BRAF mutation: Current and future clinical pathological applications in colorectal carcinoma.

The aims are to review the relevance of the BRAF mutations in the clinical settings of colorectal carcinoma. All the literature concerning BRAF mutations and colorectal carcinoma published in PubMed from 2010 to 2018 was reviewed. Multiple variants of BRAF mutations exist in colorectal cancer, the most common type being V600E. The mutation is found in 5 to 15% of colorectal carcinomas and is less common in Asian populations. BRAF mutations are linked with older age, female gender, cigarette smoking and are more common in the right (proximal) portion of the large intestine. BRAF mutations are associated with carcinomas of high histological grade and advanced cancer stages. Often BRAF mutated carcinomas demonstrate adverse histological features such as lymphovascular invasion, perineural invasion, tumour budding and lymph node metastases. BRAF mutations are found in serrated polyposis syndrome and have a negative correlation with hereditary nonpolyposis colorectal cancer (HNPCC). An array of methods of detection of BRAF mutation in colorectal carcinoma are available, such as immunohistochemistry and next generation sequencing, etc. Combinatorial approaches involving anti-BRAF therapies targeting both MAPK signalling as well as the PI3K/mTOR pathway could be a new approach for treatment of metastatic colorectal carcinoma. To conclude, BRAF mutation is important in the pathogenesis of colorectal cancer. Further research on the detection method as well as its role in target therapy will help to improve the management of patients with colorectal cancer.

Metastatic pancreatic adenocarcinoma presenting as an occipital haemorrhage.

We report a case of a 63-year-old woman who was presented to the emergency department with an occipital haemorrhage secondary to a pancreatic cerebral metastasis. Pancreatic cancer is the ninth most common cancer in women in Australia, and distant disease is present in 70% of patients with pancreatic cancer at the time of diagnosis. However, metastases to the brain are rare, accounting for only 0.33%-0.57% cases antemortem. Herein, we discuss the management of this unusual case to highlight the importance of recognising unusual central nervous system involvement of cancers, a problem which may be increasing in prevalence.

Sporadic Burkitt's lymphoma masquerading as an intussuscepted Meckel's diverticulum in a 9-year-old child.

We report the case of a 9-year-old boy who presented with abdominal pain and was found to have an intussusception with a sporadic Burkitt's lymphoma (BL) lead point. Our case was unusual in that the patient did not present with the typical clinical features of BL, nor was he in a high-risk demographic for this uncommon disease.