Pulmonary metastasis presenting as a ground glass opacity-like lesion with a thin-walled cavity: A case report

Haro, Akira; Wakasu, Sho; Takada, Kazuki; Osoegawa, Atsushi; Kamitani, Takeshi; Tagawa, Tetsuzo; Mori, Masaki

doi:10.1016/j.ijscr.2019.06.030

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Diffuse and patchy GGO are caused by diffuse thickening of the alveolar wall due to lymphangitic carcinomatosis or PTTM, and the most frequent primary site of carcinoma is the gastrointestinal tract. Focal GGO is rarely found in metastatic carcinoma and malignant neoplasms, but has been documented in cases of malignant melanoma ( 2-4 ), malignant phyllodes tumor ( 5 ), tongue cancer ( 6 ), thyroid cancer ( 7 ), and prostate cancer ( 8-10 ), including the present case ( Table I ). Since it was not feasible to distinguish metastatic lesions from primary lung adenocarcinoma based solely on radiological findings, a diagnosis was made by a histological examination of partially resected lung or biopsy specimens in the reported cases.…”

Section: Discussionmentioning

confidence: 51%

“…The subepithelial growth of carcinoma cells is similar to reported cases of malignant melanoma ( 2-4 ) and malignant phyllodes tumor ( 5 ). Lepidic growth similar to primary lung adenocarcinoma was previously documented in a case of metastatic thyroid cancer ( 7 ), and focal GGO was caused by the invasion and destruction of alveoli and hemorrhage in a case of metastatic tongue cancer ( 6 ).…”

Section: Discussionmentioning

confidence: 83%

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Focal ground glass opacity of the lung in metachronous prostate and gastric cancer: A case report

Wada,

Yamamoto,

Iwasaki

et al. 2024

Mol Clin Oncol

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Chest computed tomography (CT) revealed a focal ground glass opacity (GGO) with a minimal solid area in a 75-year-old man. The shadow was located in the periphery of the right upper lobe and measured 11 mm in diameter. The patient had a medical history of metachronous prostate and gastric cancers. The patient had been treated with androgen deprivation therapy for prostate cancer for 12 years and underwent subtotal gastrectomy for triple gastric cancers 7 months before. Since primary lung adenocarcinoma was suspected, CT-assisted percutaneous needle biopsy was performed. Histology revealed the sheet-like and trabecular proliferation of atypical cells, suggesting that the lesion was moderately to poorly differentiated adenocarcinoma. Adenocarcinoma cells showed subepithelial extension causing the thickening of alveolar walls. A tumor thrombus was not detected in the blood or lymphatic vessels. Immunohistochemistry revealed that carcinoma cells were negative for cytokeratin 7 (CK7), CK20, thyroid transcription factor-1 and CDX2 and positive for prostate-specific antigen and P504S. Based on these findings, the patient was diagnosed with metastatic carcinoma from prostate cancer. The disease remained stable for 4 months after the diagnosis, and no new lesions were observed on chest CT. Metastatic carcinoma rarely presents with focal GGO. Lung biopsy is necessary to identify the pathology of the lesion, and the primary site needs to be confirmed by immunohistochemistry with specific markers, particularly in a case of metachronous multiple cancers. A tumor thrombus, which is suggestive of lymphangitic carcinomatosis or pulmonary tumor thrombotic microangiopathy, also needs to be evaluated.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 83%

Focal ground glass opacity of the lung in metachronous prostate and gastric cancer: A case report

Wada,

Yamamoto,

Iwasaki

et al. 2024

Mol Clin Oncol

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“…As a result, 2 of 19 patients were identified as having possible intrapulmonary metastatic GGNs, suggesting that early metastasis may exist in GGNs. Clinical evidence of metastatic GGN from lung [8,9] and other organs [10][11][12][13][14] has also been reported. According to the Fleischner guidelines [24], multiple GGNs are considered as multiple primaries, and are routinely treated as independent primary tumors.…”

Section: Discussionmentioning

confidence: 90%

“…Clinical evidence of metastasis with GGNs has been reported, including pulmonary metastasis [8,9] and distant metastasis [10][11][12][13][14]. At present, a few studies have been focused on whether multiple GGNs were multiple primaries or intrapulmonary metastasis [15][16][17][18], most of which were based on the targeted genes [15][16][17], and only one study was based on genomics [18].…”

Section: Introductionmentioning

confidence: 99%

Utility of whole exome sequencing analysis in differentiating intrapulmonary metastatic multiple ground-glass nodules (GGNs) from multiple primary GGNs

Zhou

Liu

et al. 2022

Int J Clin Oncol

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Purpose Clinical evidence of metastasis with ground-glass nodules (GGNs) has been reported, including pulmonary metastasis and distant metastasis. However, the clonal relationships of multiple GGNs at the genetic level remain unclear. Experimental design Sixty tissue specimens were obtained from 19 patients with multiple GGN lung cancer who underwent surgery in 2019. Whole exome sequencing (WES) was performed on tissue samples, and genomic profiling and clone evolution analysis were conducted to investigate the genetic characteristics and clonality of multiple GGNs. Results A total of 15,435 nonsynonymous mutations were identified by WES, and GGNs with shared nonsynonymous mutations were observed in seven patients. Copy number variant (CNV) analysis showed that GGNs in ten patients had at least one shared arm-level CNV. Mutational spectrum analysis showed that GGNs in three patients had similar six substitution profiles and GGNs in fou patients had similar 96 substitution profiles. According to the clone evolution analysis, we found that GGNs in five patients had shared clonal driver gene mutations. Taken together, we identified that 5 patients may have multiple primary GGNs without any similar genetic features, 2 patients may have intrapulmonary metastatic GGNs with ≥ 3 similar genetic features, and the other 12 patients cannot be determined due to insufficient evidences in our cohort. Conclusions Our findings suggest that the intrapulmonary metastasis exist in multiple GGNs, but the number of GGNs was not associated with the probability of metastasis. Application of genomic profiling may prove to be important to precise management of patients with multiple GGNs.

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Management of Pulmonary Nodules in Oncologic Patients: AJR Expert Panel Narrative Review

Araújo-Filho

Halpenny

McQuade

et al. 2021

American Journal of Roentgenology

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Pulmonary metastasis presenting as a ground glass opacity-like lesion with a thin-walled cavity: A case report

Cited by 3 publications

References 6 publications

Focal ground glass opacity of the lung in metachronous prostate and gastric cancer: A case report

Focal ground glass opacity of the lung in metachronous prostate and gastric cancer: A case report

Utility of whole exome sequencing analysis in differentiating intrapulmonary metastatic multiple ground-glass nodules (GGNs) from multiple primary GGNs

Management of Pulmonary Nodules in Oncologic Patients: AJR Expert Panel Narrative Review

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