OncoTargets and Therapy (Jul 2021)

Heterochronous Metastases of Lung Adenocarcinoma to Pancreas and Liver: A Case Report from Pathological Perspectives

  • Zhang B,
  • Hu Q,
  • Yu J,
  • Wang J,
  • Yang H,
  • Lou J,
  • Cai G,
  • Huang H,
  • Xu M,
  • Xiao Z,
  • Zhang Y

Journal volume & issue
Vol. Volume 14
pp. 4269 – 4273

Abstract

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Bo Zhang,1,* Qida Hu,2,* Jiajie Yu,1 Junsen Wang,3 Hanjin Yang,4 Jiongbo Lou,5 Guoying Cai,6 Haifeng Huang,1 Mengqiu Xu,5 Zhaoying Xiao,5 Yun Zhang1,2 1Department of Surgery, Shengzhou People’s Hospital, Shaoxing, 312400, People’s Republic of China; 2Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China; 3Department of Pathology, Shengzhou People’s Hospital, Shaoxing, 312400, People’s Republic of China; 4Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China; 5Department of Infectious Diseases, Shengzhou People’s Hospital, Shaoxing, 312400, People’s Republic of China; 6Department of Oncology, Shengzhou People’s Hospital, Shaoxing, 312400, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yun ZhangDepartment of General Surgery, Shengzhou People’s Hospital, 666 Dangui Road, Shaoxing, 312400, People’s Republic of ChinaTel +86 575 8333 8570Email [email protected] XiaoDepartment of Infectious Diseases, Shengzhou People’s Hospital, 666 Dangui Road, Shaoxing, 312400, People’s Republic of ChinaTel +86 575 8333 8276Email [email protected]: Immunohistochemistry (IHC) is a vital tool to distinguish tumor metastases from primary lesions in addition to morphologic analysis. In this study, a 64-year-old female with a past surgical history of lung adenocarcinoma 11 years ago was presented with recurrence of liver nodular lesions after multiple surgical procedures, including the Whipple procedure for pancreatic head adenocarcinoma and cytoreductive surgery for liver metastasis. Liver biopsy and review of the previous specimens, based on IHC analyses, suggested heterochronous metastases of lung adenocarcinoma to the digestive systems in a long-time span, instead of primary pancreatic adenocarcinoma. This case demonstrates the potential for misdiagnoses from morphologic analysis alone and suggests the necessity of IHC analyses to avoid misjudgment on tumor phenotypes, when a previous oncologic history is presented.Keywords: heterochronous metastases, lung adenocarcinoma, immunohistochemistry

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