A Rare Presentation of Colorectal Cancer with Unusual Progressive Intramuscular and Subcutaneous Metastatic Spread

Document Type : Case report

Authors

1 Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

4 Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Colorectal carcinoma is one of the most common causes of cancer-related death, worldwide. Recently, due to the introduction of novel imaging and therapeutic techniques, five-year survival of patients has increased. However, distant metastasis is still expected in half of the patients. Colorectal cancer tends to target the abdominal cavity, liver, lungs, and bones as the common sites of metastasis. Nevertheless, rare cases of muscle metastasis have been reported. This report presents a 23-year-old male, who despite chemotherapy, demonstrated gradual progressive disease and metastases to the submandibular region, lungs, adrenal gland as well as muscles and subcutaneous tissues. He had developed multiple asymptomatic muscular metastases metachronously over two-year time period discovered on an 18FDGPET/CT, namely in the deltoid, external oblique abdominis, rectus abdominis, and quadriceps muscles, as well as one of the extrinsic muscles of the tongue. The presence of distant, especially extrahepatic metastasis, adversely affects the prognosis of colon carcinoma. Since limited cases of muscle metastasis have been reported in carcinoma of colon, the underlying pathophysiology, optimum treatment, and prognostic issues are yet to be substantiated.

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Main Subjects

References

1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87-108.
2. Van Cutsem E, Cervantes A, Adam R, Sobrero A, Van Krieken J, Aderka D, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386-422.
3. Van Cutsem E, Cervantes A, Nordlinger B, Arnold D. Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;25(suppl 3):iii1-9.
4. Maffione AM, Lopci E, Bluemel C, Giammarile F, Herrmann K, Rubello D. Diagnostic accuracy and impact on management of 18 F-FDG PET and PET/ CT in colorectal liver metastasis: a meta-analysisand systematic review. Eur J Nucl Med Mol Imaging. 2015;42(1):152-63.
5. Ismaili N. Treatment of colorectal liver metastases. World J Surg Oncol. 2011;9(1):154.
6. Engledow AH, Skipworth JR, Blackman G, Groves A, Bomanji J, Warren SJ, et al. The role of 18fluoro‐ deoxy glucose combined position emission and computed tomography in the clinical management of anal squamous cell carcinoma. Colorectal Dis. 2011;13(5):532-7.
7. Coelho MI, Albano MN, Costa Almeida CE, Reis LS, Moreira N, Almeida CM. Colon cancer metastasis to the thyroid gland: a case report. Int J Surg Case Rep. 2017;37:221-4.
8. Hasegawa S, Sakurai Y, Imazu H, Matsubara T, Ochiai M, Funabiki T, et al. Metastasis to the forearm skeletal muscle from an adenocarcinoma of the colon: report of a case. Surg Today. 2000;30(12):1118-23.
9. Hlavatá Z, Pazderová N, Povinec P, Paulí�ny P, Majidi A, Fiala P, et al. The value of 18-FDG PET/CT imaging in a patient with atypical metastatic colorectal cancer–case report: 18-FDG PET/CT in colorectal cancer. Klin Onkol. 2009;22(6):284-7.
10. Blank A, Roberts DE 2nd, Dawson H, Zlobec I, Lugli A. Tumor heterogeneity in primary colorectal cancer and corresponding metastases. does the apple fall far from the tree? Front Med. 2018;5:234.
11. Gambardella V, Tarazona N, Cervantes A. New molecular challenges in metastatic colorectal cancer. Medicographia. 2018;40(3):101-8.
12. Mekenkamp LJ, Heesterbeek KJ, Koopman M, Tol J, Teerenstra S, Venderbosch S, et al. Mucinous adenocarcinomas: poor prognosis in metastatic colorectal cancer. Eur J Cancer. 2012;48(4):501-9.
13. Liu YY, Chen ZH, Zhai ET, Yang J, Xu JB, Cai SR, et al. Case of metachronous bilateral isolated adrenal metastasis from colorectal adenocarcinoma and review of the literature. World J Gastroenterol. 2016;22(14):3879-84.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 7, Issue 1
January 2019
Pages 89-94

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