Advanced Appendiceal Cancer with Systematic Metastasis without Gastrointestinal Symptoms Found by Subcutaneous Tumor

• Published in: Internal Medicine Vol. 62; no. 18; pp. 0597-22 - 2660
• Main Authors: Nakamura, Satoshi, Ochiai, Yorinari, Nishihara, Yuki, Koyanagi, Anri, Miura, Yasurou, Kikuchi, Daisuke, Takazawa, Yutaka, Kuroyanagi, Hiroya, Hoteya, Shu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2023; Japan Science and Technology Agency
• Subjects: Adenocarcinoma; appendiceal cancer; Appendix; Ascites; Bone mass; BRAF mutation; Case Report; Cecum; Chemotherapy; Colon; Computed tomography; cutaneous metastasis; high microsatellite instability; Internal medicine; Metastases; Microsatellite instability; systematic metastasis; high microsatellite instability; cutaneous metastasis; systematic metastasis; BRAF mutation; appendiceal cancer
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.0597-22

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.