Molecular identification of metastatic cancer to the skin using laser capture microdissection: A case report

Sara Milchgrub, Ignacio I. Wistuba, Bong K. Kim, Cynthia J Rutherford, Jill E Urban, Ponciano D Cruz, Adi F Gazdar

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND. In the current study the authors report a 57-year-old woman with a scalp tumor and cervical lymphadenopathy who had a previously resected duodenal carcinoid. Histologic and immunophenotypic characteristics of the duodenal carcinoid differed from those of the scalp and cervical lymph node tumors, prompting the use of molecular methodologies to make the diagnosis. METHODS. Paraffin embedded tissues from the duodenal carcinoid, scalp, and lymph node tumors were dissected using microscopic visualization and laser capture microdissection. DNA was extracted and polymerase chain reaction (PCR) was performed to evaluate loss of heterozygosity and microsatellite alterations using primers flanking 22 polymorphic microsatellite markers from 9 chromosomal regions, including genes associated with MEN-1 (11q), CDKN2 (9p), p53 (17p), and bronchial carcinoid (3p). Microdissected lymphocytes from the three tissues were used as source of constitutional DNA (controls). RESULTS. Fourteen of the 22 markers were informative (heterozygous in control lymphocytes). A marker on 3p12 showed loss of the same parental allele in the three tumors. A different marker on 3p14.2 showed an identical shifted band in the three tumors indicative of a common microsatellite alteration. CONCLUSIONS. The shared molecular abnormalities among the three tumors indicated a common clonal origin, leading to a diagnosis of primary duodenal carcinoid with clear cell metastases to the scalp and cervical lymph nodes. These findings led to radiation therapy and immunotherapy rather than chemotherapy. This case illustrates the novel application of laser capture microdissection combined with PCR-based analyses of genomic markers for the identification of the origin of metastatic disease. (C) 2000 American Cancer Society.

Original languageEnglish (US)
Pages (from-to)749-754
Number of pages6
JournalCancer
Volume88
Issue number4
DOIs
StatePublished - Feb 15 2000

Fingerprint

Laser Capture Microdissection
Skin Neoplasms
Carcinoid Tumor
Scalp
Microsatellite Repeats
Neoplasms
Lymph Nodes
Lymphocytes
Multiple Endocrine Neoplasia Type 1
Polymerase Chain Reaction
Loss of Heterozygosity
DNA
Paraffin
Immunotherapy
Radiotherapy
Alleles
Neoplasm Metastasis
Drug Therapy
Genes

Keywords

  • Carcinoid
  • Chromosome 3p
  • Clear cell tumor
  • Laser capture microdissection

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Molecular identification of metastatic cancer to the skin using laser capture microdissection : A case report. / Milchgrub, Sara; Wistuba, Ignacio I.; Kim, Bong K.; Rutherford, Cynthia J; Urban, Jill E; Cruz, Ponciano D; Gazdar, Adi F.

In: Cancer, Vol. 88, No. 4, 15.02.2000, p. 749-754.

Research output: Contribution to journalArticle

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title = "Molecular identification of metastatic cancer to the skin using laser capture microdissection: A case report",
abstract = "BACKGROUND. In the current study the authors report a 57-year-old woman with a scalp tumor and cervical lymphadenopathy who had a previously resected duodenal carcinoid. Histologic and immunophenotypic characteristics of the duodenal carcinoid differed from those of the scalp and cervical lymph node tumors, prompting the use of molecular methodologies to make the diagnosis. METHODS. Paraffin embedded tissues from the duodenal carcinoid, scalp, and lymph node tumors were dissected using microscopic visualization and laser capture microdissection. DNA was extracted and polymerase chain reaction (PCR) was performed to evaluate loss of heterozygosity and microsatellite alterations using primers flanking 22 polymorphic microsatellite markers from 9 chromosomal regions, including genes associated with MEN-1 (11q), CDKN2 (9p), p53 (17p), and bronchial carcinoid (3p). Microdissected lymphocytes from the three tissues were used as source of constitutional DNA (controls). RESULTS. Fourteen of the 22 markers were informative (heterozygous in control lymphocytes). A marker on 3p12 showed loss of the same parental allele in the three tumors. A different marker on 3p14.2 showed an identical shifted band in the three tumors indicative of a common microsatellite alteration. CONCLUSIONS. The shared molecular abnormalities among the three tumors indicated a common clonal origin, leading to a diagnosis of primary duodenal carcinoid with clear cell metastases to the scalp and cervical lymph nodes. These findings led to radiation therapy and immunotherapy rather than chemotherapy. This case illustrates the novel application of laser capture microdissection combined with PCR-based analyses of genomic markers for the identification of the origin of metastatic disease. (C) 2000 American Cancer Society.",
keywords = "Carcinoid, Chromosome 3p, Clear cell tumor, Laser capture microdissection",
author = "Sara Milchgrub and Wistuba, {Ignacio I.} and Kim, {Bong K.} and Rutherford, {Cynthia J} and Urban, {Jill E} and Cruz, {Ponciano D} and Gazdar, {Adi F}",
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T1 - Molecular identification of metastatic cancer to the skin using laser capture microdissection

