Zhou Shishi, Tang Wanfen, Wang Qinghua, Zhang Xia, Jin Xiayun, Xu Xifeng, Fu Jianfei
Department of Medical Oncology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, Zhejiang Province, People's Republic of China.
Onco Targets Ther. 2021 Feb 11;14:989-993. doi: 10.2147/OTT.S287064. eCollection 2021.
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.
直肠癌的皮肤转移罕见，通常提示疾病广泛播散且预后不良。我们报告一例极为罕见的BRAF突变的微卫星稳定（MSS）直肠癌发生皮肤转移的病例。一名53岁女性，诊断为IV期不可切除的直肠腺癌，接受了化疗及分子靶向药物治疗。6个月后，她左侧腹股沟出现一个局限性皮肤结节。在接受4周期FOLFIRI方案联合贝伐单抗治疗期间，皮肤结节逐渐增大，累及左侧大腿皮肤。部分皮疹有出血且疼痛。活检标本符合直肠来源的黏液腺癌，且CDX-2表达降低。于是开始采用FOLFIRI方案联合西妥昔单抗及维莫非尼进行姑息治疗。皮肤结节体积缩小但并不稳定。患者出现严重的电解质紊乱及抑郁，选择了姑息治疗。
