Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Signet-ring adenocarcinoma is an aggressive form of primary bladder adenocarcinoma that has been associated with poor outcomes. The utility of immunohistochemical markers in tumors with signet-ring morphology may vary from more typical adenocarcinomas arising at the same location, although this has not been examined in bladder adenocarcinoma. We examined a series of bladder adenocarcinomas to determine the impact of signet-ring cell features on clinical outcomes and immunohistochemical findings. We identified 25 patients with bladder adenocarcinoma, ranging in age from 28 to 78 years (mean, 57 years) and with a male-female ratio of 18:7. Six cases were urachal in origin. Signet-ring cells occurred in 19 of 25 bladder adenocarcinomas (76%) and ranged from 5% to 100% of tumor volume, with most tumors demonstrating more than 60% signet-ring cell differentiation (15/19), when present. Regional lymph node metastases were present in 8 of 19 patients (42%) who underwent cystectomy. The percentage of tumor containing signet-ring cells was significantly associated with the presence of adverse pathologic features (defined as unresectable primary tumor or regional lymph node metastasis, P = .013) and decreased overall survival (P = .034), and the latter remained significant in multivariable analysis after adjusting for positive soft tissue margins (P = .026). A comparison between immunohistochemical markers frequently used to analyze bladder adenocarcinoma demonstrated decreased expression of several markers in signet-ring (n = 9) versus colonic-type (n = 8) morphology, including CDX-2, beta-catenin, and E-cadherin, although these results did not reach statistical significance. In summary, the extent of signet-ring differentiation in bladder adenocarcinoma is associated with worsened survival and higher stage disease; the utility of immunohistochemical analysis in foci consisting of predominant signet-ring cells may be limited, although further studies that address this finding are needed.
 ...
PMID:Clinicopathologic features and utility of immunohistochemical markers in signet-ring cell adenocarcinoma of the bladder. 1878 86

As is well-known, signet ring cell carcinoma (SRCC) rarely appears as a histological finding in the prostatic tissue. Nevertheless, a differentiation should be made between a primary tumor and a metastatic disease. We describe the case of a 52-year-old man with lower urinary tract symptoms, serum total PSA of 0.2 ng/ml, elevated serum CEA and CA19-9 levels. Two years prior to presentation, he underwent total gastrectomy with histological findings indicating poor differentiated adenocarcinoma with signet-ring cell. A palpable nodule was found on digital rectal examination and for this reason he underwent 12-core transperineal prostate biopsy with a diagnosis of poor differentiated adenocarcinoma with signet-ring cell and adipose tissue infiltration. Immunohistochemical examinations revealed positivity for PAS, CK7 and CDX-2, focal positivity for CK20 and negativity for PSA and PSAP. The diagnosis of a prostatic secondary SRCC was possible given the positivity to CK7, CDX-2, focal positivity to CK20 and negativity to PSA.
 ...
PMID:Expression of CD7, CD20 and CDX-2 in a secondary signet-ring cell tumor of the prostate: a case report. 2352 33

A 50-year-old man was referred to our hospital because of a 2-month history of painful gingival swelling. Histopathological examination of the biopsy specimen showed a metastatic adenocarcinoma, and a chest-abdominopelvic CT showed multiple metastases in the lung, liver, and spleen, but failed to demonstrate the primary tumor. He had never complained of abdominal symptoms, and physical examination did not show any abnormality in the abdomen. However, immunohistochemical staining including caudal-related homeobox transcription factor (CDX-2) of the gingival tumor and PET-CT findings strongly suggested colorectal cancer as the origin. Colonoscopy then revealed a tumor in the rectum, and systemic chemotherapy was started immediately.
...
PMID:A Case of Gingival Metastasis from Rectal Cancer in Which Immunohistochemistry and PET-CT Were Useful for the Diagnostic Procedure. 2480 3

Gastrocolic fistula (GCF) is associated with a variety of diseases, but in recent years it has most frequently been observed with gastric or colonic malignancy. The management of primary tumor lesions and optimal surgical treatment strategies remain controversial. In this study, we explore the clinical diagnosis and treatment of GCF by retrospectively analyzing the records of GCF patients treated between August 2008 and February 2014. Three female patients and one male patient with an average age of 61 years were diagnosed with GCF caused by malignancy during this period. The predominant symptoms were diarrhea, vomiting, weight loss, and abdominal pain. Gastrointestinal contrast series combined with fiber endoscopy was the most accurate method of diagnosing the GCF, while CT and MRI were helpful in identifying the extent of tumor invasion and evaluating the possibility of en-bloc resection. Pathological and immunohistochemical tests, including staining for CK-20, CK-7, and CDX-2, suggested that three cases originated in the colon and one case in the stomach. All four cases underwent single-stage en-bloc fistula resection; two severely malnourished patients received concurrent colostomies. One patient died of postoperative anastomotic leakage and cardiopulmonary failure, but the remaining three patients were discharged in improved condition. En-bloc resection followed by adjuvant chemotherapy can result in long term survival. Gastrointestinal contrast series combined with fiber endoscopy showed high sensitivity in the diagnosis of GCF. Immunohistochemical staining can be conducted for tumors with an unclear source. Single-stage radical en-bloc fistula resection is the recommended surgical treatment, and concurrent colostomy should be considered in severely malnourished patients.
...
PMID:Current diagnosis and management of malignant gastrocolic fistulas: a single surgical unit's experience. 2555 Sep 22

BACKGROUND Adenocarcinoma of the colon frequently invades adjacent organs, spreads intraperitoneal, and metastasizes to intestinal lymph nodes, lungs, and the liver. Metastasis solely to the extrahepatic bile duct is extremely rare and has only been previously reported on 15 occasions. The accurate determination that an extrahepatic common bile duct lesion is of colonic origin has critical therapeutic implications. CASE REPORT The patient was a 50-year-old male with a history of colon cancer S/P surgical resection in September 2014. At that time, the tumor extended to the serosal margin, and was staged as pT4a N0 MX stage II. In April of 2016, the patientwas admitted to our facility and an ERCP was performed. A biopsy was performed during the ERCP followed by sphincterotomy and metal stent placement. The surgical pathology revealed an adenocarcinoma with surrounding benign glandular structures. The surrounding benign glands served as an appropriate control when compared to the malignant glands. The benign glands were positive for CK-7 and the malignant glands were negative for CK-7. The malignant glands were also positive for CK-20 and CDX-2, and the benign glands were negative for CK-20 and CDX-2. This profile was consistent with an adenocarcinoma metastasis from colon primary tumor. CONCLUSIONS This case superbly illustrates the critical role of the pathologist, and their knowledge and understanding of immunohistochemistry, in arriving at the correct diagnosis and in assisting surgeons and oncologists in guiding the care, management, and appropriate therapeutic decisions regarding patients. In patients with a history of colorectal carcinoma (CRC), immunohistochemistry is required to arrive at the correct diagnosis as treatment options can be very different based on diagnosis.
 ...
PMID:Metastatic Colonic Adenocarcinoma to the Extrahepatic Common Bile Duct: The Critical Role of the Pathologist and Immunohistochemistry in Guiding Patient Care Decisions. 2828 73