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Brain and bone marrow metastases from rectal cancer
Konstantina Thomopoulou1, Stavroula Manolakou1, Ippokratis Messaritakis2
1Medical Oncology Department, University Hospital of Heraklion, Crete (Konstantina Thomopoulou, Stavroula Manolakou, Andreas Koulouris, Konstantinos Kalbakis, Dimitris Mavroudis, Ioannis Souglakos).
Annals of Gastroenterology
|January 2, 2020
Summary
This study reports two rectal cancer cases with rare metastases to the breast and bone marrow/brain. Circulating tumor cells (CTCs) positive for CEACAM5 but negative for EpCAM were detected, potentially explaining metastatic spread.
Area of Science:
- Oncology
- Cancer Metastasis Research
- Molecular Diagnostics
Background:
- Colorectal cancer (CRC) molecular characterization has advanced treatment, yet de novo metastatic disease affects 20% of patients.
- 30-40% of CRC patients treated curatively experience relapse, highlighting unmet needs in managing metastatic potential.
Observation:
- Two rectal cancer cases presented with unusual metastatic sites: isolated breast metastasis and synchronous bone marrow/brain metastases.
- The presence of circulating tumor cells (CTCs) was investigated in peripheral blood using immunofluorescence and RT-PCR.
Findings:
- CTCs were detected in both patients, positive for CEACAM5 but negative for the epithelial marker EpCAM (EpCAM-).
- This specific CTC profile (CEACAM5+, EpCAM-) may be associated with the observed uncommon metastatic patterns in rectal cancer.
Implications:
- Understanding rare metastatic patterns in rectal cancer is crucial for improving patient outcomes.
- The detection of CEACAM5+, EpCAM- CTCs offers potential insights into rectal cancer's metastatic mechanisms and patient prognosis.
- Further research into CTC characterization could refine diagnostic and therapeutic strategies for advanced rectal cancer.
