Kudou Michihiro, Murayama Yasutoshi, Konishi Hirotaka, Morimura Ryo, Komatsu Shuhei, Shiozaki Atsushi, Kuriu Yoshiaki, Ikoma Hisashi, Kubota Takeshi, Nakanishi Masayoshi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Sakakura Chouhei, Kojima Osamu, Otsuji Eigo
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine Graduate School of Medical Science, 465 Kajii-cho Hirokoji Kawaramachi, Kamigyo-ku, Kyoto, 602-8566, Japan.
Surg Today. 2015 Aug;45(8):1053-7. doi: 10.1007/s00595-014-1037-7. Epub 2014 Oct 16.
We report a rare case of peritoneal metastasis from colon cancer being found in the bilateral sites of inguinal hernia repair. The patient was an 85-year-old man who underwent colonoscopy for a positive fecal occult blood test, with a subsequent diagnosis of ascending colon cancer. He had undergone mesh plug repair for bilateral inguinal hernias at another hospital 6 years previously. We performed laparoscopy-assisted right hemi-colectomy and found nodes in the bilateral scars from the inguinal hernioplasty. Biopsy confirmed that both of the nodes were peritoneal metastasis, leading to the assumption that cancer cells disseminated within the abdominal cavity had been implanted at the repair sites, although the mechanism for this was unclear. A relationship between inflammation and peritoneal metastasis has been reported; thus, we speculated that local inflammation resulting from chronic stimulus of mesh plugs and peritoneal trauma caused peritoneal metastasis at the repair sites.
