Difference between revisions of "In-transit metastasis"

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'''In-transit metastasis''' is a type of metastatic disease, characterized by tumour nodules growing within lymphatics.<ref name=pmid15115646>{{Cite journal  | last1 = Fraker | first1 = DL. | title = Management of in-transit melanoma of the extremity with isolated limb perfusion. | journal = Curr Treat Options Oncol | volume = 5 | issue = 3 | pages = 173-84 | month = Jun | year = 2004 | doi =  | PMID = 15115646 }}</ref>  
'''In-transit metastasis''' is a type of [[metastasis|metastatic disease]], characterized by tumour nodules arising from the lymphatics<ref name=pmid15115646>{{Cite journal  | last1 = Fraker | first1 = DL. | title = Management of in-transit melanoma of the extremity with isolated limb perfusion. | journal = Curr Treat Options Oncol | volume = 5 | issue = 3 | pages = 173-84 | month = Jun | year = 2004 | doi =  | PMID = 15115646 }}</ref> between the primary tumour and its local/regional [[lymph node]]s.<ref name=cancergov>URL: [http://www.cancer.gov/dictionary?cdrid=634128 http://www.cancer.gov/dictionary?cdrid=634128]. Accessed on: 28 March 2012.</ref>


It is relatively common in [[malignant melanoma]].<ref name=pmid15115646>{{Cite journal  | last1 = Fraker | first1 = DL. | title = Management of in-transit melanoma of the extremity with isolated limb perfusion. | journal = Curr Treat Options Oncol | volume = 5 | issue = 3 | pages = 173-84 | month = Jun | year = 2004 | doi =  | PMID = 15115646 }}</ref> It may be seen in a number of tumours, e.g. squamous cell carinoma,<ref name=pmid25775628 >{{Cite journal  | last1 = Kocatürk | first1 = E. | last2 = Ülkümen | first2 = PK. | last3 = Kızıltaç | first3 = U. | last4 = Yüksel | first4 = T. | last5 = Kunter | first5 = AS. | last6 = Erhan | first6 = SŞ. | title = In-transit metastasis from primary cutaneous squamous cell carcinoma in a nonimmunosuppressed patient. | journal = J Cutan Med Surg | volume = 19 | issue = 2 | pages = 167-70 | month =  | year =  | doi = 10.2310/7750.2014.14047 | PMID = 25775628 }}</ref><ref>{{Cite journal  | last1 = Altunay | first1 = I. | last2 = Çerman | first2 = AA. | last3 = Sakiz | first3 = D. | last4 = Ates | first4 = B. | title = Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review. | journal = Ann Dermatol | volume = 27 | issue = 4 | pages = 442-5 | month = Aug | year = 2015 | doi = 10.5021/ad.2015.27.4.442 | PMID = 26273163 }}</ref>  
It is relatively common in [[malignant melanoma]].<ref name=pmid15115646>{{Cite journal  | last1 = Fraker | first1 = DL. | title = Management of in-transit melanoma of the extremity with isolated limb perfusion. | journal = Curr Treat Options Oncol | volume = 5 | issue = 3 | pages = 173-84 | month = Jun | year = 2004 | doi =  | PMID = 15115646 }}</ref> It may be seen in a number of tumours, e.g. squamous cell carinoma,<ref name=pmid25775628 >{{Cite journal  | last1 = Kocatürk | first1 = E. | last2 = Ülkümen | first2 = PK. | last3 = Kızıltaç | first3 = U. | last4 = Yüksel | first4 = T. | last5 = Kunter | first5 = AS. | last6 = Erhan | first6 = SŞ. | title = In-transit metastasis from primary cutaneous squamous cell carcinoma in a nonimmunosuppressed patient. | journal = J Cutan Med Surg | volume = 19 | issue = 2 | pages = 167-70 | month =  | year =  | doi = 10.2310/7750.2014.14047 | PMID = 25775628 }}</ref><ref>{{Cite journal  | last1 = Altunay | first1 = I. | last2 = Çerman | first2 = AA. | last3 = Sakiz | first3 = D. | last4 = Ates | first4 = B. | title = Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review. | journal = Ann Dermatol | volume = 27 | issue = 4 | pages = 442-5 | month = Aug | year = 2015 | doi = 10.5021/ad.2015.27.4.442 | PMID = 26273163 }}</ref>  
ecrrine porocarcinoma<ref name=pmid26234455>{{Cite journal  | last1 = Imafuku | first1 = K. | last2 = Hata | first2 = H. | last3 = Kitamura | first3 = S. | last4 = Iwata | first4 = H. | last5 = Shimizu | first5 = H. | title = In-transit metastasis of advanced eccrine porocarcinoma. | journal = Int J Dermatol | volume =  | issue =  | pages =  | month = Jul | year = 2015 | doi = 10.1111/ijd.12928 | PMID = 26234455 }}</ref>, [[Merkel cell carcinoma]].<ref name=pmid25754425>{{Cite journal  | last1 = Gunaratne | first1 = DA. | last2 = Howle | first2 = JR. | last3 = Veness | first3 = MJ. | title = Merkel cell carcinoma: A case of palliative upper limb amputation in a patient with refractory in-transit metastases. | journal = Australas J Dermatol | volume =  | issue =  | pages =  | month = Mar | year = 2015 | doi = 10.1111/ajd.12291 | PMID = 25754425 }}</ref>
eccrine porocarcinoma,<ref name=pmid26234455>{{Cite journal  | last1 = Imafuku | first1 = K. | last2 = Hata | first2 = H. | last3 = Kitamura | first3 = S. | last4 = Iwata | first4 = H. | last5 = Shimizu | first5 = H. | title = In-transit metastasis of advanced eccrine porocarcinoma. | journal = Int J Dermatol | volume =  | issue =  | pages =  | month = Jul | year = 2015 | doi = 10.1111/ijd.12928 | PMID = 26234455 }}</ref> [[Merkel cell carcinoma]].<ref name=pmid25754425>{{Cite journal  | last1 = Gunaratne | first1 = DA. | last2 = Howle | first2 = JR. | last3 = Veness | first3 = MJ. | title = Merkel cell carcinoma: A case of palliative upper limb amputation in a patient with refractory in-transit metastases. | journal = Australas J Dermatol | volume =  | issue =  | pages =  | month = Mar | year = 2015 | doi = 10.1111/ajd.12291 | PMID = 25754425 }}</ref>
 
