Colon Cancer with Mediastinal Metastasis
Imad Taleb *
Mohammed V Military Training Hospital Rabat Morocco, Morocco.
Saad Mohammed Amine
Mohammed V Military Training Hospital Rabat Morocco, Morocco.
Choukri Elmhadi
Mohammed V Military Training Hospital Rabat Morocco, Morocco.
Rachid Tanz
Mohammed V Military Training Hospital Rabat Morocco, Morocco.
Hassan Errihani
National institute of Oncology Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: The patient had a CAF (complete atrial fibrillation) as a comorbidity.
Objective: The most common sites of colon cancer metastasis are the regional lymph nodes, liver, lung, bone and brain.
The patient was 65 years old and had CAF as a comorbidity. She was consulted for a recent dyspnea evolving in a context of altered general state without any digestive sign. A thoracic scan showed a medial mass measuring 53*56*60mm. The lung biopsy revealed a muscular adenocarcinoma of colorectal origin with immunohistochemical expression of cytokeratin 7 (CK7), 20 and cytokeratin (CK) AE1/AE3, CDX2.The Pet Scan confirmed the existence of a hypermetabolic left anterosuperior medial mass in addition to a focal digestive hypermetabolism of the right colonic wall.
A colonoscopy was performed and showed a tumor process in the right colon with a histological and immunohistochemical profile compatible with that of the mediastinal metastasis. The tumor was MSS (microsatellite stable), RAS (rat sarcoma) and BRAF(v-raf murine sarcoma viral oncogene homolog B1)wild type. The patient received a 3-month folfox-panitimumab combination with good tolerance and a partial response of about 50% on the metastasis.
Conclusions: This case report provide a highly unusual instance of colon adenocarcinoma with extensive mediastinal lymph nodes metastasis.
Keywords: Colon cancer, chemotherapy, mediastinal metastasis, colon adenocarcinoma, mediastinal mass, thoracic scan