Unknown primary tumors

Natoli, Clara; Ramazzotti, Valerio; Nappi, Oscar; Giacomini, Patrizio; Palmeri, Sergio; Salvatore, Marco; Landriscina, Matteo; Zilli, Marinella; Natali, P. G.; Tinari, Nicola; Iacobelli, Stéfano

doi:10.1016/j.bbcan.2011.02.002

Cited by 29 publications

(39 citation statements)

References 107 publications

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“…Clinical molecular pathology tests play an increasingly critical role in the differential diagnosis of a tumor of uncertain origin. With regard to metastatic tumors, pathology tests may also provide valuable insights to guide the search for the primary tumor site (4). In the present study, pathological examination of the resected tissue indicated that the mass was a metastatic mucinous adenocarcinoma, which was most likely of gastrointestinal origin.…”

Section: Discussionmentioning

confidence: 79%

Giant adenocarcinoma of unknown origin penetrating from the pelvic cavity to subcutaneous tissue: A case report and review of the literature

et al. 2012

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Abstract. In this study, we present a case of a 43-year-old female patient who was admitted to our hospital due to a giant mass on the left buttock. Imaging tests revealed that the mass was a solid-cystic tumor with a large size of 143x430x180 mm, penetrating from the pelvic cavity to the subcutaneous tissue. Pathology tests indicated a metastatic mucinous adenocarcinoma which was most likely of gastrointestinal origin. However, there was no evidence to confirm the existence of malignant changes in the gastrointestinal tract. IntroductionIn clinical practice, patients who present with metastases but without a known primary cancer are often encountered. It is essential to determine the primary tumor and to treat it accordingly (1). However, occasionally it is difficult to identify the primary tumor site. Therefore, it is only possible to resect or treat the metastases. We report a case of a 43-yearold female patient with a giant origin-unidentified mucinous adenocarcinoma, measuring 143x430x180 mm, penetrating from the pelvic cavity to the subcutaneous tissue. The study was approved by the ethics committee of Wuhan General Hospital of Guangzhou Command, and consent was obtained from the patient involved. Case reportA 43-year-old female patient was referred to our hospital with a giant mass on the left buttock (Fig. 1). The mass was of negligible size when the patient first noticed it (approximately five years ago) and the mass gradually grew to the size of a quail's egg, without evident symptoms, including pain or limited activity. In November 2008, a percutaneous needle biopsy revealed metastatic mucinous adenocarcinoma. Pelvic CT and MRI scans demonstrated two solid-cystic lesions at the bottom of the pelvis, which were further confirmed by pelvic ultrasound to be a complex mass in the left adnexa and a right ovarian cyst. The patient underwent a left ovariectomy and right oophorocystectomy in another hospital, but the mass on the left buttock was not treated. No malignant changes were identified upon histological examination of any of the resected specimens. Following examination, the mass continued to increase in size and limited the patient's quality of life, with symptoms of local discomfort due to pressure stimuli.In November 2010, a contrast-enhanced CT scan revealed a giant solid-cystic mass with a size of 143x430x180 mm, penetrating from the pelvic cavity to the subcutaneous tissue of the left buttock, in which part of the mass was enhanced by contrast medium ( Fig. 2A and B). CT angiography revealed that the mass was fed by the tertiary branches of the left internal iliac artery (Fig. 2C and D). No adjacent bone destruction or lymph node metastasis was identified. Clinical examination revealed a large mass measuring 150x180 mm in the left buttock that was soft, painless, fluctuant, without skin redness, pigmentation or increased temperature.In mid-November 2010, surgery was performed to remove the mass (Fig. 3A). Intraoperative examination revealed that the mass was solid-cystic, with a capsule adherin...

