Atypical pattern of rectal cancer metastasis into mouth cavity

Metastasis is one the most common pathways of progression of rectal cancer. Rectal cancer metastases spread through lymphatic and blood vessels, giving metastases generally into locoregional lymphatic nodeslymphogenic metastasis and also liver and lung-hematogenic metastasis. The metastasizing process depends on creation of premetastatic niche-giving the cancer cells a prolific condition. A case of 73 years old male patient with a rectal cancer and metastases in locoregional lymphatic nodes and an atypical metastasis in the gingiva of the maxillary premolars had been accepted in the clinic of General and Liver-Pancreatic Surgery, University Hospital Alexandrovska, Sofia, Bulgaria.

Atypical presentation of metastatic disease in patients with stage 4S neuroblastoma of the observation group: description of the clinical case

The most common extracranial solid malignant tumor of childhood – neuroblastoma (NB) is characterized by the presence of two metastatic forms (stages 4 and 4S). Stage 4S is described to have metastatic spread to the liver, skin, and minimal bone marrow invasion. Certain rare localisations of NB metastases (pleura, testicles, and others) may not worsen the prognosis in children of the first year of life in the absence of severe bone marrow invasion and metastases to the skeletal bones. The article describes a clinical case of retroperitoneal NB with atypical metastasis to the pleura in a child of the first months of life with a favorable outcome with a minimum amount of chemotherapy.

Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis

Summary Papillary thyroid gland carcinoma is the most common type of malignancy of the endocrine system. Metastases to the pituitary gland have been described as a complication of papillary thyroid cancer in few reported cases since 1965. We report the case of a 68-year-old female patient with a well-differentiated form of thyroid gland cancer. Despite it being the most common malignant cancer of the endocrine system, with its papillary form being one of the two most frequently diagnosed thyroid cancers, the case we present is extremely rare. Sudden cardiac arrest during ventricular fibrillation occurred during hospitalization. Autopsy of the patient revealed papillary carcinoma of the thyroid, follicular variant, with metastasis to the sella turcica, and concomitant sarcoidosis of heart, lung, and mediastinal and hilar lymph nodes. Not only does atypical metastasis make our patient’s case most remarkable, but also the postmortem diagnosis of sarcoidosis makes her case particularly unusual. Learning points: The goal of presenting this case is to raise awareness of the clinical heterogeneity of papillary cancer and promote early diagnosis of unexpected metastasis and coexisting diseases to improve clinical outcomes. Clinicians must be skeptical. They should not fall into the trap of diagnostic momentum or accept diagnostic labels at face value. Regardless of the potential mechanisms, clinicians should be aware of the possibility of the coexistence of thyroid cancer and sarcoidosis as a differential diagnosis of lymphadenopathy. This case highlights the importance of the diagnostic and therapeutic planning process and raises awareness of the fact that one uncommon disease could be masked by another extremely rare disorder.