Tan Kok-Yang, Ho Kok-Sun, Lai Jiunn-Herng, Lim Jit-Fong, Ooi Boon-Swee, Tang Choong-Leong, Eu Kong-Weng
Department of Colorectal Surgery, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2006 Aug;35(8):585-7.
The interesting topic of cutaneous and subcutaneous metastasis from rectal carcinoma is discussed using 3 cases.
The first case was a 70-year-old man with T3N2M0 rectal mucinous adenocarcinoma, who developed an inflammatory subcutaneous metastasis at the left scapula 2 years after anterior resection. The second case was a 51-year-old man with T4N2M0 splenic flexure mucinous adenocarcinoma, who developed metastatic disease including a subcutaneous secondary to the back. The third case was a 53-year-old woman who developed vulval recurrence 10 months after abdomino-perineal resection for a low T3N1M0 rectal adenocarcinoma.
All underwent wide resection.
This entity is rare and usually signifies disseminated disease if found remote from the resection site and warrants a thorough metastatic work up. A high index of suspicion is recommended when encountered with unresolving skin lesions in cancer patients.
通过3个病例讨论直肠癌皮肤及皮下转移这一有趣的话题。
首例患者为一名70岁男性,患有T3N2M0直肠黏液腺癌,前切除术后2年在左肩胛骨处出现炎性皮下转移。第二例患者为一名51岁男性,患有T4N2M0脾曲黏液腺癌,出现转移性疾病,包括背部皮下转移。第三例患者为一名53岁女性,因低位T3N1M0直肠腺癌行腹会阴切除术后10个月出现外阴复发。
所有患者均接受了广泛切除。
该实体罕见,如果在远离切除部位发现通常意味着疾病已播散,需要进行全面的转移灶检查。癌症患者出现无法消退的皮肤病变时,建议高度怀疑。