Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading. hcg is an autocrine, acting directly on There is a triphasic population of atypical cells composed of syncytiotrophoblast, cytotrophoblast and intermediate trophoblast. abrupt lung metastases with cannonballs pattern at the time of initial diagnosis as shown in our cases have been reported in germ cell tumors, 2, 3 choriocarcinomas, 4 and endometrial cancers. Pure testicular choriocarcinoma Cannonball metastases as a presenting imaging feature: A case report and a review of literature Radiol Case Rep. 2021 . Here we describe a rare initial presentation of testicular cancer in a previously asymptomatic 22-year-old male who presented with widespread metastatic cannonball lesions in his lungs. As presented in this case, cannonball metastases may be the initial presentation in cases with no history of primary malignancy. Dizziness. Epilepsy. Cannonball metastases are common in choriocarcinoma. Cannon ball pulmonary metastases are typically seen in the patients with choriocarcinoma or renal cell carcinoma. cannonball metastases One or more large, well-circumscribed metastatic nodules in the lungs, classically in renal cell carcinoma, but also in choriocarcinoma McGraw-Hill Concise Dictionary of Modern Medicine. This is an uncommon finding, and is typically seen in patients with a history of renal cell carcinoma and choriocarcinoma. We report a case of a 62-year-old Middle Eastern male who presented with shortness of breath, chest pain and fatigue and was found to have bilateral multiple pulmonary cannonball lesions and mass in the pancreas. Cannonball metastases. The cure rates, even for metastatic gestational choriocarcinoma, more than 90% when using chemotherapy for invasive mole and choriocarcinoma. References Nabi G, Sadiq M . a type of gestational trophoblastic neoplasia. Intra-placental choriocarcinoma is a very rare variant usually, presenting with metastatic symptoms in the post-partum mother, and rarely with metastasis in the infant, and should be included on the differential diagnosis of elevated AFP in a postpartum patient. It is. Renal cell carcinoma is by far the commonest cause with choriocarcinoma, and endometrial carcinoma being less common primaries. Chest pain. 2002 by The McGraw-Hill Companies, Inc. Want to thank TFD for its existence? Choriocarcinoma exhibits varied symptoms when they metastasize to other body parts. This 83 year old woman presented with shortness of breath. can follow a molar pregnancy or can arise from the ovaries and testes as a germ cell tumor. These are highly chemo-sensitive tumors with high cure rates. If it metastasizes to the lungs and brain, it may show the following symptoms; Cough. . Cannonball metastases refer to multiple large, well-circumscribed, round pulmonary metastases. Rarely, pulmonary metastases with the same appearance may be secondary from prostate cancer, synovial sarcoma, endometrial carcinoma or hepatocellular carcinoma. Pure testicular choriocarcinoma is an extremely rare subtype of nonseminomatous germ cell tumor, accounting for less than 1% of all germ cell tumors and only 0.19% of all testicular tumors. . Striking progression of lung metastases without established primary malignancy can raise a diagnostic challenge. It is a highly aggressive malignant tumor with early multiorgan metastasis and poor prognosis. 2002 by The McGraw-Hill Companies, Inc. Want to thank TFD for its existence? About 8% of mixed germ cell tumours contain a component of choriocarcinoma [ 7 ]. Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading. We present a rare case of Cannonball Lung metastases as the presenting form of Hodgkin Lymphoma (HL). Journal Article OPEN ACCESS Pure testicular choriocarcinoma Cannonball metastases as a presenting imaging feature: A case report and a review of literature most commonly of placental origin. Overview. Visual disturbances. Breathing trouble. most commonly spreads to the lungs, leading to shortness of breath and hemoptysis. Pure testicular choriocarcinoma is an extremely rare subtype of nonseminomatous germ cell tumor, accounting for less than 1% of all germ cell tumors and . Cannonball metastases is a description given to a select type of lung metastases in which multiple large masses are evident. INTRODUCTION: Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading.1 This usually indicates an advanced stage of the disease with a poor prognosis. Cannonball metastases refer to multiple large, well-circumscribed, round pulmonary metastases that appear not unsurprisingly like cannonballs. Her CXR shows multiple large, round, well-circumscribed masses in both lungs, with the classic appearance of 'cannonball' metastases. a type of gestational trophoblastic neoplasia. Immunohistochemical stains show reactivity for hCG (diffuse), p63 (focal) and hPL (focal). More than 95% of patients with testicular cancer present with a painless testicular