''[[Tumour deposits]]'' in [[colorectal adenocarcinoma]], conceptually, are the same thing as ''in-transit metastases'';<ref name=pmid19136930>{{Cite journal  | last1 = Puppa | first1 = G. | last2 = Ueno | first2 = H. | last3 = Kayahara | first3 = M. | last4 = Capelli | first4 = P. | last5 = Canzonieri | first5 = V. | last6 = Colombari | first6 = R. | last7 = Maisonneuve | first7 = P. | last8 = Pelosi | first8 = G. | title = Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases. | journal = Mod Pathol | volume = 22 | issue = 3 | pages = 410-5 | month = Mar | year = 2009 | doi = 10.1038/modpathol.2008.198 | PMID = 19136930 }}</ref> however, the details of the definitions are different.


==General==
==General==
*May be how a tumour (e.g. melanoma<ref name=pmid22329185>{{Cite journal  | last1 = Grotz | first1 = TE. | last2 = Mansfield | first2 = AS. | last3 = Kottschade | first3 = LA. | last4 = Erickson | first4 = LA. | last5 = Otley | first5 = CC. | last6 = Markovic | first6 = SN. | last7 = Jakub | first7 = JW. | title = In-transit melanoma: an individualized approach. | journal = Oncology (Williston Park) | volume = 25 | issue = 14 | pages = 1340-8 | month = Dec | year = 2011 | doi =  | PMID = 22329185 }}</ref>) recurs.
*It is called "in-transit", as it happens while the tumour is on the way to the regional lymph node.
*May be how a tumour (e.g. melanoma<ref name=pmid22329185>{{Cite journal  | last1 = Grotz | first1 = TE. | last2 = Mansfield | first2 = AS. | last3 = Kottschade | first3 = LA. | last4 = Erickson | first4 = LA. | last5 = Otley | first5 = CC. | last6 = Markovic | first6 = SN. | last7 = Jakub | first7 = JW. | title = In-transit melanoma: an individualized approach. | journal = Oncology (Williston Park) | volume = 25 | issue = 14 | pages = 1340-8 | month = Dec | year = 2011 | doi =  | PMID = 22329185 }}</ref><ref>{{Cite journal  | last1 = Pawlik | first1 = TM. | last2 = Ross | first2 = MI. | last3 = Johnson | first3 = MM. | last4 = Schacherer | first4 = CW. | last5 = McClain | first5 = DM. | last6 = Mansfield | first6 = PF. | last7 = Lee | first7 = JE. | last8 = Cormier | first8 = JN. | last9 = Gershenwald | first9 = JE. | title = Predictors and natural history of in-transit melanoma after sentinel lymphadenectomy. | journal = Ann Surg Oncol | volume = 12 | issue = 8 | pages = 587-96 | month = Aug | year = 2005 | doi = 10.1245/ASO.2005.05.025 | PMID = 16021533 }}</ref>) recurs.
*Poor prognosticator.
*Poor prognosticator.


==Gross==
==Gross==
*Nodule in soft tissue.
*Often not apparent.
*Often not apparent.


==Microscopic==
==Microscopic==
Features:
Definition - a separate tumour nodule that is:<ref name=cancergov>URL: [http://www.cancer.gov/dictionary?cdrid=634128 http://www.cancer.gov/dictionary?cdrid=634128]. Accessed on: 28 March 2012.</ref>
*Tumour nodule within a lymphatic with or without extension into the surrounding tissue.
#>2 cm from the primary tumour.
#Arises between the nearest (regional) [[lymph node]]s and the primary tumour.
#*The tumour presumably arises from a lymphatic that drains the tissue in which the primary tumour grew.


DDx:
DDx:
*[[Lymph node metastasis]] - should have lymphoid tissue and capsule.
*[[Satellitosis]] - separate nodule <= 2 cm from the primary tumour.
*[[Tumour nodules]].
*[[Lymphovascular invasion]] - does not form a nodule and does not invade into the surround tissue.
*[[Lymph node metastasis]] - should have lymphoid tissue and capsule ''or'' be round; definitions dependent on the body site/primary tumour.
*[[Tumour deposit]] - also known as ''discoutinuous extramural extension'' and ''peritumoral deposits''; concept in [[colorectal adenocarcinoma]].
**''Tumour deposits'' conceptually are the samething as the ''in-transit metastases'';<ref name=pmid19136930>{{Cite journal  | last1 = Puppa | first1 = G. | last2 = Ueno | first2 = H. | last3 = Kayahara | first3 = M. | last4 = Capelli | first4 = P. | last5 = Canzonieri | first5 = V. | last6 = Colombari | first6 = R. | last7 = Maisonneuve | first7 = P. | last8 = Pelosi | first8 = G. | title = Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases. | journal = Mod Pathol | volume = 22 | issue = 3 | pages = 410-5 | month = Mar | year = 2009 | doi = 10.1038/modpathol.2008.198 | PMID = 19136930 }}</ref> however, the details of their definitions are different.


==See also==
==See also==
*[[Metastasis]].
*[[Metastasis]].
*[[Cancer staging]].
*[[Cancer staging]].
*[[Tumour budding]].


==References==
==References==

Latest revision as of 12:40, 11 August 2016

In-transit metastasis is a type of metastatic disease, characterized by tumour nodules arising from the lymphatics[1] between the primary tumour and its local/regional lymph nodes.[2]

It is relatively common in malignant melanoma.[1] It may be seen in a number of tumours, e.g. squamous cell carinoma,[3][4] eccrine porocarcinoma,[5] Merkel cell carcinoma.[6]

Tumour deposits in colorectal adenocarcinoma, conceptually, are the same thing as in-transit metastases;[7] however, the details of the definitions are different.

