International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - vol 05 issue 19, October, 2013

Pages: 56-60

Date of Publication: 19-Oct-2013


Print Article   Download XML  Download PDF

A RARE CASE OF ADENOCARCINOMA LUNG WITH SECONDARIES TO PROXIMAL ULNA

Author: Supradeeptha Challa, Vikram Kumar Kadiyam, Kota Aditya, Satyaprasad J.

Category: Healthcare

Abstract:Metastasis of lung carcinoma to proximal ulna is very rare. We report a case of 55 year male patient with adenocarcinoma of lung, with metastasis to proximal ulna.

Keywords: adenocarcinoma lung, metastasis.

Full Text:

INTRODUCTION

Bone is one of the most common locations for metastasis1. While any type of carcinoma is capable of forming metastasis within bone, the microenvironment of the marrow tends to favor particular types of cancer, including prostate, breast, and lung carcinoma2. Particularly in prostate carcinoma, bone metastases tend to be the only site of metastasis3.

Bone metastases most commonly affect the axial skeleton. The axial skeleton contains the red marrow, while appendicular skeleton contains relatively fatty marrow4. The drainage of blood to the skeleton via the vertebral-venous plexus may, at least in part, explain the tendency of breast and prostate, kidney, thyroid, and lung cancers, to produce metastases in the axial skeleton and limb girdles5. The vertebral-venous plexus does not provide the entire explanation of why these cancers metastasize to the skeleton. Molecular and cellular biological characteristics of the tumor cells and the tissues to which they metastasize are of paramount importance and influence the pattern of metastatic spread6-8.

Skeletal metastases account for 70% of all malignant bone tumours9. The incidence of bone metastases from lung carcinoma is 36%10. The frequency of bone metastasis is significantly higher among patients with adenocarcinoma than small cell or squamous carcinoma11, 12. Because of the relatively avascular marrow, metastases below the elbow and knee are relatively rare13. No case report of adenocarcinoma lung with secondaries to proximal ulna is published till date except in felines14.

CASE REPORT

A 55 year old male patient came to department of Orthopaedics with complaints of pain and swelling at right elbow and forearm since 2 months which is insidious in onset and gradually progressing. Pain is of diffuse in elbow region, stabbing in nature, non-radiating, severe with movements of elbow, and rated 7/10 on a visual analogue score. Patient had no history of trauma. Additional symptoms included mild shortness of breath. Patient is a smoker (1 packet beedies/day) and alcoholic (90 ml/day). The patient was afebrile. Vital signs were normal. Respiration is 19 cycles per minute. On auscultation of lungs, there is mild decrease in breath sound on right side of chest.  On inspection of the forearm, there is diffuse swelling at right elbow and forearm of size 12x6 cms. Skin over swelling darkened, shiny. No scars, no sinuses, no visible pulsations.

On palpation, local rise of temperature present. Severe tenderness present over olecranon which is irregular in outline. Radial head is not palpable. Swelling is hard to firm in nature, pitting edema present, skin not pinchable over swelling. Distal radial pulse felt. No distal neurological deficits. Mild decrease in flexion of elbow and other movements are normal. Radiographs of right forearm showing osteolytic lesion of proximal ulna extending into diaphysis (Figure 1 and2). Articular surfaces are maintained. Radiograph of chest showing radio dense lesion in right lung (Fig 3).

FNAC Smears (Figure 4) from lytic lesions of right ulna shows abundant cellularity of cuboidal cells arranged in small and large clusters, sheets and papilloid structures and also scattered discretely. At places, these cells show acinar or microfollicular arrangement. The nuclei are large hyperchromatic with well dispersed chromatin and prominent nucleoli cytoplasm is densely eosinophilic. These features suggestive of metastasis of adenocarcinoma of  lung to proximal ulna. The FNAC report of right supraclavicular lymphnodes shows same features.  Patient was referred to cancer trust hospital for further management. 

DISCUSSION

Lung cancer can metastasize to virtually any bone, although the axial skeleton and proximal long bones are most commonly involved15. Metastatic tumor cells colonize the bone matrix and stimulate the activity of osteoclasts and/or osteoblasts, causing osteolysis and possible excessive bone formation around sites of tumor cell deposits in bone. This disruption in bone metabolism leads to significant skeletal morbidity most commonly bone pain16. To our knowledge, this is the first case report of adenocarcinoma lung metastasis to proximal ulna.

CONCLUSION

Metastasis of adenocarcinoma to ulna is very rare.

References:

  1. Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin. Cancer Res. 2006; 12: 6243–49.
  2. Guise T. Examining the metastatic niche: targeting the microenvironment. Semin. Oncol. 2010; 37: 2–14.
  3. Jimenez-Andrade JM, Mantyh WG, Bloom AP, Ferng AS, Geffre CP, Mantyh PW. "Bone cancer pain". Ann. N. Y. Acad. Sci. 2010; 1198: 173–81.
  4. Boland PJ, Lane JM, Sundaresan N. Metastatic disease of the spine. Clin Orthop. 1982; 169: 95–102.
  5. Batson O. The role of vertebral veins in metastatic processes. Ann Intern Med 1942; 16: 38–45.
  6. Bundred N, Walker RA, Ratcliffe WA, et al. Parathyroid hormone related protein, and skeletal morbidity in breast cancer. Eur J Cancer 1992; 28: 690–2.
  7. Coleman R, Rubens R. The clinical course of bone metastases in breast cancer. Br J Cancer 1987; 77: 336–40.
  8. Koenders P, Beex LV, Langens R, et al. Steroid hormone receptor activity of primary human breast cancer and pattern of first metastasis. Breast Cancer Res Treat 1991; 18: 27–32.
  9. Greenspan A, Jundt G, Remagen W. Differential diagnosis in orthopaedic oncology. Philadelphia: Lippincott Williams and Wilkins, c2007. (2006) ISBN:0781779308
  10. Galasko C. The anatomy and pathways of skeletal metastases. In: Weiss L, Gilbert A, editors. Bone metastases. Boston: GK Hall; 1981. p. 49–63.
  11. Ryo H, Sakai H, Yoneda S, Noguchi Y. Bone metastasis of primary lung cancer. Nihon Kokyuki Gakkai Zasshi. 1998; 36(4): 317-22.
  12. A.S. Shinto, L. Pachen, S. T K, C.D. Joseph. Skeletal Metastases In Apparently Operable Lung Cancer Evaluated With Whole Body Bone Scan – A Pilot Study In South India. The Internet Journal of Thoracic and Cardiovascular Surgery. 2010; 14: Number 2.
  13. Samuel Kenan, Jeffrey I. Mechanick. Skeletal matastases. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003.
  14. Raquel Salgüero, Sorrel Langley-Hobbs, James Warland, Malcolm Brearley. Metastatic carcinoma in the ulna of a cat secondary to a suspected pulmonary tumour. Journal of Feline Medicine and Surgery. 2012; 4: 1-4.
  15. Beckles MA, Spiro SG, Colice GL, R udd RM. Initial evaluation of the patient with lung cancere- symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest. 2003; 123: 97s-104s.
  16. Mercadante S. Malignant bone pain: pathophysiology and treatment. Pain. 1997; 69: 1–18.

Research Incentive Schemes

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09

Study by Dheeraj Kumar Chopra et al. entitled "Lipid-Based Solid Dispersions of Azilsartan Medoxomil with Improved Oral Bioavailability: In Vitro and In Vivo Evaluation" published in Vol 12 issue 19


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.



Company name

International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2020 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions