Ito Homare, Horie Hisanaga, Sadatomo Ai, Naoi Daishi, Tahara Makiko, Kono Yoshihiko, Inoue Yoshiyuki, Koinuma Koji, Lefor Alan Kawarai, Sata Naohiro
Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
J Surg Case Rep. 2017 Dec 15;2017(12):rjx247. doi: 10.1093/jscr/rjx247. eCollection 2017 Dec.
Metachronous solitary metacarpal bone metastasis from rectal cancer has not been reported previously. Here, we describe a 54-year-old woman who underwent abdominoperineal resection for rectal cancer following neoadjuvant chemoradiotherapy. The resected specimen contained adenocarcinoma with no lymph node metastases (Stage II, T3N0M0); no adjuvant chemotherapy was administered. Fifteen months after surgery, the patient presented with pain and swelling of the right thumb. Radiography revealed metacarpal bone destruction, and fluorine-18 fluorodeoxyglucose positron emission tomography showed uptake only in the metacarpal bone. Open biopsy revealed an adenocarcinoma, and a right thumb resection was performed. Histological examination indicated features of adenocarcinoma similar to the findings of a rectal lesion, leading to a diagnosis of metachronous solitary metacarpal bone metastasis from rectal cancer. The patient remains free of disease after 6 years of follow-up. Our findings suggest that surgical resection may lead to favorable outcomes in patients with resectable solitary bone metastases.
此前尚未有关于直肠癌异时性孤立性掌骨转移的报道。在此,我们描述了一名54岁女性,她在接受新辅助放化疗后因直肠癌接受了腹会阴联合切除术。切除标本为腺癌,无淋巴结转移(II期,T3N0M0);未进行辅助化疗。术后15个月,患者出现右手拇指疼痛和肿胀。影像学检查显示掌骨破坏,氟-18氟脱氧葡萄糖正电子发射断层扫描显示仅掌骨有摄取。切开活检显示为腺癌,遂行右手拇指切除术。组织学检查显示腺癌特征与直肠病变结果相似,从而诊断为直肠癌异时性孤立性掌骨转移。随访6年后,患者无疾病复发。我们的研究结果表明,手术切除对于可切除的孤立性骨转移患者可能会带来良好的预后。