Department of Gastroenterology, Toranomon Hospital, Japan.
Department of Gastroenterological Surgery, Toranomon Hospital, Japan.
Intern Med. 2023 Sep 15;62(18):2655-2660. doi: 10.2169/internalmedicine.0597-22. Epub 2023 Feb 8.
An 86-year-old woman with a subcutaneous nodule in her left axilla visited our hospital. She had no gastrointestinal symptoms, but contrast-enhanced computed tomography revealed a cecal mass and systemic metastasis, including cutaneous, bone, peritoneal dissemination and ascites. Colonoscopy revealed a circumferential, elevated cecal lesion. She underwent right hemicolectomy to prevent colon obstruction. The pathological diagnosis was poorly differentiated adenocarcinoma (por1>tub2>muc) arising from the appendix with a BRAFV600E mutation and microsatellite instability-high. Chemotherapy was administered, and she is currently still alive and undergoing chemotherapy. We describe a rare case of advanced appendiceal cancer without gastrointestinal symptoms diagnosed due to cutaneous metastasis.
一位 86 岁女性因左侧腋窝皮下结节就诊于我院。她无胃肠道症状,但增强 CT 显示盲肠肿块和全身转移,包括皮肤、骨、腹膜播散和腹水。结肠镜检查发现盲肠环形隆起性病变。为预防结肠梗阻,行右半结肠切除术。病理诊断为阑尾来源的低分化腺癌(por1>tub2>muc),伴 BRAFV600E 突变和微卫星不稳定高。给予化疗,目前患者仍存活并继续化疗。我们描述了一例罕见的无胃肠道症状的晚期阑尾癌病例,因皮肤转移而确诊。