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L.F. Sua
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 3
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-020 - Adenocarcinoma Metastatic Gastrointestinal Origin and Lung Squamous Carcinoma Associated with HIV Disease: Case Report (ID 1284)
09:30 - 09:30 | Author(s): L.F. Sua
- Abstract
Background:
Individuals infected with HIV have a higher predisposition to develop malignancies. The spectrum of neoplastic diseases in HIV-infected patients has changed after the introduction of antiretroviral therapy which decreased the AIDS defining malignancies such as Kaposi's sarcoma (KS) and non-Hodgkin lymphoma (NHL), but augmented other tumor types contributing to increased mortality of patients on chronic treatment. We report a patient with HIV on more than 10 years of antiretroviral treatment in whom diagnosis of a metastatic adenocarcinoma of gastrointestinal origin and a concomitant primary lung squamous carcinoma was made.
Methods:
Clinical History Revission
Results:
A 68-year-old man with a history of HIV on antiretroviral treatment (ART) since 2004, ex-smoker with COPD, osteoporosis and chronic malnutrition, who presents with cough, dyspnea and hemoptysis. On the chest CT-scan a right paravertebral mass associated with atelectasis, a parahilar mass extending to the left upper lobe, and a mass in the pancreatic head is observed. A bronchoscopy with biopsies is performed. The morphological and inmunophenotypic expression patterns of the right lower lobe show metastatic adenocarcinoma of gastrointestinal origin while the left lower lobe biopsy shows primary squamous cell lung carcinoma and the presences of Aspergillus. The patient continued with hemoptysis, developed refractory respiratory failure and died.
Conclusion:
With the widespread use of potent ART there was a dramatic decrease in the incidence of KS and NHL and a significant increase in the incidence of several other malignancies. Although the biology of malignancy in HIV-infected people is often more aggressive than in those without HIV infection, standard treatment is generally indicated and can be associated with a favorable outcome, depending upon the tumor type, stage, and comorbidity. In this case two advanced stage tumor lesions associated with hemoptysis were documented, which finally led to the death of the patient. Figure 1 Figure 2
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P1.04-037 - Lung and Hypopharyngeal Angiosarcoma (AS) in a Renal Transplant Patient: Case Report (ID 1636)
09:30 - 09:30 | Author(s): L.F. Sua
- Abstract
Background:
(AS) are rare malignant soft tissue tumors of endothelial cell origin representing 2% of all sarcomas. Most AS develops in the absence of precursor lesions. To date, only 20 cases of (AS) have been described after renal transplantation, occurring mostly on the skin or in a dialysis fistula, their pulmonary location is very rare. We report the case of a patient with a renal transplant who presents a hypo pharyngeal and a right lower lobe (RLL) lesion where a Angiosarcoma was documented.
Methods:
Clinical History Revision
Results:
A 78 years-old patient, ex-smoker, with end-stage renal failure received a cadaveric donor renal transplant in 2000. Immunosuppressed with relatively low doses of tacrolimus and steroids, graft function remained stable with a serum creatinine in 1,2 until January 2015 when he consults with dysphonia, dysphagia, cough, and mild hemoptysis. The patient had bilateral neck lymphadenopathy, bilateral basal crackles and the rest of the physical examination within normal parameters. Pulmonology evaluated the patient finding a hypopharyngeal mass and another with round morphology in RLL that were metabolically active in PET-CT. A hypopharyngeal biopsy is taken and a CT-guided transthoracic puncture, finding a high grade undifferentiated tumor of mesenchymal origin, expressing Vimenin and CD10, with vascular marker CD31 and gene C-Myc. Gene p53 and Ki-67 in 90% of the tumor. No lymphoid or epithelial line markers are expressed. The patient is currently in chemotherapy and immunotherapy.
Conclusion:
The use of potent immunosuppressive agents has significantly reduced the rates of acute rejection after renal transplantation. However, increased cancer incidence after renal transplantation has become an important problem. Skin tumors, post-transplant lymphoproliferative diseases and organ cancers are the most common malignant tumors seen in these patients. Angiosarcoma is rarely seen in this group of patients, and location in lung and hypopharynx without evidence elsewhere of commitment affectation is very rare. Figure 1 Figure 2
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P1.04-043 - Pulmonary Lepidic Adenocarcinoma in a Patient with Prior Diagnosis of Breast Cancer: Case Report (ID 1289)
09:30 - 09:30 | Author(s): L.F. Sua
- Abstract
Background:
The combined effect of improved cancer diagnosis and management has led to a marked increase in cancer survivors. Consequently, an appreciable proportion of cancer diagnoses are registered among patients who had already received a cancer diagnosis in the past, and more accurate diagnostic procedures lead to the identification of more than one cancer in a subset of patients. We present the case of a patient with breast cancer in whom a lepidic primary lung adenocarcinoma was discovered during a follow-up.
Methods:
Medical History Revission
Results:
A 68-years-old female with breast cancer EC EIII diagnosed in March / 2010, handled with lumpectomy and lymph node removal, solid mucinous ductal carcinoma Ki67 expression: 35% RH: E (+) 100%, P (-), HER 2 NEU negative, negative margins with angiolymphatic invasion 3/15. She received radiotherapy, tamoxifen and later anastrozole. In Dec / 2010 she presents tumor recurrence managed with radical mastectomy, received chemotherapy with Adriamycin and Cyclophosphamide. In April / 2013 she consults with two months of dry cough and dyspnea, normal physical examination, an unremarkable mammography, chest CT-scan with irregular right basal nodular lesion and mediastinal nodes. The patient underwent resection through thoracoscopy, pathology shows lepidic adenocarcinoma pattern with mutated EGFR exon 19 and exon 21 negative, with metastatic nodal involvement by the primary lung tumor and previous breast carcinoma.
Conclusion:
Patients that have been diagnosed with a cancer, have an increased lifetime risk for developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Cancer patients could survive longer due to settling treatment modalities, and then would likely develop a new malignancy. The monitoring and evaluation procedures are especially useful for early detection of tumors associated when there’s a known tumor lesion. Figure 1Figure 2
