Large Cell Neuroendocrine Carcinoma of the Ovary and its Skin Metastases: A case report and review of the literature Ovarian Large Cell Neuroendocrine Carcinoma

Cokmert, Suna; Demir, Lutfiye; Doğanay, Latife; Demir, Namık; Kocacelebi, Kenan; Unek, IT; Gezer, Emre; Kılıç, Koray; Alakavuklar, Mehmet

doi:10.7727/wimj.2014.010

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…Based on the site of the lesion, skin metastases are classified as metastatic umbilical tumors, which are known as Sister Joseph nodules (SJNs), and non-SJN skin metastases (Figure 1) (Tables S1–S4) [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58]. Skin metastases can further be divided according to the time of appearance: Skin metastases at initial diagnosis and skin recurrences.…”

Section: Patternsmentioning

confidence: 99%

Cutaneous Metastases in Ovarian Cancer

Otsuka

2019

Cancers

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Skin metastases in ovarian cancer are uncommon, but their incidence may be increasing due to improved survival rates. Skin metastases can be divided into umbilical metastases, which are known as Sister Joseph nodules (SJNs) and are associated with peritoneal metastasis, and non-SJN skin metastases, which usually develop within surgical scars and in the vicinity of superficial lymphadenopathy. As most skin metastases develop after specific conditions, recognition of preceding metastatic diseases and prior treatments is necessary for early diagnosis of skin lesions. The prognosis of skin metastases in ovarian cancer varies widely since they are heterogeneous in the site of lesion and the time of appearance. Patients with SJNs at initial diagnosis and patients with surgical scar recurrences without concomitant metastases may have prolonged survival with a combination of surgery and chemotherapy. In patients who developed skin recurrences as a late manifestation, symptoms should be treated with external beam radiotherapy and immune response modifiers. Immune checkpoint blockade can enhance anti-tumor immunity and induce durable clinical responses in multiple tumor types, including advanced chemoresistant ovarian cancer. With the use of radiation therapy, which enhances the systemic anti-tumor immune response, immune checkpoint blockade may be a promising therapeutic strategy for distant metastasis, including skin metastasis.

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Section: Patternsmentioning

confidence: 99%

Cutaneous Metastases in Ovarian Cancer

Otsuka

2019

Cancers

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“…Cases of skin (cutaneous/subcutaneous) metastases derived from neuroendocrine tumors of the lung [3][4][5][6][7][8], gastrointestinal [2,[9][10][11] and genitourinary tract [12][13][14][15] as well as of other origins or with unknown primary tumor site [16][17][18] have been exceptionally reported. In line with observations and revisions by Amorim et Al.…”

Section: Discussionmentioning

confidence: 99%

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Ciliberti¹,

Carbonara

Grillo³

et al. 2020

BMC Cancer

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Background: Skin metastases from pancreatic neuroendocrine carcinoma (PNEC) are rare and their palliative treatment is challenging. We report our experience in the multimodal management of one of the few reported cases of metastatic PNEC with multiple visceral and subcutaneous secondary lesions, focusing on the effectiveness of palliative radiotherapy for skin metastases. Case presentation: A 61-years old woman affected by a metastatic PNECwith subcutaneous growing and bleeding secondary lesions (at the scalp, right scapular region and at the back of the left thoracic wall, respectively) obtained a successful control of visceral metastases with the use of chemotherapy and an unexpected local response of her skin metastases with palliative radiotherapy. In particular, two subsequent radiation treatments were performed using different fractionation schedules (30 Gy in 10 fractions and 20 Gy in 5 fractions, respectively). Both radiation treatments were well-tolerated and patient's quality of life was improved. Local response was maintained until patient's deaththat occurred due to cachexia. Conclusions: The presented case highlights the effectiveness and the good tolerance of radiotherapy in the treatment of subcutaneous metastases; nevertheless, further knowledge of the optimal local palliative approach for PNEC metastatic sites is necessary. The experience gained in this work is the occasion to encourage a routine integrated multidisciplinary team management of metastatic PNECs because of their clinical complexity. The aim is to guarantee the optimization of the care with personalized and more effective systemic and local treatmentsalso including supportive cares and treatment-related side effects management.

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“…The clinicopathological features of 31 cases with FIGO stage I/II (Table 1) and 25 cases with FIGO stage III/IV (Table 2) [7,8,14,17,18,20,[25][26][27][28][29][30][31][32][33][34][35] were reviewed. A Kaplan-Meier survival curve (SPSS Statistics version 24; IBM, Armonk, NY) of all 53 cases excluding 3 cases without clinical outcome data showed total 5year survival of 34.6% and median survival time of 17 months.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, pathological examination has to be performed to differentiate non-epithelial ovarian cancer or other diseases including inflammation in these LCNEC cases. In the previous cases with stage III/IV [7,8,14,17,18,20,[25][26][27][28][29][30][31][32][33][34], most patients underwent laparotomy for diagnosis and treatment. However, complete surgery could not be performed in many cases, leading to the deterioration of the patients' general condition and much poorer outcomes.…”

Section: Discussionmentioning

confidence: 99%

Role of diagnostic laparoscopy in patients with large cell neuroendocrine carcinoma of the ovary with cancerous peritonitis: case report and review of the literature

et al. 2019

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Background Large cell neuroendocrine carcinoma is a very rare ovarian neoplasm that has a poor clinical outcome even in the early stage, and there is as yet no established treatment. Diagnostic laparoscopy has been used to determine the possibility of primary optimal cytoreductive surgery or neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. However, the role of diagnostic laparoscopy is still unclear in large cell neuroendocrine carcinoma due to its rarity. Case presentation A 31-year-old woman with abdominal distention was referred to our hospital. She was strongly suspected of having advanced ovarian cancer because of a huge pelvic mass, massive ascites, and their appearance on medical imaging. However, cytological examinations from ascitic fluid by abdominal paracentesis did not show any malignant cells. She underwent diagnostic laparoscopy to evaluate the possibility of primary optimal cytoreductive surgery, and only tissue sampling was performed for pathological diagnosis because of the countless disseminated lesions of various sizes in the intraperitoneal organs. The patient had no postoperative complications, leading to the early start of postoperative chemotherapy. Conclusions To date, there have been no systematic reviews that focused on determining the treatment strategy using laparoscopy. Diagnostic laparoscopy can be helpful to determine the optimal treatment, including primary debulking surgery, neoadjuvant chemotherapy, or best supportive care, assisting in decision-making particularly for patients with advanced large cell neuroendocrine carcinoma with carcinomatous peritonitis.

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Large Cell Neuroendocrine Carcinoma of the Ovary and its Skin Metastases: A case report and review of the literature Ovarian Large Cell Neuroendocrine Carcinoma

Cited by 8 publications

References 23 publications

Cutaneous Metastases in Ovarian Cancer

Cutaneous Metastases in Ovarian Cancer

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Role of diagnostic laparoscopy in patients with large cell neuroendocrine carcinoma of the ovary with cancerous peritonitis: case report and review of the literature

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