“… 2 Cutaneous metastases may also be present at the time of diagnosis, but this is extremely rare. Riyadh Hakami 8 report a patient diagnosed with rectal cancer associated with extensive skin metastasis to the perineum and inguinal area, who carried the mutation c.34G>T (p.G12C) in exon 2 of the K-RAS oncogene. Besides, Amarjothi JMV 9 report a 25-year-old man with rectal adenocarcinoma with multiple peritoneal metastases, and it is not clear whether there was a BRAF mutation.…”
Cutaneous metastasis of rectal cancer is rare and typically indicates widespread disease and poor prognosis. We report an exceedingly rare case of BRAF-mutated MSS rectal cancer with metastasis to the skin. A 53-year-old woman presented with stage IV unresectable adenocarcinoma of the rectum and received chemotherapy and molecularly targeted agents. Six months later she developed a focal skin nodule in the left groin. During treatment with four cycles of FOLFIRI plus bevacizumab, the skin nodules gradually increased in size, involving the skin of the left thigh. A portion of the rash was bleeding and painful. The biopsy specimen was consistent with a mucinous adenocarcinoma of rectal origin and expressed reduced CDX-2. Palliative treatment with FOLFIRI plus cetuximab and vemurafenib was initiated. The cutaneous nodules decreased in size but were not stable. The patient had severe electrolyte disturbances and depression and opted for palliative care.
“… 2 Cutaneous metastases may also be present at the time of diagnosis, but this is extremely rare. Riyadh Hakami 8 report a patient diagnosed with rectal cancer associated with extensive skin metastasis to the perineum and inguinal area, who carried the mutation c.34G>T (p.G12C) in exon 2 of the K-RAS oncogene. Besides, Amarjothi JMV 9 report a 25-year-old man with rectal adenocarcinoma with multiple peritoneal metastases, and it is not clear whether there was a BRAF mutation.…”
Cutaneous metastasis of rectal cancer is rare and typically indicates widespread disease and poor prognosis. We report an exceedingly rare case of BRAF-mutated MSS rectal cancer with metastasis to the skin. A 53-year-old woman presented with stage IV unresectable adenocarcinoma of the rectum and received chemotherapy and molecularly targeted agents. Six months later she developed a focal skin nodule in the left groin. During treatment with four cycles of FOLFIRI plus bevacizumab, the skin nodules gradually increased in size, involving the skin of the left thigh. A portion of the rash was bleeding and painful. The biopsy specimen was consistent with a mucinous adenocarcinoma of rectal origin and expressed reduced CDX-2. Palliative treatment with FOLFIRI plus cetuximab and vemurafenib was initiated. The cutaneous nodules decreased in size but were not stable. The patient had severe electrolyte disturbances and depression and opted for palliative care.
“…Skin metastasis typically develops within the first 3 years after primary surgical procedure and is usually asymptomatic. Silent metastasis as a primary sign of rectal cancer is extremely rare 2 . Possible routes of skin metastases include lymphatic and hematogenous spread, direct extension, or implantation during biopsy or surgery 3 .…”
“…The most common pattern of colorectal metastases is spread to the abdominal cavity, liver, lungs or bones. Unusual sites of metastatic disease are rare but reported throughout the literature 1–6 . The metastatic spread of colorectal cancer to the skin has been described, and is usually reported in combination with advanced, widely metastatic disease and therefore usually carries a poor prognosis.…”
Section: Figurementioning
confidence: 99%
“…Unusual sites of metastatic disease are rare but reported throughout the literature. [1][2][3][4][5][6] The metastatic spread of colorectal cancer to the skin has been described, and is usually reported in combination with advanced, widely metastatic disease and therefore usually carries a poor prognosis. The rate of cutaneous metastasis of colorectal metastases is between 2% and 6%.…”
mentioning
confidence: 99%
“…This case is even more unusual as only 0.8% of patients will present with an isolated cutaneous metastasis as a presentation of an internal malignancy. 5 A literature review identified one similar presentation of a caecal adenocarcinoma metastasizing to the great toe following initial treatment. 4 On this occasion, the patient had pain in the big toe for a number of monthsattributing it to gout before imaging and biopsy demonstrated metastatic disease.…”
Masquerading mucinous metastases: cutaneous colorectal cancer metastasis of the toesA 74-year-old female was admitted from the community with a 3-month history of a progressive, fungating lesion of the right great toe (Fig. 1). This lesion had been debrided previously and was thought to be a lymphangioma associated with chronic lymphoedema. The patient had no other symptoms on presentation, specifically no symptoms to suggest a primary malignancy. The case was referred on to medical oncology following biopsy on two separate occasions, which demonstrated tissue consistent with metastatic disease.Detailed histopathology showed cells with a polypoid mucosa covered in an atypical mucinous epithelium showing gastrointestinal differentiation, which stained positive for CK 20 and CDX and negative for CK7, S100, p63, PAX 8 and GCDFP-15 on immunohistochemistry. There was a focus of squamous epithelium within the sample consistent with the tissue of origin. A computed
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