mass. "Cannonball appearance," as a rare and yet underrated CT feature of COVID-19 pneumonia, has been typically linked to certain hematogenous pulmonary metastases and some inflammatory/infection conditions, including tuberculosis, but no other viral or atypical pneumonia. They are usually associated with disseminated malignancy and indicate grim prognosis. Headache. Cannonball metastases classically present in cases with choriocarcinoma and renal cell carcinoma as well as endometrial and prostate cancer [9]. The French terms " envole de ballons " and " lcher de ballons ", which translate to "balloons release", are also used to describe this same appearance. Choriocarcinoma syndrome is a rare clinical entity with advanced, high volume choriocarcinomatous tumors and markedly elevated B-hCG (>50,000 IU/L). Cannonball opacities usually correspond to metastases associated with renal cell carcinoma, choriocarcinoma, endometrial cancer, prostate cancer and some gastrointestinal malignancies. We herein report three cases with cannonball metastases at initial presentation. Choriocarcinoma is a tumour of germ cell origin which recapitulates the developing trophoblast. Pure testicular choriocarcinoma is an extremely rare subtype of nonseminomatous germ cell tumor, accounting for less than 1% of all germ cell tumors and only 0.19% of all testicular tumors. Choriocarcinoma (see comment) Comment: The specimen shows a highly mitotically active neoplasm arising in the endomyometrium. 5, 6 it is noteworthy that these cancers are frequently described as hcg expressing tumors, as already indicated. Choriocarcinoma is a malignant nonseminomatous germ cell tumor (GCT) composed of trophoblastic cells with associated hemorrhage Essential features Tumor that arises from trophoblastic tissue and consists of syncytiotrophoblasts, cytotrophoblasts and intermediate trophoblasts with associated hemorrhage Increased serum beta hCG cannonball metastases One or more large, well-circumscribed metastatic nodules in the lungs, classically in renal cell carcinoma, but also in choriocarcinoma McGraw-Hill Concise Dictionary of Modern Medicine. @article{Aftan2021PureTC, title={Pure testicular choriocarcinoma Cannonball metastases as a presenting imaging feature: A case report and a review of literature}, author={Mohanad Kareem Aftan and Noor Badrawi and Shareefa Abdulghaffar and Ayoub Ahmad Abedzadeh and Usama M Albastaki and Lakshmiah Ganapathy Raman and Ethar Faris G. Alzeena . Pure choriocarcinoma is extremely rare and represents less than 1% of testicular GCTs and only about 0.19% of all testicular tumours. [10] [ PubMed] 14. Epidemiology. Striking progression of lung metastases without established primary malignancy can raise a. It is characterized by early hematogenous spread to the lungs. Choriocarcinoma is a hypervascular tumor and uterine choriocarcinoma is usually associated with congestion of the pelvic veins. The primary tumors for these lesions can be remembered with the help of this mnemonic: CRESP Mnemonic C: choriocarcinoma R: renal cell carcinoma E. made up of cytotrophoblasts and syncytiotrophoblasts without villi. Classically, when cannonball lesions are associated with metastatic disease, they are seen in renal cell carcinoma and choriocarcinoma. Patient 1: A 53-year-old male was diagnosed with middle and lower esophageal squamous cell carcinoma with multiple bone metastases staged with T4aN2M1 and began to receive palliative concurrent chemoradiotherapy on September 29, 2016, and admitted to the hospital on January 28, 2020. Large, round, well-circumscribed metastatic pulmonary nodules are called 'cannon ball' metastases. Multiple bilateral cannon-ball lung metastases from carcinoma of the prostate: orchiedectomy induced remission. We present a case of 23-year-old male presented to the hospital with mild hemoptysis which was thought as a . made up of cytotrophoblasts and syncytiotrophoblasts without villi. Epidemiology. most commonly spreads to the lungs, leading to shortness of breath and hemoptysis. Choriocarcinoma is a malignant, trophoblastic cancer, usually of the placenta. Recognition is important because the diagnosis of this syndrome identifies poor prognosis without mortality-proven management options. Differential diagnosis includes tuberculosis, fungal infections and granulomatosis with polyangiitis. most commonly of placental origin. Pure testicular choriocarcinoma is an extremely rare subtype of nonseminomatous germ cell tumor, accounting for less than 1% of all germ cell tumors and only 0.19% of all testicular tumors. Incidence. Striking progression of lung. Two patients ended up having a choriocarcinoma but no awareness of the presence of primary tumors, and the third had abrupt lung metastases of . As presented in this case, cannonball metastases may be the initial presentation in cases with no history of primary malignancy. 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