Li Yingjie, Li Mingshan, Li Xiaoxia, Sang Haiquan
Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Medicine (Baltimore). 2017 Mar;96(11):e6357. doi: 10.1097/MD.0000000000006357.
Metastasis of cancer cells involves shedding from the primary tumor through various means to distant tissues and organs with continued growth and formation of new metastatic tumors of the same cancer type as the original tumor. The common sites for colon cancer metastases include the pelvis, retroperitoneal lymph nodes, liver, and lungs; Colon cancer metastases to the appendix are rare, as reported in this case.
A 45-year-old man was admitted to our department with a 24-hour history of abdominal distension and incomplete obstruction. Colonoscopy showed an elevated lesion in the ascending colon and the pathologic diagnosis was adenocarcinoma.
This patient underwent a radical right hemi-colectomy. The post-operative pathologic examination revealed metastatic adenocarcinoma in all layers of the appendix, especially the muscularis mucosae. The diagnosis was adenocarcinoma of the ascending colon (pT4bN2bM0 stage IIIC) with metastatic adenocarcinoma of the appendix.
An absent right colic artery with lymph node fusion might increase the risk of appendiceal cancer metastasis.
癌细胞转移包括通过各种方式从原发肿瘤脱落至远处组织和器官，并持续生长，形成与原发肿瘤相同类型的新转移瘤。结肠癌转移的常见部位包括骨盆、腹膜后淋巴结、肝脏和肺部；如本病例报道，结肠癌转移至阑尾较为罕见。
一名45岁男性因腹胀和不完全性肠梗阻24小时入院。结肠镜检查显示升结肠有一隆起性病变，病理诊断为腺癌。
该患者接受了根治性右半结肠切除术。术后病理检查显示阑尾各层均有转移性腺癌，尤其是黏膜肌层。诊断为升结肠癌（pT4bN2bM0，IIIC期）伴阑尾转移性腺癌。
右结肠动脉缺如伴淋巴结融合可能增加阑尾癌转移的风险。
