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Tumor-to-tumor metastasis from lung cancer: a clinicopathological postmortem study

Virchows Archiv volume 463, pages 525–534 (2013)Cite this article

Abstract

This study examined 47 cases of lung cancer concomitant with other tumors and found eight cases (17 %) with nine foci of tumor-to-tumor metastasis, defined as metastasis of lung cancer into another tumor. Donor lung cancers were four adenocarcinomas, two squamous cell carcinomas, and two small cell carcinomas. Tumor-to-tumor metastasis was found in five of six renal cell carcinomas (83 %), one of eight thyroid papillary carcinomas (13 %), one of three adrenocortical adenomas (33 %), one of three pancreatic endocrine microadenomas (33 %), and another lung cancer (one of six cases of multiple lung cancers, 17 %). The higher recipient incidence in renal cell carcinoma was statistically significant compared with prostatic carcinoma (0/16, P < 0.001), colorectal carcinoma (0/7, P = 0.005), and gastric carcinoma (0/5, P = 0.015). Generalized metastases were found in 88 % of the tumor-to-tumor metastasis cases. The total clinical course of patients with tumor-to-tumor metastasis was shorter than that of the patients without tumor-to-tumor metastasis (mean, 5.4 versus 18.8 months; P = 0.046). Tumor-to-tumor metastasis sometimes mimicked undifferentiated recipient tumor cells. Immunostains for thyroid transcription factor 1 (TTF-1), Napsin A, cytokeratin 7 (CK7), and CK5/6 were useful to confirm tumor-to-tumor metastasis. However, TTF-1-, Napsin A-, and/or CK7-negative lung adenocarcinoma components metastasized to renal cell carcinoma in three cases, and recipient renal cell carcinomas were focally Napsin A+ (two cases) or CK7+ (two cases). Tumor-to-tumor metastasis can occur as a result of metastasis from lung cancer with more aggressive behavior. Tumor-to-tumor metastasis should be carefully distinguished from undifferentiated recipient tumor cells.

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Acknowledgments

The authors thank Kenji Okada for excellent technical assistance and Daniel Mrozek for editing the manuscript.

Conflict of interest statement

We declare that we have no conflict of interest.

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Affiliations

  1. Department of Pathology, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, 154-0001, Tokyo, Japan

    Susumu Matsukuma, Takako Kono, Hiroaki Takeo, Yusuke Hamakawa & Kimiya Sato

  2. Health Care Center, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, 154-0001, Tokyo, Japan

    Susumu Matsukuma

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  1. Susumu Matsukuma
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  2. Takako Kono
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  3. Hiroaki Takeo
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  4. Yusuke Hamakawa
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  5. Kimiya Sato
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Correspondence to Susumu Matsukuma.

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Matsukuma, S., Kono, T., Takeo, H. et al. Tumor-to-tumor metastasis from lung cancer: a clinicopathological postmortem study. Virchows Arch 463, 525–534 (2013). https://doi.org/10.1007/s00428-013-1455-8

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  • DOI: https://doi.org/10.1007/s00428-013-1455-8

Keywords

  • Tumor-to-tumor metastasis
  • Cancer-to-cancer metastasis
  • Lung cancer
  • Renal cell carcinoma
  • Multiple lung cancers
  • Endocrine microadenoma
  • Immunohistochemistry