Cutaneous metastasis of ascending colon cancer harboring a BRAF V600E mutation

Abstract

Rationale: Cutaneous metastases from colorectal cancer are extremely rare and generally appear several years after diagnosis or resection of the primary colorectal tumor. Although cutaneous metastasis is unusual, it often indicates a poor prognosis. Patient concerns: We treated a 62-year-old woman with multiple cutaneous metastatic nodules on the chest, back, and armpit 7 months after resection of ascending colon cancer. Diagnoses: The patient was diagnosed with cutaneous metastasis of ascending colon cancer with BRAF V600E mutation. Interventions: After 6 cycles of fluorouracil, leucovorin, oxaliplatin, cetuximab, and emurafenib, most of the metastatic lesions had begun to shrink, and no new metastases were observed. Serum tests showed that the levels of several tumor markers were decreased. Outcomes: The patient responded well to treatment and survived for 6.5 months after presentation with skin metastasis. Lessons: Cutaneous metastasis of colorectal cancer with BRAF V600E mutation is a rare but important phenomenon that should not be ignored. Cutaneous metastasis of colorectal cancer frequently indicates advanced disease and poor prognosis. The SWOG 1406 program is one of the treatment options, but this needs further exploration.

Destination Unknown: A Unique Case of Metastatic Colorectal Carcinoma to the Breast, Axilla & Skin

“…Based on a small number of case reports of this entity, recommendations suggest that single cutaneous metastases should undergo wide excision with margins at least 1 cm, as was performed in this case. This is in contrast to cases of diffuse cutaneous metastases which are generally treated by palliative systemic therapies [8]. Despite statistics suggesting relatively poor survival outcomes, this patient has now survived up to four years since her initial diagnosis.…”

Cutaneous metastases with different clinical presentations: case series and review of the literature

“…Scrotum is an exceedingly unusual site for colorectal cancer metastasis [5]. These metastases generally occur within the first 2 years following surgery and often present simultaneously with metastases to the liver, peritoneum, and lung [6].…”

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

“…The most frequent site of metastasis in BRAF-mutant CRC is the liver (63%), followed by distant lymph nodes (56%) and the perineum (46%) [18] . Lianggong et al reported the first case of cutaneous metastases of BRAF-mutant CRC [21] . In this case, FOLFIRI (irinotecan, calcium leucovorin, and 5-FU) in combination with cetuximab and the BRAF inhibitor vemurafenib caused cutaneous and liver metastases to shrink.…”