A Case of Local Recurrence and Multiple Lung Metastasis 4 Years and 2 Months After Polypectomy of sm Rectal Cancer

Shuichiro Uehara¹⁾²⁾, Shigeru Nishida¹⁾, Yoshito Saito¹⁾²⁾, Hisao Kano¹⁾²⁾, Mitsuhiko Kashio¹⁾²⁾, Seigo Yasumuro¹⁾ and Masahiro Fukuzawa²⁾

Department of Surgery, Itabashi-ku Ishikai Hospital¹⁾ First Department of Surgery, Nihon University School of Medicine²⁾

A 55-year old woman was referred to our hospital because of a positive fecal occult blood test during a mass screening examination. She had undergone a polypectomy of the rectum 4 years and 2 months previously. The polypectomy specimen was a well-differentiated adenocarcinoma. No other surgical resections were performed, and a follow-up examination performed one year and four months after polypectomy produced no abnormal findings. After her referral to our hospital, a colonoscopy showed a submucosal tumor-like lesion in the rectum. A chest X-ray roentogenogram showed multiple coin lesions. We diagnosed a local recurrence and multiple lung metastases. An operation was therefore performed. The local recurrence occurred at the same site as the previous, polypectomized region. After a review of the previous polypectomized specimen, vessel invasion was identified. The patient was diagnosed as having a recurrence of sm1 rectal cancer. The recurence of sm1 colorectal cancer is very rare.

Key words
submucosal invasive colorectal cancer, local recurrence, distal metastasis

Reprint requests
Shuichiro Uehara First Department of Surgery, Nihon University School of Medicine 30-1 ooyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610 JAPAN

Accepted
July 30, 2001

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