Thyroid cancer with metastatic disease to the pelvis is extremely rare. The patient in our case, an 86-year-old male, presented after total thyroidectomy for follicular thyroid cancer (FTC) with symptoms of recurrent urinary tract infections and retentions, surprisingly leading to the discovery of a large sacral mass on the CT abdomen and pelvis. The biopsy showed metastatic carcinoma with morphology and immunohistochemistry to be consistent with FTC. In our case, due to symptomatology, prostate cancer was initially considered high in the differential for primary source rather than thyroid cancer. The mass was considered too large for surgery, and he was referred to a radiation oncologist for radiation therapy for the sacral mass.

BACKGROUND: Rectal mucinous adenocarcinoma (MAC) is a rare pathological type of rectal cancer with unique pathological features and a poor prognosis. It is difficult to diagnose and treat early because of the lack of specific manifestations in some aspects of the disease. The common metastatic organs of rectal cancer are the liver and lung; however, rectal carcinoma with metastasis to subcutaneous soft tissue is a rare finding.
METHODS: In this report, the clinical data, diagnosis and treatment process, and postoperative pathological features of a patient with left waist subcutaneous soft tissue masses were retrospectively analyzed. The patient underwent surgical treatment after admission and recovered well after surgery. The final pathological diagnosis was rectal MAC with left waist subcutaneous soft tissue metastasis.
CONCLUSIONS: Subcutaneous soft tissue metastasis of rectal MAC is rare, and it can suggest that the tumor is disseminated, and it can appear even earlier than the primary malignant tumor, which is occult and leads to a missed diagnosis and misdiagnosis clinically. When a subcutaneous soft tissue mass of unknown origin appears in a patient with rectal cancer, a malignant tumor should be considered.

BACKGROUND: Colon cancer with liver metastasis is a common occurrence in clinical practice. The presence of liver metastasis has a significant impact on the treatment strategy of patients, so the first step is to diagnose whether it is liver metastasis. Imaging is one of the auxiliary methods for diagnosing liver metastases, but due to the presence of different diseases with the same shadow, we need to be cautious when using imaging methods for the diagnosis of liver metastases.
METHODS: We report a 53-year-old female patient with sigmoid colon cancer and perforation who underwent a surgical operation. Three years after the operation, reexamination of the liver through computed tomography and magnetic resonance imagery scanning revealed multiple progressive liver lesions. However, the liver biopsy did not show malignant changes. Repeated analysis of the patient\'s liver magnetic resonance imaging revealed that multiple liver nodules were significantly enhanced in the arterial phase and that the portal vein density/signal ratio was higher than that of the liver parenchyma. The coincidence of doughnut-shaped nodules and high signal in the hepatobiliary phase, combined with the results of pathological liver puncture examination, led to nodular regenerative hyperplasia being considered as a possible diagnosis.
CONCLUSIONS: A review of the relevant literature showed that following oxaliplatin chemotherapy for colorectal cancer, it is not uncommon for doughnut-shaped nodules with obvious enhancement in the middle hepatic artery phase and high signal intensity in the hepatobiliary phase to develop. Such changes should be paid sufficient attention by radiologists.

Carcinoma en cuirasse (CeC) is a rare case of cutaneous metastases most commonly seen in the breast or visceral organs. The term carcinoma en cuirasse is largely used to describe the coalescing and fibrotic textural changes in the skin that can be seen in these metastatic lesions, which often manifest in a large plaque-like distribution. While most cases of CeC are found on the trunk, CeC has been reported in other body locations. However, to our knowledge, it has not yet been described on the face. In this report, we discuss a rare case of metastatic cutaneous squamous cell carcinoma (cSCC) that presented on the head and neck of a 67-year-old female, for which we have coined the term \"carcinoma en bascinet.\" This novel term stems from the fibrotic changes associated with significant metastatic carcinomas of the head and neck, which bear a resemblance to a bascinet, which is a medieval-style helmet worn by European soldiers during the 14th and 15th centuries. We present this case of carcinoma en bascinet secondary to metastatic cSCC to demonstrate how metastatic cSCC can present in a facial distribution, causing significant morbidity and, as in this case, mortality. We hope that this case will increase the awareness of the highly variable presentation of metastatic cSCC, specifically as an extensive papulonodular and fibrotic plaque, allowing patients to receive early initiation of systemic therapy for symptom management and hence maximizing their quality of life.

