Breast metastasis of gastric signet-ring cell carcinoma

Wei, Liyuan; Kong, Mei; Zhang, Zhen; Zhang, Xiaochen

doi:10.1631/jzus.b1700159

Cited by 12 publications

(18 citation statements)

References 17 publications

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“…Most patients survive less than one year after the diagnosis of breast metastasis 1 . Systemic treatments include neoadjuvant chemotherapy appropriate for the primary tumor and curative or palliative surgery for the primary cancer or breast metastasis 17 . There is no survival gain with breast surgery, but it can alleviate symptoms in some cases 18,19 .…”

Section: Results Antibody Resultsmentioning

confidence: 99%

Breast metastasis of gastric signet ring cell carcinoma mimicking breast lymphangitic carcinomatosis

Andrade¹,

Buzzellin²,

Cançado³

et al. 2019

Mastology

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Introdução: A incidência de metástase mamária de adenocarcinoma gástrico é extremamente baixa. De 1908 até o momento, 44 casos foram relatados na literatura, dos quais 30 são do tipo em anel de sinete. Relato do caso: Paciente de 49 anos em propedêutica de sangramento digestivo alto. Apresentava linfadenomegalia axilar esquerda, associada a assimetria mamária, edema e espessamento de pele. Ultrassonografia mamária evidenciou lesão heterogênea em mama esquerda. Histologia de core biopsy da área compatível com adenocarcinoma gástrico tipo difuso de Lauren, com células em anel de sinete. Imuno-histoquímica positiva para pancitoqueratinas CK7, CK20, CDX2 e negativa para RE, RP e ERB2. Achados compatíveis com adenocarcinoma gástrico (embolia linfática), favorecendo a possibilidade de neoplasia secundária. Ao momento do diagnóstico, a paciente já apresentava sinais radiológicos de múltiplas metástases. Discussão: As metástases mamárias do carcinoma gástrico diferem do câncer de mama primário nas características histopatológicas. As manifestações clínicas das metástases de câncer gástrico são variadas, mas é sabido que há tendência maior de alterações inflamatórias que nos tumores primários. No processo metastático, o envolvimento mamário pode ser o primeiro evento ou ocorrer em um contexto polimetastático. A maioria dos pacientes tem sobrevida inferior a RESUMO ABSTRACT Introduction: The incidence of breast metastasis from gastric adenocarcinoma is extremely low. Since 1908, 44 cases have been reported in the literature, of which 30 are signet ring cell type. Case report: A 49-year-old patient being investigated for digestive bleeding was found to have left axillary lymphadenopathy, associated with breast asymmetry, associated with breast asymmetry, edema and thickening of the skin. Breast ultrasonography showed a heterogeneous lesion in the left breast. Core biopsy histology was compatible with Lauren diffuse gastric adenocarcinoma with signet ring cells. There was positive immunohistochemical staining for CK7, CK20 and CDX2 and negative for RE, RP and ERB2. Our findings were compatible with gastric adenocarcinoma (lymphatic embolism), favoring the possibility of a secondary neoplasm. At the time of diagnosis, the patient already had radiological signs of multiple metastases. Discussion: Breast metastases of gastric carcinoma differ from primary breast cancer in histopathological features. The clinical manifestations of gastric cancer metastasis vary, but it is known that there is a greater tendency for inflammatory disorders compared to primary tumors. In the metastatic process, breast involvement may be the first event or occur in a context of multiple metastases. Most patients have a one-year survival after diagnosis. There is no gain in survival with breast surgery, but it can alleviate the symptoms in some cases. Conclusion: Gastric cancer with breast metastasis is a rare condition associated with poor prognosis. The diagnosis is based on clinical history, histological findings and immunohistochemical markers, di...

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Section: Results Antibody Resultsmentioning

confidence: 99%

Breast metastasis of gastric signet ring cell carcinoma mimicking breast lymphangitic carcinomatosis

Andrade¹,

Buzzellin²,

Cançado³

et al. 2019

Mastology

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“…A further key point in the literature is that a milieu rich in estrogen and estrogen receptors promotes tumorigenesis and the formation of metastatic lesions in gastric cancer patients. As a result, the mammary gland is susceptible to the malignant properties of this cancer [44]. Moreover, germline mutations in the CDH1 gene that cause hereditary diffuse gastric cancer syndrome (HDGC) are also found in 0.7% of women with breast cancer, suggesting that there is an inherited correlation between diffuse gastric and breast cancers, mainly those of the lobular type [45].…”