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Section: Discussionmentioning

confidence: 79%

Giant adenocarcinoma of unknown origin penetrating from the pelvic cavity to subcutaneous tissue: A case report and review of the literature

et al. 2012

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“…El CPD es un tumor muy agresivo y de mal pronóstico, que a pesar de ser la octava causa de cáncer, es la cuarta causa de muerte por cáncer en el mundo (1,2,8). La supervivencia después del diagnóstico varía de 11 semanas a 11 meses (9), con una media de 3 meses (3).…”

Section: Metodologíaunclassified

“…Representa el 3% al 5% de todos los tumores malignos (1,2,8). Así mismo, tiene una incidencia de 7 a 12 casos/100 000 habitantes/año (2,10). Cada año en Estados Unidos (EE.…”

Section: Metodologíaunclassified

“…El cáncer de primario desconocido (CPD) es un grupo heterogéneo de tumores malignos con confirmación histológica de una de las lesiones metastásicas, en los cuales la lesión primaria no es identificada a pesar de un enfoque diagnóstico estandarizado (1,2). Representa el octavo cán-cer más frecuente en el mundo (1), es una neoplasia de mal pronóstico, con supervivencia media de 3 meses (3).…”

Section: Introductionunclassified

“…En el 10%-30% de los casos, no se logra encontrar el tumor que origina la metástasis aun después realizar una búsqueda exhaustiva con las técnicas más avanzadas -como el perfil molecular-e incluso después de la autopsia (4). Debido a la gran dificultad para encontrar el sitio primario y ofrecer un tratamiento específico, recientemente se han investigado nuevas formas de actuar frente a este tumor en las que se incluyen estudios moleculares, imagenológicos, de inmunohistoquímica y genéticos, que permitan mejorar la supervivencia de estos pacientes (2,(4)(5)(6)(7).…”

Section: Introductionunclassified

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Cáncer metastásico con primario desconocido. Una revisión

Rodríguez

Regino

Grosso

2018

Rev. Colomb. Gastroenterol.

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ResumenEl tumor metastásico no siempre tiene un origen evidente, hasta en un tercio de los casos nunca se encuentra el tumor primario. Este artículo es una guía de los avances más recientes para mejorar el enfoque diagnóstico y el manejo del paciente con este tumor fatal y frecuente. El objetivo de este artículo, además de ser una guía, es ayudar a evitar errores comunes y graves. Uno de los errores más importantes es no tener en cuenta el papel fundamental de la confirmación histológica, pues esta puede evitar investigaciones innecesarias.En el artículo también se detallan los componentes de la evaluación estándar, la clasificación según su pronóstico y las indicaciones de la evaluación secundaria, que incluye las indicaciones de la endoscopia alta y baja, los marcadores tumorales, la tomografía por emisión de positrones (TEP), el papel que ocupa el perfil genético, la epigenética y el ácido desoxirribonucleico (ADN) viral. Adicionalmente, se indica el momento en que se debe detener la investigación. Recientemente, el tratamiento se ha modificado, lo que parece cambiar la historia de estos pacientes y de sus contrapartes con primario conocido. Palabras claveTumor metastásico, primario desconocido, cáncer. AbstractMetastatic tumors do not always have obvious origins: in one third of these cases, the primary tumor is never found. This article is a guide to the most recent advances in diagnostic approaches and patient management of these fatal and frequent tumors. An additional objective of this article is to help avoid common and serious errors. One of the most important errors is not taking the fundamental role of histological confirmation into account since it can avoid unnecessary investigations.The article also details the components of a standard evaluation, classification according to prognosis and indications for a secondary evaluation. These include indications for upper and lower endoscopy, tumor markers, positron emission tomography, and the roles of genetic profiling, epigenetics and viral DNA. It also indicates the moment at which an investigation should be stopped. Recently, treatment has changed, and these changes seems to have changed the history of these patients and their counterparts with known primary tumors.

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Management of the Patients with Carcinoma of Unknown Primary and the Role of Biomarkers

Ağalar

Şimşek

2022

Biomarkers in Carcinoma of Unknown Primary

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Unknown primary tumors

Cited by 29 publications

References 107 publications

Giant adenocarcinoma of unknown origin penetrating from the pelvic cavity to subcutaneous tissue: A case report and review of the literature

Giant adenocarcinoma of unknown origin penetrating from the pelvic cavity to subcutaneous tissue: A case report and review of the literature

Cáncer metastásico con primario desconocido. Una revisión

Management of the Patients with Carcinoma of Unknown Primary and the Role of Biomarkers

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