A Case of BRAF Mutant, MSI-high Cecum Cancer with Unusual Metachronous Lymph Node Metastasis

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  • 稀なリンパ節転移形式を示したBRAF変異型MSI-high盲腸癌の1例

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<p>A 75-year-old woman was admitted to our hospital due to right lower abdominal pain. Computed tomography revealed cecum cancer with para-aortic lymph node swelling. Ileocecal resection with regional lymph node dissection and sampling of para-aortic lymph nodes were performed. Histopathological examination revealed regional and para-aortic lymph node involvement. One month after operation, the CT scan delineated a swollen lymph node in the right external iliac region. Following the administration of systemic chemotherapy, the mass remained stable with some favorable controlled para-aortic nodules, and no other new metastatic legions were recognized. Para-aortic and right external iliac lymph node dissection was performed, however, lymph node recurrence in the right inferior epigastric and mesenteric region developed. As high microsatellite instability with BRAF V600E mutation was confirmed, pembrolizumab was administered. Further investigations into distant lymph node metastasis from colorectal cancer, including the relation to such tumor genetic features or tumor location, are expected.</p>

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