A case of rectal carcinoma with skin and bone marrow metastasis with concurrent extensive visceral involvement; unusual and dismal co-incidence
| Autor: | Ragıp Ortac, Cagatay Arslan, Cenk Ahmet Sen |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Oncology medicine.medical_specialty Skin Neoplasms Time Factors Bevacizumab Colorectal cancer Biopsy Adenocarcinoma Gastroenterology Metastasis Fatal Outcome FOLFOX Predictive Value of Tests Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols Biomarkers Tumor medicine Rectal Adenocarcinoma Humans Hepatology Drug Substitution Ileostomy Rectal Neoplasms business.industry Liver Neoplasms Middle Aged medicine.disease Immunohistochemistry Treatment Outcome medicine.anatomical_structure Bone marrow neoplasm Disease Progression Bone marrow Bone Marrow Neoplasms business medicine.drug |
| Zdroj: | Expert Review of Gastroenterology & Hepatology. 9:727-730 |
| ISSN: | 1747-4132 1747-4124 |
| Popis: | Novel systemic therapies and modern surgical and ablative approaches have improved the survival rates for the patients with metastatic colorectal cancer. However, there are still patients with poor prognosis and underlying mechanisms that could not be defined clearly. Metastatic colorectal cancer patients with skin metastasis have a poor prognosis. A 45-year-old man, who presented with large bowel obstruction, was diagnosed with metastatic rectal adenocarcinoma. Unresectable liver metastases were found at diagnosis. FOLFOX plus bevacizumab treatment was started, but the patient developed bowel obstruction after the third cycle. Therefore, ileostomy was performed. Multiple skin, lung, liver and bone metastases appeared during that time. Bone marrow biopsy demonstrated diffuse infiltration by adenocarcinoma cells. Even though partial remission was achieved after 4 cycles of FOLFIRI-cetuximab, the disease progressed after the 8th cycle. The patient lost his life due to disease progression 8 months after the diagnosis. Bone marrow and skin are unusual sites of metastasis for colorectal carcinoma. Metastases in bone marrow and skin develop at later stages of metastatic disease. This patient lived only 4 months after the development of skin and bone marrow metastases. Skin and bone marrow metastases may be the harbingers of short survival. Biopsy of metastatic sites is crucial for diagnosis and detailed molecular analysis. Molecular pathway alterations underlying worse disease course may be found, and hence probable targets for drug improvement may be indicated. |
| Databáze: | OpenAIRE |
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