Cutaneous Metastasis of Rectal Cancer as a Diagnostic Challenge: A Clinical Case and Literature Review
Ekaterina Zelenova,
Tatiana Belysheva,
Denis Sofronov,
Vera Semenova,
Galimat Radjabova,
Yana Vishnevskaya,
Irina Kletskaya,
Elena Sharapova,
Ivan Karasev,
Denis Romanov,
Malika Denieva,
Nikolay Petrochenko,
Timur Valiev,
Tatiana Nasedkina
Affiliations
Ekaterina Zelenova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Tatiana Belysheva
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Denis Sofronov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Vera Semenova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Galimat Radjabova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, 119048 Moscow, Russia
Yana Vishnevskaya
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Irina Kletskaya
Russian Children’s Clinical Hospital, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 119571 Moscow, Russia
Elena Sharapova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Ivan Karasev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Denis Romanov
Center of Innovative Medical Technologies, 119991 Moscow, Russia
Malika Denieva
Department of Polyclinic Therapy, Chechen State University, 364061 Grozny, Russia
Nikolay Petrochenko
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Timur Valiev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Russia
Tatiana Nasedkina
Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
Background/Objectives: Metastatic colorectal cancer remains a fatal disease, with a 5-year survival rate lower than 15%. The most common metastatic sites are the lungs and the liver, while skin metastases are very rare and often indicate a poor prognosis with a lower survival rate. Methods. Herein, we present the clinical case of a 62-year-old female patient with rectal cancer metastases to the skin of the anogenital and abdominal regions, diagnosed 2 years after completion of treatment of the underlying disease. Results: Histological examination of the skin lesions revealed adenocarcinoma, and expression of the same immunohistochemical markers was also found in the primary tumor and in the cutaneous metastases. However, next-generation sequencing demonstrated differences in the mutational profiles of the primary tumor and metastasis to the skin. Somatic mutations in the APC, TP53, and PTPN11 genes were revealed in primary rectal adenocarcinoma, but another pathogenic TP53 mutation and a frameshift variant in the DYNC1I1 gene were found in cutaneous metastases. The patient underwent several courses of FOLFOX6 chemotherapy in combination with bevacizumab, but the treatment was unsuccessful. An analysis of 50 clinical cases from the literature concerning various manifestations of cutaneous metastases of rectal cancer showed a median survival of 8.5 months from the time of detection of the skin lesions. Conclusions: In this regard, careful skin examination of patients with rectal cancer and timely detection of cutaneous metastases are essential steps in the follow-up of patients who have undergone treatment of the primary tumor.