Metachronous rectal metastasis from primary transverse colon cancer: a case report

• DOI: 10.1186/s40792-018-0498-0
• Publication Date: 2018-08-09T09:42:18Z
• Authors: Shigehiro Kojima; Tsuguo Sakamoto; Yuko Nagai; Masayuki Honda; Fumihiro Ogawa
• Keywords: Transverse colon; Submucosa; Primary tumor

Colorectal metastases from primary colorectal cancers are very rare, and little is known about their epidemiological aspects or the best diagnostic therapeutic strategies. Herein, we report a case of 65-year-old woman with suspected metachronous metastasis to rectum transverse colon cancer.The patient underwent laparoscopic extended right hemicolectomy for cancer. Histopathological examination showed moderately differentiated adenocarcinoma, tumor was diagnosed as stage IIA (T3, N0, M0). Fifteen months after her colectomy, computed tomography scan demonstrated rectal ovarian tumor. Colonoscopy revealed superficial elevated lesion in middle rectum, histological analysis adenocarcinoma. Laparoscopic low anterior resection preserving left colic artery bilateral adnexectomy were performed. Histological that adenocarcinoma mainly present submucosa muscularis propria, while carcinoma-involved region mucosal layer had colonization representing spread metastatic cells along basement membrane preexisting crypts and/or villi. The proved be positive cytokeratin 20 negative 7 staining, indicating tumors similar cancer architectural cytological atypia. Both adenocarcinomas p53 immunohistochemical staining RAS wild type genetic assessment. These findings support possible diagnosis recovered well surgery, neither relapse nor observed 18 surgery.Distinguishing can challenging, but comprehensive evaluation features, clinical history, distribution enable making correct implementing optimal treatment.