Brain and bone marrow metastases from rectal cancer

Konstantina Thomopoulou; Stavroula Manolakou; Ippokratis Messaritakis; Maria Tzardi; Eleni Lagoudaki; Anastasios Koutsopoulos; Andreas Koulouris; George Kanellis; Konstantinos Kalbakis; Dimitrios Mavroudis; Ioannis Souglakos

Authors Konstantina Thomopoulou, Stavroula Manolakou, Ippokratis Messaritakis, Maria Tzardi, Eleni Lagoudaki, Anastasios Koutsopoulos, Andreas Koulouris, George Kanellis, Konstantinos Kalbakis, Dimitrios Mavroudis, Ioannis Souglakos.

Abstract

Despite the development of new treatment options based on the molecular characterization of colorectal cancer, 20% of patients present de novo metastatic disease, whereas 30-40% of patients who receive curative treatment relapse during follow up. Herein, we report 2 cases with rectal cancer that developed uncommon sites of metastasis; the first patient had an isolated breast metastasis, while the second patient developed bone marrow infiltration with synchronous brain metastases. In order to evaluate the uncommon metastatic pattern of rectal cancer, we detected and enumerated circulating tumor cells (CTCs) using both immunofluorescence
and real-time reverse transcriptase polymerase chain reaction in these patients’ peripheral blood. The procedure revealed the presence of CTCs, positive for CEACAM5 but negative for epithelial phenotype (EpCAM-), that might explain the patients’ metastatic potential and survival.

Keywords Rectal cancer, rare metastases, circulating tumor cells

Ann Gastroenterol 2020; 33 (1): 95-97