General

  • It is called "in-transit", as it happens while the tumour is on the way to the regional lymph node.
  • May be how a tumour (e.g. melanoma[8][9]) recurs.
  • Poor prognosticator.

Gross

  • Nodule in soft tissue.
  • Often not apparent.

Microscopic

Definition - a separate tumour nodule that is:[2]

  1. >2 cm from the primary tumour.
  2. Arises between the nearest (regional) lymph nodes and the primary tumour.
    • The tumour presumably arises from a lymphatic that drains the tissue in which the primary tumour grew.

DDx:

  • Satellitosis - separate nodule <= 2 cm from the primary tumour.
  • Lymphovascular invasion - does not form a nodule and does not invade into the surround tissue.
  • Lymph node metastasis - should have lymphoid tissue and capsule or be round; definitions dependent on the body site/primary tumour.
  • Tumour deposit - also known as discoutinuous extramural extension and peritumoral deposits; concept in colorectal adenocarcinoma.
    • Tumour deposits conceptually are the samething as the in-transit metastases;[7] however, the details of their definitions are different.

See also

References

  1. ↑ 1.0 1.1 Fraker, DL. (Jun 2004). "Management of in-transit melanoma of the extremity with isolated limb perfusion.". Curr Treat Options Oncol 5 (3): 173-84. PMID 15115646.
  2. ↑ 2.0 2.1 URL: http://www.cancer.gov/dictionary?cdrid=634128. Accessed on: 28 March 2012.
  3. ↑ Kocatürk, E.; Ülkümen, PK.; Kızıltaç, U.; Yüksel, T.; Kunter, AS.; Erhan, SŞ.. "In-transit metastasis from primary cutaneous squamous cell carcinoma in a nonimmunosuppressed patient.". J Cutan Med Surg 19 (2): 167-70. doi:10.2310/7750.2014.14047. PMID 25775628.
  4. ↑ Altunay, I.; Çerman, AA.; Sakiz, D.; Ates, B. (Aug 2015). "Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review.". Ann Dermatol 27 (4): 442-5. doi:10.5021/ad.2015.27.4.442. PMID 26273163.
  5. ↑ Imafuku, K.; Hata, H.; Kitamura, S.; Iwata, H.; Shimizu, H. (Jul 2015). "In-transit metastasis of advanced eccrine porocarcinoma.". Int J Dermatol. doi:10.1111/ijd.12928. PMID 26234455.
  6. ↑ Gunaratne, DA.; Howle, JR.; Veness, MJ. (Mar 2015). "Merkel cell carcinoma: A case of palliative upper limb amputation in a patient with refractory in-transit metastases.". Australas J Dermatol. doi:10.1111/ajd.12291. PMID 25754425.
  7. ↑ 7.0 7.1 Puppa, G.; Ueno, H.; Kayahara, M.; Capelli, P.; Canzonieri, V.; Colombari, R.; Maisonneuve, P.; Pelosi, G. (Mar 2009). "Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases.". Mod Pathol 22 (3): 410-5. doi:10.1038/modpathol.2008.198. PMID 19136930.
  8. ↑ Grotz, TE.; Mansfield, AS.; Kottschade, LA.; Erickson, LA.; Otley, CC.; Markovic, SN.; Jakub, JW. (Dec 2011). "In-transit melanoma: an individualized approach.". Oncology (Williston Park) 25 (14): 1340-8. PMID 22329185.
  9. ↑ Pawlik, TM.; Ross, MI.; Johnson, MM.; Schacherer, CW.; McClain, DM.; Mansfield, PF.; Lee, JE.; Cormier, JN. et al. (Aug 2005). "Predictors and natural history of in-transit melanoma after sentinel lymphadenectomy.". Ann Surg Oncol 12 (8): 587-96. doi:10.1245/ASO.2005.05.025. PMID 16021533.
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