Document Detail

Lymph node metastasis from colon carcinoma at 11 years after the initial operation managed by lymph node resection and chemoradiation: A case report and a review of the literature.
MedLine Citation:
PMID:  22609701     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: Lymph node metastasis from colorectal cancer after a disease-free interval (DFI) of >5years is extremely rare, and occurs in <0.6% cases.
PRESENTATION OF CASE: A 60-year-old man underwent low anterior resection for sigmoid colon cancer. The lesion was an adenocarcinoma with no lymph node metastasis of Stage II. At 9years after the colectomy, he was diagnosed with prostate cancer and was treated with radiation and hormonal therapies; at 11years, he exhibited suddenly elevated carcinoembryonic antigen levels. Computed tomography (CT) and positron emission tomography-CT revealed a 2.0-cm para-aortic lymph nodes swelling invading the small intestine. These lymph nodes and the affected segment of the small intestine were resected, and histopathology of the resected specimen confirmed a metastatic tumor. The patient was administered radiation therapy after 22 cycles of 5-fluorouracil, oxaliplatin and leucovorin. He however presented with a residual lesion in the para-aortic lymph node, but currently, he has been symptom free for 4years.
DISCUSSION: A review of the literature indicates that the median survival of all previously reported patients is 12months, and that colon cancer with a long DFI might be a slow growing. One of these patients and our patient both had received radiation and/or hormonal therapy for another cancer, which probably impaired their immune systems, thus resulting in metastatic tumors.
CONCLUSION: We report a case of lymph node metastasis after a DFI of >5years and review relevant literature to assess the significance and possible reasons for delayed colorectal cancer metastases.
Masatsugu Ishii; Naokazu Chiba; Daiki Ono; Takeshi Nakamura; Syuuji Ishikawa; Yoshito Arisawa; Mitsumasa Hashimoto
Publication Detail:
Type:  Journal Article     Date:  2012-04-24
Journal Detail:
Title:  International journal of surgery case reports     Volume:  3     ISSN:  2210-2612     ISO Abbreviation:  Int J Surg Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-19     Completed Date:  2012-10-02     Revised Date:  2013-03-01    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  358-61     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Department of Surgery, Kawasaki Municipal Ida Hospital, 2-27-1 Ida Nakahara-ku Kawasaki, Kanagawa 211-0035, Japan.
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