Cutaneous Metastasis of Transverse Colon Cancer with an Aberrant Pattern of CK7/CK20/CDX2 and High Microsatellite Instability

Intern Med. 2023 Dec 15;62(24):3625-3630. doi: 10.2169/internalmedicine.1629-23. Epub 2023 May 10.

Abstract

A 79-year-old woman was diagnosed with transverse colon cancer, moderately differentiated adenocarcinoma. She underwent surgery and postoperative adjuvant chemotherapy. At 80 years old, the patient exhibited changes in skin tone at the chest and abdomen with CK7+/CK20-/CDX2- immunostaining that was later identified as poorly differentiated adenocarcinoma. The diagnosis was cancer of unknown primary origin. The patient passed away three months after the detection of the skin lesion. Autopsy revealed recurrence at the transverse colon, multiple organ metastases, a similar postmortem immunostaining pattern, and high-frequency microsatellite instability (MSI-high). We herein report this case of CK7+/CK20-/CDX2- and MSI-high transverse colon cancer showing cutaneous metastasis.

Keywords: CDX2-; CK7+/CK20-; colorectal cancer; cutaneous metastasis; microsatellite instability.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / pathology
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor
  • CDX2 Transcription Factor
  • Colon, Transverse* / pathology
  • Colonic Neoplasms* / genetics
  • Female
  • Homeodomain Proteins
  • Humans
  • Keratin-20
  • Microsatellite Instability
  • Skin Neoplasms* / genetics

Substances

  • Homeodomain Proteins
  • CDX2 Transcription Factor
  • Biomarkers, Tumor
  • Keratin-20
  • CDX2 protein, human