Meng Ling-Kang, Zhu Dan, Zhang Yu, Fang Yuan, Liu Wei-Zhen, Zhang Xia-Qing, Zhu Yong
Department of Colorectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, Jiangsu Province, China.
World J Clin Cases. 2022 Jan 21;10(3):1122-1130. doi: 10.12998/wjcc.v10.i3.1122.
Distant metastasis of colorectal cancer to the anus is very rare, with only 30 related cases published in PubMed thus far. Therefore, recurrence of colorectal cancer derived anus metastases is rarely seen and less presented.
Here we report an 80-year-old male patient who underwent radical resection for sigmoid colon cancer in January 2010 and another surgery for anal fistula resection in December 2010. Postoperative pathology of the anal fistula revealed a metastatic moderately differentiated adenocarcinoma. The patient subsequently received chemotherapy and radiotherapy. In May 2020, after the patient reported symptoms of anal swelling and pain, computed tomography and magnetic resonance imaging revealed a perianal abscess. Perianal mass biopsy was performed, and the postoperative pathological diagnosis was metastatic moderately differentiated adenocarcinoma.
This case highlights that there is a risk of recurrence of anal metastasis of colorectal cancer even after 10 years of follow-up. We also reviewed the literature and discuss potential mechanisms for anal metastasis of colorectal cancer, thus providing some suggestions for treatment of these cases.
结直肠癌远处转移至肛门极为罕见，截至目前，PubMed上仅发表了30例相关病例。因此，结直肠癌源性肛门转移的复发很少见且报道较少。
本文报告1例80岁男性患者，该患者于2010年1月接受了乙状结肠癌根治性切除术，并于2010年12月接受了肛瘘切除术。肛瘘术后病理显示为转移性中分化腺癌。该患者随后接受了化疗和放疗。2020年5月，患者报告出现肛门肿胀和疼痛症状，计算机断层扫描和磁共振成像显示肛周脓肿。进行了肛周肿物活检，术后病理诊断为转移性中分化腺癌。
该病例表明，即使经过10年随访，结直肠癌肛门转移仍有复发风险。我们还回顾了文献并讨论了结直肠癌肛门转移的潜在机制，从而为这些病例的治疗提供一些建议。
