Cutaneous metastasis of cecum cancer with MSI-high and BRAFV600E mutation: a case report.

BRAFV600E Case report Colon cancer Cutaneous metastasis Microsatellite instability

Journal

Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125

Informations de publication

Date de publication:
18 Aug 2021
Historique:
received: 07 04 2021
accepted: 05 08 2021
entrez: 18 8 2021
pubmed: 19 8 2021
medline: 19 8 2021
Statut: epublish

Résumé

Cutaneous metastases of colorectal cancer (CRC) are rare, occurring in 0.7% to 5% of cancer patients. Furthermore, the molecular subtypes of cutaneous metastasis of CRC are unclear. Here, we present a rare case of cutaneous metastasis of high-frequency microsatellite instability (MSI-high)/BRAFV600E-mutant cecum cancer. A 77-year-old woman presented at the outpatient clinic with a subcutaneous mass on her left back. An excisional biopsy was performed and metastatic cutaneous adenocarcinoma was diagnosed. A computed tomography scan of the thorax and abdomen showed thickening of the cecum wall, the presence of pericolic lymph nodes, multiple masses in the liver, and a single nodule in the right lung. Right colectomy with D2 lymphadenectomy and functional end-to-end anastomosis was performed because of the almost-complete intestinal obstruction. The expression of KRAS wild type, BRAFV600E mutation, and MSI-high was detected in the cecum cancer using molecular pathological examination. She received chemotherapy with XELOX + BEV regimen (capecitabine + oxaliplatin + bevacizumab). After four administrations, a computed tomography scan showed reduction of distant metastases, which suggested partial response. We encountered a rare case of cutaneous metastasis of MSI-high and BRAFV600E-mutant cecum cancer. In the future, it will be necessary to accumulate more cases to identify clinical features and more effective treatments for CRCs with cutaneous metastasis.

Sections du résumé

BACKGROUND BACKGROUND
Cutaneous metastases of colorectal cancer (CRC) are rare, occurring in 0.7% to 5% of cancer patients. Furthermore, the molecular subtypes of cutaneous metastasis of CRC are unclear. Here, we present a rare case of cutaneous metastasis of high-frequency microsatellite instability (MSI-high)/BRAFV600E-mutant cecum cancer.
CASE PRESENTATION METHODS
A 77-year-old woman presented at the outpatient clinic with a subcutaneous mass on her left back. An excisional biopsy was performed and metastatic cutaneous adenocarcinoma was diagnosed. A computed tomography scan of the thorax and abdomen showed thickening of the cecum wall, the presence of pericolic lymph nodes, multiple masses in the liver, and a single nodule in the right lung. Right colectomy with D2 lymphadenectomy and functional end-to-end anastomosis was performed because of the almost-complete intestinal obstruction. The expression of KRAS wild type, BRAFV600E mutation, and MSI-high was detected in the cecum cancer using molecular pathological examination. She received chemotherapy with XELOX + BEV regimen (capecitabine + oxaliplatin + bevacizumab). After four administrations, a computed tomography scan showed reduction of distant metastases, which suggested partial response.
CONCLUSIONS CONCLUSIONS
We encountered a rare case of cutaneous metastasis of MSI-high and BRAFV600E-mutant cecum cancer. In the future, it will be necessary to accumulate more cases to identify clinical features and more effective treatments for CRCs with cutaneous metastasis.

Identifiants

pubmed: 34406516
doi: 10.1186/s40792-021-01265-w
pii: 10.1186/s40792-021-01265-w
pmc: PMC8374022
doi:

Types de publication

Journal Article

Langues

eng

Pagination

185

Informations de copyright

© 2021. The Author(s).

Références

Clin Cancer Res. 2014 Oct 15;20(20):5322-30
pubmed: 25139339
J Natl Compr Canc Netw. 2019 Oct 1;17(10):1174-1183
pubmed: 31590148
Cancer Res. 2005 Jul 15;65(14):6418-24
pubmed: 16024646
Cancer. 2011 Oct 15;117(20):4623-32
pubmed: 21456008
Cancer Discov. 2015 Jan;5(1):43-51
pubmed: 25358689
J Clin Oncol. 2018 Mar 10;36(8):773-779
pubmed: 29355075
Medicine (Baltimore). 2020 May 22;99(21):e20026
pubmed: 32481270
N Engl J Med. 2005 Dec 22;353(25):2654-66
pubmed: 16371631
N Engl J Med. 2003 Jul 17;349(3):247-57
pubmed: 12867608
Dermatologica. 1961 Nov;123:311-25
pubmed: 14472139
Ann Surg Oncol. 2020 Dec;27(13):5074-5083
pubmed: 32583196
Eur J Cancer. 2014 Jan;50(1):57-63
pubmed: 24138831
J Am Acad Dermatol. 1990 Jan;22(1):19-26
pubmed: 2298962
Cancer Immunol Immunother. 2010 Nov;59(11):1739-44
pubmed: 20680271
Br J Cancer. 2009 Jan 27;100(2):266-73
pubmed: 19165197
J Clin Oncol. 2010 Jul 10;28(20):3219-26
pubmed: 20498393
J Natl Cancer Inst. 2018 Jan 1;110(1):
pubmed: 28922790
J Am Acad Dermatol. 1993 Aug;29(2 Pt 1):228-36
pubmed: 8335743
Br J Cancer. 2005 May 9;92(9):1746-53
pubmed: 15856045
Am J Pathol. 1994 Jul;145(1):148-56
pubmed: 8030745
An Bras Dermatol. 2013 Nov-Dec;88(6 Suppl 1):56-8
pubmed: 24346880
Int J Clin Oncol. 2020 Jan;25(1):1-42
pubmed: 31203527
Cancer Res. 2003 Sep 1;63(17):5564-72
pubmed: 14500396
N Engl J Med. 2019 Oct 24;381(17):1632-1643
pubmed: 31566309
J Clin Oncol. 2020 Jan 1;38(1):11-19
pubmed: 31725351

Auteurs

Kosuke Yunoki (K)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Takuya Yano (T)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan. yano-tuk@umin.ac.jp.

Masanori Yoshimitsu (M)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Ko Oshita (K)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Tetsushi Kubota (T)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Michihiro Ishida (M)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Daisuke Satoh (D)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Yasuhiro Choda (Y)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Kanyu Nakano (K)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Yasuhiro Shirakawa (Y)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Hiroyoshi Matsukawa (H)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Hitoshi Idani (H)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Shigehiro Shiozaki (S)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.

Masazumi Okajima (M)

Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Classifications MeSH