From ACTH-Dependent to ACTH-Independent Cushing’s Syndrome from a Malignant Mixed Corticomedullary Adrenal Tumor: Potential Role of Embryonic Stem Cells
| Autor: | Daniel Marrero-Rodríguez, Claudia Ramírez-Rentería, Ana Laura Espinosa-de-los-Monteros, Mayte Lizeth Padilla-Cristerna, Guillermo Montoya-Martínez, Mercado Moises, M.D.P. Figueroa-Corona, Espinosa-Cardenas Etual, Keiko Taniguchi-Ponciano, Rocío Arreola-Rosales, Paola Briseño-Díaz, Guillermo Castellanos |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pathology
medicine.medical_specialty endocrine system biology business.industry Endocrinology Diabetes and Metabolism Chromogranin A 030209 endocrinology & metabolism Case Report medicine.disease RC648-665 Embryonic stem cell Diseases of the endocrine glands. Clinical endocrinology Metastasis Pheochromocytoma 03 medical and health sciences 0302 clinical medicine SOX2 Cancer stem cell 030220 oncology & carcinogenesis Synaptophysin biology.protein medicine Stem cell business |
| Zdroj: | Case Reports in Endocrinology, Vol 2020 (2020) Case Reports in Endocrinology |
| ISSN: | 2090-6501 |
| Popis: | Context. Truly, mixed corticomedullary adrenal tumors (MCATs) may not come from colliding tumors but from a single stem cell. Objective. To report the immunohistochemical and molecular evaluation of a patient with ectopic ACTH syndrome (EAS) from a MCAT which has single cells with features of both 96 medullary and cortical differentiation. Case Description and Methods. A 16-year-old woman presented with severe EAS and a large right MCAT composed of ACTH-secreting cells resembling pheochromocytoma and another lineage similar to adrenal carcinoma. Immunohistochemistry (IHC) showed positivity for medullary (ACTH, chromogranin A, synaptophysin, and PS-100) and epithelial components (inhibin, melan-A, and calretinin). Embryonic stem cell markers were evaluated using RT/PCR and immunofluorescence. After initial surgery, the tumor recurred shifting to rapidly progressive ACTH-independent liver metastasis. Results. Histopathology and IHC revealed two distinct and intermingled cellular patterns, while some cells immunostained for both medullary and cortical markers. Demonstration of all stem cell biomarkers by RT/PCR and immunofluorescence was predominantly localized to the nucleus, whereas SOX2 immunoreactivity was evident in the cytoplasm as well. Conclusion. The expression of cancer stem cell biomarkers points towards the involvement of primitive embryonic cells as the origin of this neoplasm and maybe to the clinically aggressive and biochemically changing behavior. |
| Databáze: | OpenAIRE |
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