Solitary Cervical Metastasis of Poorly Differentiated Adenocarcinoma with Neuroendocrine Differentiation of the Rectum: Report of a Case

Yasuo Kabeshima, Maiko Takahashi, Noriaki Kameyama, Atsushi Toizumi, Yoichiro Tamura and Takahisa Kageyama

Department of Surgery, National Kasumigaura Hospital

Colorectal cancer metastasis of to the soft tissue of the head and neck is rare, while unusual colorectal cancer metastatic sites have included the pancreas, spleen, larynx, tonsil, and thyroid gland. Since only 8 cases have been reported primary at this site in the English literature, we report a case with solitary cervical metastasis from rectal carcinoma.
A 73-year-old Japanese woman who underwent abdominoperineal resection and was pathologically diagnosed with pT2pN1 adenocarcinoma was treated postoperatively with 5-fluorouracil but developed a left cervical induration grew 2 months later, there after that progressively grew. CT and magnetic resonance imaging indicated a large soft tissue mass contacting cervical vertebrae apart from Virchow's lymphnode. Since biopsy of the cervical mass revealed metastatic adenocarcinoma, similar to that of the primary rectal adenocarcinoma, and there was no other metastatic lesion, we resected the cervical tumor and treated her with 5-fluorouracil, leucovorin, and radiation to the cervical area. She lived for 16 months after cervical tumor resection. This case is extremely rare as the site of solitary metastasis of colorectal cancer controlled by radical surgery, and chemotherapy.

Key words
rectal carcinoma, cervical metastasis, neuroendocrine differentiation

Reprint requests
Yasuo Kabeshima Department of Surgery, National Kasumigaura Hospital
2-7-14 Shimotakatsu, Tsuchiura-shi, 300-8585 JAPAN

Accepted
September 24, 2003

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