Primary Renal Neuroblastoma Mimicking Wilms Tumor

Neuroblastoma (NB) is the most common extracranial solid malignancy in children younger than 5 years of age. It is an aggressive malignancy with evidence of secondary metastasis at the time of the initial presentation. NB is rightly known as a great masquerader. Herein, we describe three children who presented with renal masses mimicked as Wilms tumor initially and later diagnosed as NB on biopsy. The response to therapy was not satisfactory in all three children. A higher level of awareness and early recognition is important for diagnosing and managing NB. We should rule out NB when there is a diagnostic dilemma before nephrectomy in these patients. Intrarenal NB should be considered with the combination of renal mass and hypertension with elevated catecholamines. The distinction between these two tumors is important since both malignancies have different therapeutic and prognostic implications.

Colorectal Metastasis from Ovarian Neoplasm Mimicking Primary Colon Cancer

Metastasis to the colon from another primary internal malignancy is an untypical and a seldom reported entity. Direct visualization during colonoscopy is considered the gold standard of diagnosis. Pathologic diagnosis with immunohistochemical staining is essential to differentiate primary colorectal malignancy from secondary metastasis to the colon. We, hereby, present a case of a 53-year-old female status-post resection of left-sided papillary serous ovarian neoplasm who presented 2 years later with a single rectosigmoid intraluminal ulcerative mass imitating a primary colon cancer. Biopsies of the mass were consistent with metastasis from her primary ovarian carcinoma. We believe this case is unique because of the rarity of ovarian cancer metastasizing to the colon intraluminally rather than through direct locoregional invasion. Furthermore, it highlights the importance of considering secondary metastasis in patients with previous history of another primary internal malignancy.

Merkel cell carcinoma with kidney metastasis in a 81-year-old man. A rare case report

Merkel cell carcinoma (MCC) is a primary neuroendocrine carcinoma of the skin. The prognosis of the disease is considered poor. Secondary metastasis is common, however a secondary metastasis to kidney from Merkel cell is a very rare phenomenon. We report a case of a man with a MCC metastasis to the right kidney. The suggested management is surgery and afterwards a platinum-based chemotherapy.

Low T3 syndrome with hyperthyrotropinemia and early detection of liver metastasis.

e23010 Background: Numerous clinical studies have shown an association between changing thyroid gland (TG) function and the development of tumors. The purpose of the study was to analyze the dynamics of thyroid hormones in the pituitary gland, TG and blood serum (BS) during liver metastasis in order to create thyroid profile of metastasis and to detect thyroid markers of metastasis in BS. Methods: The experiment included 44 white male rats weighing 180-250 g. Sarcoma 45 was transplanted intrasplenically. Levels of thyroid stimulating hormone (TSH) were studied in the pituitary gland, TG, BS; the amount of free (fT4) and total (T4) thyroxine and free (fT3) and total (T3) triiodothyronine in TG and BS were determined by radioimmunoassay (Immunotech, Czech Republic; Arian analyzer, Russia). Results: Exertion of the pituitary gland and overproduction of TSH were observed since the early days of the tumor development, later accompanied by TG hypofunction. Quantitative changes of thyroid hormones in organs did not coincide with their dynamics in BS. The first diagnostic signs of experimental liver metastasis, in the absence of formed metastases in the body, were hyperthyrotropinemia and a tendency to fT3 decrease in BS. Already formed liver metastases were characterized by a marked low T3 syndrome which transformed into a more severe lowT3/lowT4 syndrome during the secondary metastasis. Conclusions: The development of liver metastases is accompanied by the exertion and imbalance of the thyroid system function. Analysis of dynamics of the thyroid axis hormones in BS allows predicting the appearance of liver metastasis and identification of “the point of no return” in the development of the pathology that leads to secondary metastasis and irreversible progression of the disease.