Section: Clinical Examplesmentioning

confidence: 99%

“…Imaging studies show that when the metastatic focus is a mass, mammography findings generally show a round lesion with well-defined margins. These masses can present as benign lesions; however, ill-defined margins may also be evident ( Case 11 , Figures 11(a)–11(f) ) [41, 44]. Conversely, only a few cases of microcalcifications associated with breast metastases that arise from gastric cancer are reported in the literature [46].…”

Section: Clinical Examplesmentioning

confidence: 99%

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A Case Series of Breast Metastases from Different Extramammary Malignancies and Their Literature Review

Moreno-Astudillo

Villaseñor‐Navarro

Sánchez-Goytia

et al. 2019

Case Reports in Radiology

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Metastasis to the breast from all other primary sites is unusual. Twelve patients were diagnosed between 2007 and 2017 at National Cancer Institute, Mexico. Solitary or multiple masses, round or oval, and hypoechoic and solid lesions with posterior acoustic shadowing were patterns commonly reported in these patients; other arrangements include diffuse involvement of the breast simulating an inflammatory carcinoma. The development of a breast metastasis is revealed, in our experience, as a negative prognostic factor. Thus, the radiologist should know about the varied appearance of metastatic breast lesions and provide radiopathological correlations when available.

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“…The R26hAR L/wt : p16 L/L : PB-Cre4 compound mice revealed an earlier onset of PIN as well as prostatic carcinomas. Moreover, we identified a rare form of highly malignant tumor, sarcomatoid carcinoma with signet ring cell carcinoma (SRCC) in R26hAR L/wt : p16 L/L : PB-Cre4 compound mice [29–31]. These results not only implicate a biological role for transgenic AR expression and p16 Ink4a deletion in the pathogenesis of prostatic SRCC but also provide a new and unique GEM model for investigating the molecular mechanisms for SRCC development.…”

Section: Introductionmentioning

confidence: 97%

Deletion of the p16INK4a tumor suppressor and expression of the androgen receptor induce sarcomatoid carcinomas with signet ring cells in the mouse prostate

Lee

Aldahl

et al. 2019

PLoS ONE

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The tumor suppressor p16Ink4a, encoded by the INK4a gene, is an inhibitor of cyclin D-dependent kinases 4 and 6, CDK4 and CDK6. This inhibition prevents the phosphorylation of the retinoblastoma protein (pRb), resulting in cellular senescence through inhibition of E2F-mediated transcription of S phase genes required for cell proliferation. The p16Ink4a plays an important role in tumor suppression, whereby its deletion, mutation, or epigenetic silencing is a frequently observed genetic alteration in prostate cancer. To assess its roles and related molecular mechanisms in prostate cancer initiation and progression, we generated a mouse model with conditional deletion of p16Ink4a in prostatic luminal epithelium. The mice underwent oncogenic transformation and developed prostatic intraepithelial neoplasia (PIN) from eight months of age, but failed to develop prostatic tumors. Given the prevalence of aberrant androgen signaling pathways in prostate cancer initiation and progression, we then generated R26hARL/wt:p16L/L: PB-Cre4 compound mice, in which conditional expression of the human AR transgene and deletion of p16Ink4a co-occur in prostatic luminal epithelial cells. While R26hARL/wt:PB-Cre4 mice showed no visible pathological changes, R26hARL/wt:p16L/L: PB-Cre4 compound mice displayed an early onset of high-grade PIN (HGPIN), prostatic carcinoma, and metastatic lesions. Strikingly, we observed tumors resembling human sarcomatoid carcinoma with intermixed focal regions of signet ring cell carcinoma (SRCC) in the prostates of the compound mice. Further characterization of these tumors showed they were of luminal epithelial cell origin, and featured characteristics of epithelial to mesenchymal transition (EMT) with enhanced proliferative and invasive capabilities. Our results not only implicate a biological role for AR expression and p16Ink4a deletion in the pathogenesis of prostatic SRCC, but also provide a new and unique genetically engineered mouse (GEM) model for investigating the molecular mechanisms for SRCC development.

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Breast metastasis of gastric signet-ring cell carcinoma

Cited by 12 publications

References 17 publications

Breast metastasis of gastric signet ring cell carcinoma mimicking breast lymphangitic carcinomatosis

Breast metastasis of gastric signet ring cell carcinoma mimicking breast lymphangitic carcinomatosis

A Case Series of Breast Metastases from Different Extramammary Malignancies and Their Literature Review

Deletion of the p16INK4a tumor suppressor and expression of the androgen receptor induce sarcomatoid carcinomas with signet ring cells in the mouse prostate

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