This case is pathognomonic of cannonball metastases, most commonly from a renal cell carcinoma, as was later seen on CT. 2. level 2. Multiple lung nodules are classically seen with hematogenous dissemination of malignant tumors in the lungs when they are known as cannonball secondaries. A diagnosis of gallbladder cancer with distant metastases was made. 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. Treatment with doxorubicin was initiated to decrease tumor burden and improve functional status, however the disease progressed and the patient passed away. The cannonball pulmonary appearance is hematogenous dissemination of various primary tumors but rarely a Hodgkin's lymphoma, a disease that most commonly manifests with lymphadenopathy, often affecting the mediastinum and supraclavicular or cervical lymph nodes. | Figure 1 Chest X-ray showing multiple pulmonary nodules [1] The histopathological examination (HPE) revealed a well-differentiated adenocarcinoma of the stomach [ Figure 5 ]. A recent colonoscopy showed no evidence of malignancy. Hereby, we report two cases of COVID-19 delta variant-induced pneumonia manifesting unusually in chest CT scan with cannonball appearance. Cannonball metastases treatment Diagnostic challenge Lymphadenopathy may be hilar, mediastinal or both. Cannonball metastases refer to multiple large, well-circumscribed, round pulmonary metastases that appear not unsurprisingly like cannonballs. cannonball metastases: One or more largee.g., 5 cm in diameterround, well-circumscribed metastatic nodules in the lungs, classically seen in renal cell carcinoma, but also in choriocarcinoma Lung metastases are characterized by casual (random) distribution. This patient was short of breath and came to A&E after 7 months of increasing lethargy and weight loss. The French use another more elegant descriptor, "envole de ballons" which translates to "balloons release". 3 As RCC is an immunogenic tumor, targeted therapy and immunomodulatory therapy (i.e. Lymph node metastasis is not always associated with lung metastasis. Lung: classic cannonball metastases - radiograph lateral, illustration relating to dogs including description, information, related content and more. These are highly chemo-sensitive tumors with high cure rates. DISCUSSION: Cannonball metastases are not commonly present at the time of diagnosis of synovial sarcoma. The French terms " envole de ballons " and " lcher de ballons ", which translate to "balloons release", are also used to describe this same appearance. A Barium Meal X-ray revealed 'cannon-ball' pulmonary metastases, with free flow of dye in the stomach [ Figure 4 ]. Deprecated: The each() function is deprecated.This message will be suppressed on further calls in /home/customer/www/radipedia.com/public_html/WikiMedia/includes . They are usually associated with disseminated malignancy and indicate grim prognosis. However, the patient declined further treatment and chose hospice and palliative care at home [Figure 4]. Sarcomas constitute a heterogeneous group of neoplasms, but with a very aggressive evolution in most cases. All information is peer reviewed. However, the patient declined further treatment and chose hospice and palliative care at home [Figure 4]. This opposed to sarcoidosis, which rarely causes mediastinal nodular enlargement without hilar enlargement. The primary tumors for these lesions can be remembered with the help of this mnemonic: CRESP Mnemonic C: choriocarcinoma R: renal cell carcinoma E. We present a ca Metastases are present in variable numbers and are usually well defined and peripheral in distribution. Related terms: . References To report the case of a patient with metastatic pulmonary. Striking progression of lung. The lung and pleura are the most common sites of visceral metastases from melanoma 1 and autopsy series of patients with late-stage melanoma show lung metastases in >85% of patients. It is a highly aggressive malignant tumor with early multiorgan metastasis and poor prognosis. cannonball metastases One or more large, well-circumscribed metastatic nodules in the lungs, classically in renal cell carcinoma, but also in choriocarcinoma Conflict of interest: None declared. The abdominal CT scan showed no abnormalities. Malignant tumours that commonly metastasise to the lung include breast, thyroid, gastrointestinal tract and renal cell carcinomas, also head and neck tumours and soft tissue sarcomas. Cannonball appearance can bring diagnostic dilemmas and difficulties in monitoring treatment response in patients with or suspicious for hematogenous pulmonary metastasis. Felis ISSN 2398-2950. Presented, is the case of a male patient, 69 years old, with . 5, 6 it is noteworthy that these cancers are sometimes described as human chorionic gonadotropin (hcg) expressing tumors as well.7 other than pregnancy, hcg may also be secreted abnormally by certain tumors, View / Download Pdf Share at Facebook Abstract. A CECT of the chest revealed multiple bilateral "cannonball" pulmonary metastases. 2 Cannonball metastases are commonly associated with beta-human chorionic gonadotropin-secreting tumours, 3 but rarely seen in the context of malignant melanoma. ( A) Chest radiography and ( B) computed tomography of chest showed multiple large and round nodules. The form and the size of the nodules can vary within appreciable limits. Sign and Cannonball Metastases. Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading. Upper gastrointestinal (GI) endoscopy with a guided biopsy was ordered. A diagnosis of gallbladder cancer with distant metastases was made. Cannonball metastases refer to well-defined spherical nodules scattered over both lungs, being a classical presentation of hematogenous tumor spreading. The radiographic appearance may, therefore, be indistinguishable . Journal of Cancer Science and Clinical Therapeutics 3 (2019): 102-104. If the nodules have small (miliary) sizes and their quantity is innumerable (the . References Nabi G, Sadiq M . Cannonball metastases is a radiographic descriptor that refers to the presence of multiple, variable sized, well circumscribed, rounded pulmonary lesions that can range up to several centimeters in diameter. Secondary 'cannonball' metastases to the lung are frequent and usually associated with disseminated malignancy and poor prognosis. Cannon ball metastases refer to large, well circumscribed, round pulmonary metastases that appear like cannon balls. At diagnosis of cannonball metastases, the disease is advanced, incurable and is associated with poor prognosis. Cannonball metastases refer to multiple large, well-circumscribed, round pulmonary metastases. More than 95% of patients with testicular cancer present with a painless testicular mass. The chest CT scan revealed a so-called cannonball-like distribution of multiple rounded nodules, with well-defined margins, ranging from 0.5 to 5 cm, scattered in both lungs (Figs 1A, 1B). Striking progression of lung metastases without established primary malignancy can raise a Department of Radiology, Russian National Research Medical University, Moscow, Russia. DarkePGG. This film was the first interaction with a doctor their entire life. such a sole presentation of cannonball metastases is classically seen in germ cell tumor, 2, 3 choriocarcinoma 3, 4 and endometrial cancer. Cannonball Lung Metastases from A Retroperitoneal Sarcoma. Cannon ball pulmonary metastases are typically seen in the patients with choriocarcinoma or renal cell carcinoma. Multiple bilateral cannon-ball lung metastases from carcinoma of the prostate: orchiedectomy induced remission. Large, round, well-circumscribed metastatic pulmonary nodules are called 'cannon ball' metastases. Sunitinib, Bevacizumab, Alpha interferon and Nivolumab) are standard treatments in metastatic disease. 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