Tumor-to-tumor metastasis from lung cancer: a clinicopathological postmortem study

Abstract

This study examined 47 cases of lung cancer concomitant with other tumors and found eight cases (17 %) with nine foci of tumor-to-tumor metastasis, defined as metastasis of lung cancer into another tumor. Donor lung cancers were four adenocarcinomas, two squamous cell carcinomas, and two small cell carcinomas. Tumor-to-tumor metastasis was found in five of six renal cell carcinomas (83 %), one of eight thyroid papillary carcinomas (13 %), one of three adrenocortical adenomas (33 %), one of three pancreatic endocrine microadenomas (33 %), and another lung cancer (one of six cases of multiple lung cancers, 17 %). The higher recipient incidence in renal cell carcinoma was statistically significant compared with prostatic carcinoma (0/16, P < 0.001), colorectal carcinoma (0/7, P = 0.005), and gastric carcinoma (0/5, P = 0.015). Generalized metastases were found in 88 % of the tumor-to-tumor metastasis cases. The total clinical course of patients with tumor-to-tumor metastasis was shorter than that of the patients without tumor-to-tumor metastasis (mean, 5.4 versus 18.8 months; P = 0.046). Tumor-to-tumor metastasis sometimes mimicked undifferentiated recipient tumor cells. Immunostains for thyroid transcription factor 1 (TTF-1), Napsin A, cytokeratin 7 (CK7), and CK5/6 were useful to confirm tumor-to-tumor metastasis. However, TTF-1-, Napsin A-, and/or CK7-negative lung adenocarcinoma components metastasized to renal cell carcinoma in three cases, and recipient renal cell carcinomas were focally Napsin A+ (two cases) or CK7+ (two cases). Tumor-to-tumor metastasis can occur as a result of metastasis from lung cancer with more aggressive behavior. Tumor-to-tumor metastasis should be carefully distinguished from undifferentiated recipient tumor cells.

Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

“…MTC is a relatively rare type of primary thyroid carcinoma, accounting for only about 5% of all thyroid carcinomas. The majority of previously reported recipient primary thyroid carcinomas were PTC, including FVPTC (12 among 14 cases) (1, 2, 3, 5, 6, 7, 9, 11). The other two cases were oncocytic/hurthle cell carcinomas (4, 8).…”

“…Fourteen cases of metastatic tumor to the primary thyroid carcinoma have been reported previously in the literature. The majority of reported primary thyroid carcinomas were papillary thyroid carcinoma (PTC), including follicular variant papillary thyroid carcinoma (FVPTC) (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11). To our knowledge, there has been no reported case of a tumor metastasizing to medullary thyroid carcinoma (MTC).…”

Unusual imaging of pancreatic metastasis: A case report of tumor-to-tumor metastasis

“…Matsukuma investigating 47 autopsy cases of lung cancer concomitant with other tumors found tumorto-tumor metastasis in only one pancreatic endocrine microadenoma [7].…”

“…Several authors have reported in literature lung cancer is the most common donor tumor, whereas RCC is the most common recipient [5][6][7][8][9]. The reason for tumor-to-tumor metastasis favoring specific tumors is still unknown.…”

“…The reason for tumor-to-tumor metastasis favoring specific tumors is still unknown. The RCC's rich vascularity, high content of glycogen and lipid, tendency to be localized without infiltration or metastasis could explain its favorable environment for receiving metastases from other cancers [6,7,9].…”