Abstract
Introduction
Intestinal adenosquamous carcinoma (ASC) is a rare colorectal neoplasm frequently occurring at onset as a locally advanced disease with distant metastases. The liver is the most common site of metastasis, followed by the peritoneum and the lung. Cutaneous metastases from usual colorectal adenocarcinoma occur in about 3% of cases, both at the time of diagnosis in advanced disease and during the follow-up. To the best of our knowledge, skin metastasis from ASC has never been described, and no biological landscape of ASC has ever been investigated.
Methods
We report a case of synchronous intestinal ASC and cutaneous single facial metastasis in a 70-year-old man with morphological, immunohistochemical, and molecular analysis of primary and metastatic lesions.
Results
Primary and metastatic ASC showed the same morphological and immunohistochemical features. Target sequencing analysis revealed, both in primary tumor and metastasis, a pathogenic KRAS gene missense mutation c.38G > A p.(Gly13Asp) and a likely pathogenic CTNNB1 gene missense mutation c.94G > A p.(Asp32Asn). A nuclear localization of β-catenin protein in adenocarcinomatous component of primary and metastatic lesions was observed on immunohistochemistry.
Conclusion
We describe a case of single synchronous facial cutaneous metastasis from intestinal ASC showing KRAS and CTNN1B mutations both on primary and metastatic lesions.
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References
Petrelli NJ, Valle AA, Weber TK, Rodriguez-Bigas M (2009) Adenosquamous carcinoma of the colon and rectum. Dis Colon Rectum 39(11):1265–1268
Remo A, Fasasn M, Bonetti RL, varresi V, Tatangelo F et al (2019) Morphology and molecular features of rare colorectal carcinoma Histotypes. Cancers (Basel) 11(7):1036
Pancione M, Remo A, Colantuoni V (2012) Genetic and epigenetic events generate multiple pathways in colorectal cancer progression. Patholog Res Int 2012:509348
Masoomi H, Ziogas A, Lin BS, Barleben A, Mills S, Stamos MJ et al (2012) Population-based evaluation of adenosquamous carcinoma of the colon and rectum. Dis Colon Rectum 55(5):509–514
Sunkara T, Caughey ME, Makkar P, John F, Gaduputi V (2018) Adenosquamous Carcinoma of the Colon. Case Rep Gastroenterol 11(3):791–796
Frizelle FA, Hobday KS, Batts KP, Nelson H (2001) Adenosquamous and squamous carcinoma of the colon and upper rectum: a clinical and histopathologic study. Dis Colon Rectum 44(3):341–346
Hashimi Y, Dholakia S (2013) Facial cutaneous metastasis of colorectal adenocarcinoma. BMJ Case Rep 2013. https://doi.org/10.1136/bcr-2013-009875
Aravind B, Kumar R, Basnyat P (2013) Cutaneous metastases secondary to colorectal carcinoma may not be as ominous as previously thought: a case report and review of the literature. BMJ Case Rep 2013. https://doi.org/10.1136/bcr-2013-008556
Herxheimer G (1907) Uber heterologe cancroid. Beitr Pathol Anat 41:348–412
Wang DY, Ye F, Lin JJ, Xu X (2017) Cutaneous metastasis: a rare phenomenon of colorectal cancer. Ann Surg Treat Res 93(5):277–280
Ishida H, Yamaguchi T, Chiba K, Iijima T, Horiguchi SI (2017) A case report of ascending colon adenosquamous carcinoma with BRAF V600E mutation. Int Cancer Conf J 6(3):93–97
Margonis GA, Kim Y, Sasaki K, Samaha M, Amini N, Pawlik TM (2016) Codon 13 KRAS mutation predicts patterns of recurrence in patients undergoing hepatectomy for colorectal liver metastases. Cancer 122(17):2698–2707
Tejpar S, Celik I, Schlichting M, Sartorius U, Bokemeyer C, Van Cutsem E (2012) Association of KRAS G13D tumor mutations with outcome in patients with metastatic colorectal cancer treated with first-line chemotherapy with or without cetuximab. J Clin Oncol 30:3570–3577
Kim S, Jeong S (2019) Mutation hotspots in the βCatenin gene: lessons from the human cancer genome databases. Mol Cells 42(1):8–16
Al-Fageeh M, Li Q, Dashwood WM, Myzak MC, Dashwood RH (2004) Phosphorylation and ubiquitination of oncogenic mutants of beta-catenin containing substitutions at Asp32. Oncogene 23(28):4839–4846
Truica CI, Byers S, Gelmann EP (2000) Beta-catenin affects androgen receptor transcriptional activity and ligand specificity. Cancer Res 60(17):4709–4713
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by [Paola Parente], [Paola Parrella], [Fabiola Fiordelisi], [Tiziana Pia Latiano], [Maria Teresa Pellico], and [Evaristo Maiello]. The first draft of the manuscript was written by [Paola Parente, Claudia Covelli, Paola Parrella, Paolo Graziano], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Parente, P., Covelli, C., Parrella, P. et al. Intestinal adenosquamous carcinoma with a synchronous skin metastasis: a immunohistochemical and molecular analysis. Int J Colorectal Dis 35, 337–341 (2020). https://doi.org/10.1007/s00384-019-03464-2
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DOI: https://doi.org/10.1007/s00384-019-03464-2