Primary renal neuroendocrine tumours are very rare clinical entities, and as such, relatively little is known about their clinical progression. Here, we outline the case of a young female patient presenting with abdominal pain and a large 14 cm right renal mass. Initial radiological studies demonstrated localised disease, but during surgical resection, widespread liver metastasis was identified. Histological analysis revealed a grade 2, well-differentiated neuroendocrine tumour pT3a. Whilst surgical resection remains the gold standard for localised disease, further work is required to understand the pathogenesis, prognostic indicators and treatment following metastatic spread. The poor prognosis seen in primary renal neuroendocrine neoplasia highlights the importance of further directed research in this area.

Brain metastases of various types of cancer are diagnosed in 8-10% of all cancer patients. In the world literature, only 30 cases of cancer metastasis to the pituitary adenoma are described. This article presents yet another observation of a patient with breast cancer metastasis into the hormone-inactive pituitary adenoma at the Burdenko neurosurgical center, Russia The patient underwent endoscopic endonasal transsphenoid removal of the neoplasm. During microscopy and immunohistochemical studies of the biopsy, two types of tissue (pituitary adenoma and cancer metastasis) with different Ki-67 treated surgically (1% and over 40%) were found.
Метастазы различных видов рака в головной мозг выявляются у 8-10% от всех онкологических пациентов. В мировой литературе описано всего 30 случаев метастазирования рака в аденому гипофиза. В нашей публикации представлено еще одно наблюдение хирургического лечения пациентки с метастазом рака молочной железы в гормонально-неактивную аденому гипофиза, которое проведено в ФГАУ \'Национальный медицинский исследовательский центр нейрохирургии им. акад. Н.Н. Бурденко\' Минздрава России. Пациентка подверглась эндоскопическому эндоназальному транссфеноидальному удалению новообразования. При проведении микроскопии и иммуногистохимического исследования биоптата выявлено два вида ткани (аденома гипофиза и метастаз рака) с разными индексами Ki-67 (1% и свыше 40%).

BACKGROUND: A disadvantage of prostate-specific antigen (PSA) for the early detection of prostate cancer (PCa) is that many men must be screened, biopsied, and diagnosed to prevent one death.
OBJECTIVE: To increase the specificity of screening for lethal PCa at an early stage.
METHODS: We conducted a case-control study nested within a population-based cohort. PSA and three additional kallikreins were measured in cryopreserved blood from a population-based cohort in Västerbotten, Sweden. Of 40379 men providing blood at ages 40, 50, and 60 yr from 1986 to 2009, 12542 men were followed for >15 yr. From this cohort, the Swedish Cancer Registry identified 1423 incident PCa cases, 235 with distant metastasis.
METHODS: Risk of distant metastasis for different PSA levels and a prespecified statistical model based on the four kallikrein markers.
CONCLUSIONS: Most metastatic cases occurred in men with PSA in the top quartile at age 50 yr (69%) or 60 yr (74%), whereas 20-yr risk of metastasis for men with PSA below median was low (≤0.6%). Among men with PSA >2 ng/ml, a prespecified model based on four kallikrein markers significantly enhanced the prediction of metastasis compared with PSA alone. About half of all men with PSA >2 ng/ml were defined as low risk by this model and had a ≤1% 15-yr risk of metastasis.
CONCLUSIONS: Screening at ages 50-60 yr should focus on men with PSA in the top quartile. A marker panel can aid biopsy decision making.
RESULTS: For men in their fifties, screening should focus on those in the top 10% to 25% of PSA values because the majority of subsequent cases of distant metastasis are found among these men. Testing of four kallikrein markers in men with an elevated PSA could aid biopsy decision making.