Carcinosis, or carcinomatosis, is disseminated cancer, forms of metastasis, whether used generally or in specific patterns of spread. Usage
Carcinomatosis is often restricted to tumors of epithelial origin, adenocarcinomas, while sarcomatosis describes the dissemination of tumors of mesenchymal origin, sarcomas. Lung
Lymphangitic carcinomatosis
When most tumors metastasize to the lung, they form distinct nodules, but about 7% spread through the lymph vessels of the lung. They may impair breathing in several ways; the lung becomes stiffer; blood vessels traveling alongside the distended lymph vessels become compressed. Miliary carcinosis
A pattern of multiple small nodular metastases has been described as miliary carcinosis which has a radiographic appearance similar to miliary tuberculosis. Body cavities
Any potential space may be seeded with tumor cells that grow along surfaces, but which may not invade below the surfaces. In rare cases, the joint spaces are affected. Peritoneal carcinomatosis
The lining of the abdominal cavity is a common site for surface dissemination. Ovarian carcinomas are common. Fluid produced by the cells can produce ascites which is typical in carcinomatosis, but less common in peritoneal sarcomatosis. Fluid can be serous as seen in primary peritoneal carcinoma or mucinous such as found in pseudomyxoma peritonei which is typically a tumor derived from the appendix. Pleural carcinosis
Pleural carcinosis is associated with malignant pleural effusion and poor prognosis. Leptomeningeal carcinomatosis
The meningeal covering of the central nervous system may be the site of tumor growth. Breast cancer, lung cancer and melanoma are the most common tumors. Treatment
Colorectal cancer patients with peritoneal involvement can be treated with Oxaliplatin- or Irinotecan-based chemotherapy.
To likely compensate for the cells energy demand, an upregulation of fatty acid β-oxidation and a decreased concentration of certain amino acids that feed anaplerotically into the citrate cycle, such as glutamine (via the fifth site of the citrate cycle), leucine, isoleucine, threonine (all via the sixth site of the citrate cycle) and aspartate (via the 10th site of the citrate cycle), could be detected. In summary, this reduced mitochondrial respiration and glycolytic flux results in impaired mitochondrial flexibility with a large dependence on fatty acid β-oxidation.However, neurons, with the exception of hypothalamic neurons, are not capable of satisfying their large energy demands by degrading fatty acids. It is speculated that an upregulation of β-oxidation also occurs in brain cells due to the hypofunctional mtFASII pathway. The consequence would be an increased risk for hypoxia and oxidative stress, which may contribute to neurological symptoms in the long term. Methylmalonic acid
Methylmalonic acid is formed from the essential amino acids valine, methionine, threonine and isoleucine, from odd-chained fatty acids, from propionate and from cholesterol side chain, on the degradation path into the citrate cycle. In this process, the last intermediate methylmalony-CoA can be converted to methymalonic acid by a deacylase before incorporation at the succinyl-CoA site of the citrate cycle. At this point, the acyl-CoA synthease encoded by ACSF3 could convert the methylmalonic acid back to methylmalonyl-CoA and then feed it to the citrate cycle with the help of the methylmalonyl-CoA mutase and its cofactor vitamin B12.