A Rare Metastasis to Rectovesical Extraperitoneum from Cecal Cancer -Report of a case

Takamitsu Inokuma, Yoshito Ikematsu, Hideo Kida, Shinji Waki, Takachika Ozawa* and Takashi Kanematsu**

Department of Surgery and Department of Pathology*, Hamamatsu Medical Center
Department of Surgery, Nagasaki University Graduated School of Biomedical Sciences**

We report an unusual case of recurrent colon cancer. A 62-year-old man who underwent right hemicolectomy for cecum cancer in 2000 had had a 7 cm tumor resected and found histologically to be well-differentiated adenocarcinoma with lymph node metastasis along the middle colic artery. Seventeen months after initial surgery, a metastatic lesion was found in the rectovesical pouch. No other recurrent lesions were found, so we conducted total pelvic exenteration. In a resected specimen, a tumor was found in extraperitoneal connective tissue. Parietal peritoneum, mucosa of the rectum and bladder were free from cancer-cell invasion. Intraabdominal operative cytology findings were also negative. The definitive diagnosis was a solitary metastatic tumor in extraperitoneal connective tissue arising from cecum cancer. This recurrence is extremely rare, and more case reports are needed to determine the mechanism behind these metastases.

Key words
colon cancer, metastasis, rectovesical pouch

Reprint requests
Takamitsu Inokuma Second Department of Surgery, Nagasaki University Graduated School of Biomedical Sciences
1-7-1 Sakamoto, Nagasaki, 852-8501 JAPAN

Accepted
November 30, 2005

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