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The macro-metastasis/organ parenchyma interface (MMPI) - A hitherto unnoticed area
R Blazquez1, D Sparrer1, C Wendl2
1Department of Internal Medicine III, University Hospital Regensburg, 93053 Regensburg, Germany.
Abstract:
The macro-metastasis/organ parenchyma interface (MMPI) was previously considered an inert anatomical border which sharply separates the affected organ parenchyma from the macro-metastatic tissue. Recently, infiltrative growth of macro-metastases from various primary tumors was described in the brain, liver and lung, with significant impact on survival. Strikingly, the MMPI patterns differed between entities, so that at least nine different patterns were described. The MMPI patterns could be further classified into three major groups: displacing, epithelial and diffuse infiltrating. Additionally, macro-metastases are a source of further tumor cell dissemination in the affected organ; and these intra-organ metastatic dissemination tracks starting from the MMPI also vary depending on the anatomical structures of the colonized organ and influence disease outcome. In spite of their relevance, MMPIs and organ-specific dissemination tracks are still largely overlooked by many clinicians, pathologists and/or researchers. In this review, we aim to address this important issue and enhance our current understanding of the different MMPI patterns and dissemination tracks in the brain, liver and lung.
Insights
The macro-metastasis/organ parenchyma interface (MMPI) is not inert but shows diverse infiltrative patterns impacting survival. Understanding these patterns and intra-organ dissemination tracks is crucial for cancer research and treatment.
Area of Science:
- Oncology
- Pathology
- Cancer Biology
Background:
- The macro-metastasis/organ parenchyma interface (MMPI) was traditionally viewed as a passive boundary.
- Recent findings reveal infiltrative growth patterns of macro-metastases in organs like the brain, liver, and lung.
- These infiltrative patterns significantly impact patient survival.
Purpose of the Study:
- To review and elucidate the diverse patterns of the MMPI.
- To describe intra-organ metastatic dissemination tracks originating from the MMPI.
- To highlight the clinical and research relevance of MMPI patterns and dissemination tracks.
Main Methods:
- Review of existing literature on macro-metastasis and organ parenchyma interfaces.
- Classification of MMPI patterns into displacing, epithelial, and diffuse infiltrating groups.
- Analysis of organ-specific dissemination tracks originating from the MMPI.
Main Results:
- At least nine distinct MMPI patterns have been identified, falling into three major categories.
- Macro-metastases actively contribute to intra-organ tumor cell dissemination via specific tracks.
- MMPI patterns and dissemination tracks vary significantly across different organs (brain, liver, lung).
Conclusions:
- The MMPI is a dynamic interface with diverse infiltrative growth patterns.
- Intra-organ metastatic dissemination tracks from the MMPI are critical determinants of disease outcome.
- Further research and clinical attention are needed to understand and utilize MMPI characteristics for improved cancer management.
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