T2 - A case report

AU - Milchgrub, Sara

AU - Wistuba, Ignacio I.

AU - Kim, Bong K.

AU - Rutherford, Cynthia J

AU - Urban, Jill E

AU - Cruz, Ponciano D

AU - Gazdar, Adi F

PY - 2000/2/15

Y1 - 2000/2/15

N2 - BACKGROUND. In the current study the authors report a 57-year-old woman with a scalp tumor and cervical lymphadenopathy who had a previously resected duodenal carcinoid. Histologic and immunophenotypic characteristics of the duodenal carcinoid differed from those of the scalp and cervical lymph node tumors, prompting the use of molecular methodologies to make the diagnosis. METHODS. Paraffin embedded tissues from the duodenal carcinoid, scalp, and lymph node tumors were dissected using microscopic visualization and laser capture microdissection. DNA was extracted and polymerase chain reaction (PCR) was performed to evaluate loss of heterozygosity and microsatellite alterations using primers flanking 22 polymorphic microsatellite markers from 9 chromosomal regions, including genes associated with MEN-1 (11q), CDKN2 (9p), p53 (17p), and bronchial carcinoid (3p). Microdissected lymphocytes from the three tissues were used as source of constitutional DNA (controls). RESULTS. Fourteen of the 22 markers were informative (heterozygous in control lymphocytes). A marker on 3p12 showed loss of the same parental allele in the three tumors. A different marker on 3p14.2 showed an identical shifted band in the three tumors indicative of a common microsatellite alteration. CONCLUSIONS. The shared molecular abnormalities among the three tumors indicated a common clonal origin, leading to a diagnosis of primary duodenal carcinoid with clear cell metastases to the scalp and cervical lymph nodes. These findings led to radiation therapy and immunotherapy rather than chemotherapy. This case illustrates the novel application of laser capture microdissection combined with PCR-based analyses of genomic markers for the identification of the origin of metastatic disease. (C) 2000 American Cancer Society.

AB - BACKGROUND. In the current study the authors report a 57-year-old woman with a scalp tumor and cervical lymphadenopathy who had a previously resected duodenal carcinoid. Histologic and immunophenotypic characteristics of the duodenal carcinoid differed from those of the scalp and cervical lymph node tumors, prompting the use of molecular methodologies to make the diagnosis. METHODS. Paraffin embedded tissues from the duodenal carcinoid, scalp, and lymph node tumors were dissected using microscopic visualization and laser capture microdissection. DNA was extracted and polymerase chain reaction (PCR) was performed to evaluate loss of heterozygosity and microsatellite alterations using primers flanking 22 polymorphic microsatellite markers from 9 chromosomal regions, including genes associated with MEN-1 (11q), CDKN2 (9p), p53 (17p), and bronchial carcinoid (3p). Microdissected lymphocytes from the three tissues were used as source of constitutional DNA (controls). RESULTS. Fourteen of the 22 markers were informative (heterozygous in control lymphocytes). A marker on 3p12 showed loss of the same parental allele in the three tumors. A different marker on 3p14.2 showed an identical shifted band in the three tumors indicative of a common microsatellite alteration. CONCLUSIONS. The shared molecular abnormalities among the three tumors indicated a common clonal origin, leading to a diagnosis of primary duodenal carcinoid with clear cell metastases to the scalp and cervical lymph nodes. These findings led to radiation therapy and immunotherapy rather than chemotherapy. This case illustrates the novel application of laser capture microdissection combined with PCR-based analyses of genomic markers for the identification of the origin of metastatic disease. (C) 2000 American Cancer Society.

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