In-transit metastasis

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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 deposits - 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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