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

Satoshi Nakamura; Yorinari Ochiai; Yuki Nishihara; Anri Koyanagi; Yasurou Miura; Daisuke Kikuchi; Yutaka Takazawa; Hiroya Kuroyanagi; Shu Hoteya

doi:10.2169/internalmedicine.0597-22

CASE REPORTS

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

Satoshi Nakamura, Yorinari Ochiai, Yuki Nishihara, Anri Koyanagi, Yasurou Miura, Daisuke Kikuchi, Yutaka Takazawa, Hiroya Kuroyanagi, Shu Hoteya

Author information

Satoshi Nakamura
Department of Gastroenterology, Toranomon Hospital, Japan
Yorinari Ochiai
Department of Gastroenterology, Toranomon Hospital, Japan
Yuki Nishihara
Department of Gastroenterological Surgery, Toranomon Hospital, Japan
Anri Koyanagi
Department of Pathology, Toranomon Hospital, Japan
Yasurou Miura
Department of Pathology, Toranomon Hospital, Japan
Daisuke Kikuchi
Department of Gastroenterology, Toranomon Hospital, Japan
Yutaka Takazawa
Department of Pathology, Toranomon Hospital, Japan
Hiroya Kuroyanagi
Department of Gastroenterological Surgery, Toranomon Hospital, Japan
Shu Hoteya
Department of Gastroenterology, Toranomon Hospital, Japan

Keywords: appendiceal cancer, cutaneous metastasis, systematic metastasis, BRAF mutation, high microsatellite instability

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 18 Pages 2655-2660

DOI https://doi.org/10.2169/internalmedicine.0597-22

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Abstract

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.

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