Laparoscopic Resection of an Isolated Myometrial Metastasis From Ileocecal Cancer: A Case Report.

A 67-year-old woman was diagnosed with ileocecal cancer presenting with intestinal obstruction. She underwent an ileocecal resection and D3 lymph node dissection. Pathological diagnosis showed a moderately differentiated adenocarcinoma, pT4aN0M0. Adjuvant chemotherapy using oxaliplatin and capecitabine was administered for six months. A CT scan one year after the initial operation revealed a myometrial nodule measuring 3 cm in diameter as a new lesion. We resected the myometrial nodule using laparoscopy, and no peritoneal metastases were observed. The intraoperative frozen section was suggestive of myometrial metastasis originating from colon cancer. Peritoneal washing cytology was negative for malignancy. Subsequently, a laparoscopic total hysterectomy and bilateral salpingo-oophorectomy were performed. The results of immunohistochemical stains were consistent with the patient's known colon cancer. The resected uterus, ovaries, and fallopian tubes were found to be free of metastatic colon cancer. We diagnosed the uterine lesion as an isolated myometrial metastasis from colon cancer and proceeded with surveillance without additional adjuvant treatment. She is alive and well one year after the second operation. When uterine metastasis from colon cancer is uncertain on cross-sectional imaging, laparoscopy is a useful tool for making an accurate diagnosis and exploring other intraperitoneal lesions.