A Case of Isolated Metastasis to Small Bowel after Resection of Stage IV Rectal Cancer

Izumi Nakamura, Yudai Nagasawa¹⁾, Tetsuro Ito, Masaru Saito, Kensuke Kumamoto, Satoshi Suzuki, Yoshiyuki Endo, Shinji Ohki, Takashi Sugino²⁾ and Seiichi Takenoshita

Department of Organ Regulatory Surgery, Fukushima Medical University
Department of Surgery, Ohta Atami Hospital¹⁾
Department of Basic Pathology, Fukushima Medical University²⁾

We report a rare case of rectal cancer with small-bowel metastasis. A 73-year-old man who had undergone low anterior resection combined with partial liver resection in June 2003 was found 3.5 years later to have elevated CA19-9. Abdominal computed tomography showed a small-bowel lesion in the pelvis. Positron-emission-tomography-CT showed an abdominal concentration in the small bowel in the pelvis, necessitating laparotomy in January 2007 based on a diagnosis of tumor metastasis from rectal cancer. A tumor infiltrating to the ileal serosal surface necessitated partial ileal resection. Pathological findings for the resected specimen showed a histological similarity to primary rectal cancer. Now, over 6 years after rectal cancer surgery, the patient lives with multiple lung metastases and residual liver metastases and visits the outpatient clinic for chemotherapy, maintaining a good quality of life (QOL). Surgical resection thus occasionally bring a good prognosis and QOL to a patient with isolated small-bowel metastasis from colorectal cancer, despite other metastasis.

Key words
colon cancer, small-bowel metastasis

Reprint requests
Izumi Nakamura Department of Organ Regulatory Surgery, Fukushima Medical University
1 Hikarigaoka, Fukushima, 960-1295 JAPAN

Accepted
December 16, 2009

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