Metastatic Carcinoma in the Anal Sphincter Muscles from Sigmoid Colon Cancer: Report of a Case

Hideyuki Hemmi, Masataka Ikeda, Hirofumi Yamamoto, Ichiro Takemasa, Masaya Nomura, Mitsugu Sekimoto and Morito Monden

Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University

We report a case of vasculogeneous metastasis of anal cancer from sigmoid colon cancer. A 59-year-old man undergoing sigmoidectomy combined with bladder and ileum resection, and ileal conduit reconstruction on November 2001 under a diagnosis of sigmoid colon cancer with direct bladder invasion was histologically diagnosed from the resected specimen as having moderately differentiated adenocarcinoma invading the bladder. Intermediate mesenteric lymph node metastasis resulted in final pathological stage IIIb. After 18 months, an anal tumor was found and the biopsy specimen showed moderately differentiated adenocarcinoma. Endorectal magnetic resonance imaging showed the lesion to be between the internal and external sphincter muscles necessitating abdominoperineal resection in July 2003. Pathological findings for the resected specimen showed histological similarity to primary sigmoid colon cancer, no anal fistula, and intact anorectal epithelium, suggesting that anal tumor was a vasculogeneous metastasis of sigmoid colon cancer. A few reports on vasculogenous metastatic anal carcinoma have been made, so report this rare case.

Key words
sigmoid colon cancer, anal metastasis

Reprint requests
Hideyuki Hemmi Gastroenterological Surg Department of Surgery, Graduate School of Medicine, Osaka University
E2-2-2 Yamadaoka, Suita, 565-0871 JAPAN

Accepted
March 26, 2008

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