Long-term survival of a patient with metachronous rectal metastasis from primary cecal cancer who underwent repetitive resection and chemotherapy: a case report

World Journal of Surgical Oncology

Takafumi Tabuchi¹  Hideyuki Ubukata¹  Takanobu Tabuchi¹  Takeshi Nakachi¹  Jiro Shimazaki¹ 

[1] Department of Gastrointestinal Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Ami, Inashiki, Ibaraki 300-0395, Japan

关键词: Chemotherapy;    Metastasis;    Colorectal cancer;   

Others  :  819835
DOI  :  10.1186/1477-7819-12-107

 received in 2014-01-31, accepted in 2014-04-07,  发布年份 2014

【 摘 要 】

There are few reported cases of colorectal metastasis from cancers of other organs, particularly other segments of the colon. Here we describe the long-term survival of a 68-year-old male patient with metachronous rectal metastasis from cecal cancer who underwent repetitive resection and chemotherapy. The patient underwent ileocecal resection and hepatectomy for cecal cancer with liver metastasis (T3, N1a, M1a, Stage IVA) in 2006. The patient subsequently underwent splenectomy for splenic metastasis in 2007. In August 2008, barium enema revealed compression of the rectal wall, and abdominal computed tomography (CT) detected a mass along the rectum extending into the pelvis. Rectal metastasis from cecal cancer was suspected and Hartmann’s operation with bilateral seminal vesicle dissection was performed. Histological examination of the excised tumor revealed moderately differentiated adenocarcinoma formed in the muscularis propria of the rectum and infiltrating the connective tissue between the seminal vesicle and rectum. However, no tumor was detected in the rectal mucosa or submucosa. These histological findings supported the diagnosis of rectal metastasis from cecal cancer. The patient has been monitored at our clinic for 60 months after surgical removal of the rectal metastasis. The findings from this case should alert oncologists to the potential danger of rectal metastasis from primary colon cancer and the benefits of timely complete resection in terms of improved patient outcomes.

【 授权许可】

   
2014 Shimazaki et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Sobin LH, Gospodarowicz MK, Wittekind C (Eds): TNM Classification of Malignant Tumors. 7th edition. Oxford: Wiley-Blackwell; 2009.
• [2]Amin AA, Reddy A, Jha M, Prasad K: Rectal metastasis from breast cancer: an interval of 17 years. BMJ Case Rep 2011, 2011:bcr0120113683.
• [3]López Deograscias M, Flores Jaime L, Arias-Camisón I, Zamacola I, Murillo Guibert J, Suescun García R, Querejeta Usabiaga J, Martínez García F: Rectal metastasis from lobular breast carcinoma 15 years after primary diagnosis. Clin Transl Oncol 2010, 12(2):150-153.
• [4]Inada K, Shida D, Noda K, Inoue S, Warabi M, Umekita N: Metachronous colonic metastasis from pancreatic cancer seven years post-pancreatoduodenectomy. World J Gastroenterol 2013, 19(10):1665-1668.
• [5]Mehta RS, Liman AD, Passero VA, Liman AK: Lung cancer with gastrointestinal metastasis - review of theories of metastasis with three rare case descriptions. Cancer Microenviron 2013, 6(3):203-211.
• [6]Nakamura M, Ami K, Wataya Y, Amagasa H, Ganno H, Kurokawa T, Fukuda A, Nagahama T, Ando M, Okada Y, Tei S, Arai K: A case of colon cancer with long-term survival treated by resection of recurrence on the rectum and chemotherapy for lung metastasis. Gan To Kagaku Ryoho 2011, 38(12):2307-2309.
• [7]Kalaitzis J, Filippou G, Zizi-Sermpetzoglou A, Marinis A, Hadjimarcou A, Paschalidis N, Rizos S: Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall. World J Surg Oncol 2010, 8:17.
• [8]Grothey A, Sargent D, Goldberg RM, Schmoll HJ: Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004, 22:1209-1214.
• [9]Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, Hamaguchi T, Hyodo I, Igarashi M, Ishida H, Ishiguro M, Kanemitsu Y, Kokudo N, Muro K, Ochiai A, Oguchi M, Ohkura Y, Saito Y, Sakai Y, Ueno H, Yoshino T, Fujimori T, Koinuma N, Morita T, Nishimura G, Sakata Y, Takahashi K, Takiuchi H, Tsuruta O, Tamaguchi T, et al.: Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol 2012, 17:1-29.
• [10]Colucci G, Gebbia V, Paoletti G, Giuliani F, Caruso M, Gebbia N, Carteni G, Agostara B, Pezzella G, Manzione L, Borsellino N, Misino A, Romito S, Durini E, Cordio S, Di Seri M, Lopez M, Maiello E, Montemurro S, Cramarossa A, Lorusso V, Di Bisceglie M, Chiarenza M, Valerio MR, Guida T, Leonardi V, Pisconti S, Rosati G, Carrozza F, Nettis G, et al.: Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell’Italia Meridionale. J Clin Oncol 2005, 23:4866-4875.
• [11]Tournigand C, André T, Achille E, Lledo G, Flesh M, Mery-Mignard D, Quinaux E, Couteau C, Buyse M, Ganem G, Landi B, Colin P, Louvet C, de Gramont A: FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: A Randomized GERCOR Study. J Clin Oncol 2004, 22:229-237.
• [12]Martin LW, Warren RS: Current management of colorectal liver metastases. Surg Oncol Clin N Am 2000, 9:853-876.
• [13]Penna C, Nordlinger B: Colorectal metastasis (liver and lung). Surg Clin North Am 2002, 82:1075-1090.
• [14]Kato T, Yasui K, Hirai T, Kanemitsu Y, Mori T, Sugihara K, Mochizuki H, Yamamoto J: Therapeutic results for hepatic metastasis of colorectal cancer with special reference to effectiveness of hepatectomy: analysis of prognostic factors for 763 cases recorded at 18 institutions. Dis Colon Rectum 2003, 46(Suppl):S22-S31.
• [15]Watanabe K, Nagai K, Kobayashi A, Sugito M, Saito N: Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer. Br J Surg 2009, 96:1058-1065.
• [16]Hirosawa T, Itabashi M, Ohnuki T, Yamaguchi N, Sugihara K, Kameoka S, Japanese Society for Cancer of the Colon and Rectum (JSCCR) Study Group for Pulmonary Metastases from Colorectal Cancer: Prognostic factors in patients undergoing complete resection of pulmonary metastases of colorectal cancer: a multi-institutional cumulative follow-up study. Surg Today 2013, 43:494-499.