A Six-year Survival Case of Advanced Sigmoid Colon Cancer with Metastases to Both the Virchow and Para-aortic Lymph-node.

Abstract Background Extended excision of the permeation organ neighborhood is often performed in locally invasive colon cancer, and it is reported to have a survival benefit. In addition, some cases of secondary lymph node metastases in a permeation organ were reported. However, they are reports of synchronous secondary lymph node metastases, not metachronous secondary lymph node metastases. To the best of our knowledge, there are no cases of metachronous secondary lymph node metastases after the resection of a primary colorectal cancer in PubMed. Case presentation The case was a 67-year-old man who underwent colonoscopy because of weight loss. Sigmoid colon cancer with all circumference-related stenosis was found by examination, and the patient was transferred to our hospital for the purpose of scrutiny and treatment. The small intestine ileus caused by the invasion of sigmoid colon cancer developed after the transfer. Laparoscopic high anterior resection and extended excision of small intestine segmental resection was performed after the intestinal tract decompression with a nasal ileus tube. Histopathological analysis revealed a pathological diagnosis of pT4b (ileal submucosal invasion) N0 (0/11) M0 f Stage II, tub2, ly1, v2, PN0. Although adjuvant chemotherapy with capecitabine after the operation was planned for half a year, treatment was suspended in the first course by the patient’s self-judgment. No recurrence was observed for a year after the operation, but metastasis recurrence in the para-aortic lymph node was found by a computed tomography (CT) one and a half years after the operation. 18 F-fluorodeoxyglucose (FDG) positron emission tomography revealed that FDG was accumulated only in the para-aortic lymph node. Laparoscopic metastasis lymphadenectomy was performed due to the diagnosis of metachronous metastasis to the para-aortic lymph node alone. Intraoperative findings revealed that lymph node metastasis occurred in the mesentery of the ileum. No adjuvant treatment was done after the secondary operation, and he is still alive with no recurrence 1 year and 9 months after the operation. Conclusions We report a rare case of a laparoscopic resection of a metachronous secondary lymph node metastasis in the mesentery of the ileum after surgery for sigmoid colon cancer with ileum invasion.

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Successful Resection of Isolated Para-Aortic Lymph Node Recurrence from Advanced Sigmoid Colon Cancer following 156 Courses of FOLFIRI Regimen

Case Reports in Surgery ◽

10.1155/2016/4548798 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Kaoru Takeshima ◽

Kazuo Yamafuji ◽

Atsunori Asami ◽

Hideo Baba ◽

Nobuhiko Okamoto ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Sigmoid Colon ◽

Left Renal Vein ◽

Pathological Examination ◽

Sigmoid Colon Cancer ◽

Aortic Lymph Node ◽

Metastatic Involvement ◽

Disease Free

Isolated para-aortic lymph node (PLN) recurrence from colorectal cancer (CRC) is rare, with no currently validated treatments. Few reports have described the successful resection of isolated PLN involvement from CRC following chemotherapy. We report the case of a 63-year-old man who underwent sigmoidectomy for sigmoid colon cancer at our hospital. Pathological examination demonstrated advanced sigmoid colon cancer with metastatic involvement in both of the tested PLNs. Palliative chemotherapy was initiated four weeks after surgical resection, with administration of the FOLFIRI regimen. Four years after the operation, computed tomography (CT) revealed an enlarged PLN below the left renal vein. As PLN enlarged to 15 mm in the minor axis on a CT scan in 2014 after receiving a total of 156 courses of the FOLFIRI regimen, we considered the enlarged PLN to represent an isolated metastasis. Accordingly, lymph node resection was performed with microscopically negative margins. The patient maintained a good quality of life without any side effects throughout the whole course of his treatment and remains disease-free at 24 months without chemotherapy after resection of the isolated PLN. Curative resection following chemotherapy may improve survival of carefully selected advanced CRC patients with locoregional recurrence, such as isolated PLN involvement.

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A Long Survival Case of Lateral Lymph Node Recurrence of Sigmoid Colon Cancer with Bladder Invasion Resected by Laparoscopic Surgery

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.69.159 ◽

2016 ◽

Vol 69 (3) ◽

pp. 159-163

Author(s):

Yoshinori Takeda ◽

Yosuke Fukunaga ◽

Toshiya Nagasaki ◽

Masashi Ueno

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Laparoscopic Surgery ◽

Sigmoid Colon ◽

Sigmoid Colon Cancer ◽

Lateral Lymph Node ◽

Long Survival ◽

Lymph Node Recurrence ◽

Bladder Invasion ◽

Survival Case

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Ten-Year Survival of a Patient Treated with Stereotactic Gamma Knife Radiosurgery for Brain Metastases from Colon Cancer with Ovarian and Lymph Node Metastases: A Case Report

Case Reports in Gastroenterology ◽

10.1159/000445976 ◽

2016 ◽

Vol 10 (1) ◽

pp. 204-211 ◽

Cited By ~ 2

Author(s):

Nobuhiro Morinaga ◽

Naritaka Tanaka ◽

Yoshinori Shitara ◽

Masatoshi Ishizaki ◽

Takatomo Yoshida ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Brain Metastasis ◽

Brain Metastases ◽

Sigmoid Colon ◽

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Sigmoid Colon Cancer ◽

Ovarian Lesion ◽

Node Metastases

Brain metastasis from colorectal cancer is infrequent and carries a poor prognosis. Herein, we present a patient alive 10 years after the identification of a first brain metastasis from sigmoid colon cancer. A 39-year-old woman underwent sigmoidectomy for sigmoid colon cancer during an emergency operation for pelvic peritonitis. The pathological finding was moderately differentiated adenocarcinoma. Eleven months after the sigmoidectomy, a metastatic lesion was identified in the left ovary. Despite local radiotherapy followed by chemotherapy, the left ovarian lesion grew, so resection of the uterus and bilateral ovaries was performed. Adjuvant chemotherapy with tegafur-uracil (UFT)/calcium folinate (leucovorin, LV) was initiated. Seven months after resection of the ovarian lesion, brain metastases appeared in the bilateral frontal lobes and were treated with stereotactic Gamma Knife radiosurgery. Cervical and mediastinal lymph node metastases were also diagnosed, and irradiation of these lesions was performed. After radiotherapy, 10 courses of oxaliplatin and infused fluorouracil plus leucovorin (FOLFOX) were administered. During FOLFOX administration, recurrent left frontal lobe brain metastasis was diagnosed and treated with stereotactic Gamma Knife radiosurgery. In this case, the brain metastases were well treated with stereotactic Gamma Knife radiosurgery, and the systemic disease arising from sigmoid colon cancer has been kept under control with chemotherapies, surgical resection, and radiotherapy.

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