arrow). Compare with pictures in Figure 2.
Mentions: She had a history of total hysterectomy for uterine MMMT (Figure 3) one and a half years ago. Multiple pelvic lymph node enlargements were found 6 months later and a recurrence of MMMT was confirmed by surgical biopsy. At that time, there was no small cell carcinoma component in uterine cancer pathologically. No further treatment for MMMT was given to her. Based on her past history, we initially suspected lung and femur metastases of MMMT. The protruding mass lesion on the orifice of the left lower lobe basal segment was found and biopsied by the bronchoscopy. However, the pathologic features of this mass was the typical small cell lung carcinoma (Figure 4) rather than metastatic MMMT from uterus. We assumed that all of these findings are attributable to small cell lung cancer, and we started the treatment accordingly. She was treated with etoposide plus cisplatin. Radiation was delivered to her femur for palliation of pain. After 2 cycles of chemotherapy, most lesions that were located relatively central (mediastinal lymph nodes and the mass around the left lower lobar bronchus) slightly decreased, but the most of peripheral masses increased (Figure 5). In the meantime, she had to undergo hemiarthroplasty of the left hip due to persistent pain. The pathologic finding of femur head was consistent with metastatic adenocarcinoma (Figure 6). It was possible that the metastases of carcinomatous component of MMMT probably appeared in the femur. After these observations, we had the percutaneous needle biopsy for the peripheral lung mass on the left lower lobe which showed rapid growing even after chemotherapy because we suspected the possible presences of both primary and metastatic lung cancers. The pathology revealed the metastasis of sarcomatous component of MMMT (Figure 7). This finding was coincident with the pathology of uterine cancer.

Bottom Line: Rarely, metastatic cancer can coexist with primary.We experienced a case of concurrent diagnosis of primary small cell lung cancer and pulmonary metastasis of uterine malignant mixed Müllerian tumor (MMMT).We suggest that we have to consider the possible presence of concomitant malignancies of different origins in one organ especially with patients who had a history of malignancy in another organ.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonology, Department of Internal Medicine, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
A patient who has multiple lung masses with a history of malignancy in organs other than the lung is more likely to be diagnosed with metastatic rather than primary lung cancer. Rarely, metastatic cancer can coexist with primary. We experienced a case of concurrent diagnosis of primary small cell lung cancer and pulmonary metastasis of uterine malignant mixed Müllerian tumor (MMMT). The patient was a 52-year-old female with femur fracture and multiple lung masses with a history of an operation for uterine MMMT. The small cell lung cancer was diagnosed by bronchoscopic biopsy. The central lung mass decreased after chemotherapy for small cell lung cancer but multiple peripheral masses increased. A percutaneous biopsy for one of peripheral masses revealed metastatic uterine MMMT. We suggest that we have to consider the possible presence of concomitant malignancies of different origins in one organ especially with patients who had a history of malignancy in another organ.

No MeSH data available.


Related in: MedlinePlus