The thyroid lesion presented as a tumour-to-tumour deposit within a benign Hurthle adenoma. The primary tumour metastasized to the lung and the thyroid within a year from its onset. The primary tumour metastasized to the lung and the thyroid within a year from its onset. Results: The primary colon cancer emerged between 5 and 8 years before the clinical diagnosis.
Primary cancer and metastases were microsatellite stable and displayed low chromosomal instability.
This approach allowed us to follow the progression of the disease back in time, dating each ancestral node of the phylogenetic tree in the past history of the tumour.
Using whole genome sequencing data from primary and metastatic sites we inferred the complete chronology of the cancer by exploiting the time of needle tract seeding as an in vivo 'stopwatch'.
The chest wall metastasis was caused by needle tract seeding, implying a known time of onset.
Patients and methods: Here, we describe the case of a colorectal cancer (CRC) patient presenting with synchronous lung metastasis and metachronous thyroid, chest wall and urinary tract metastases over the course of 5 years.