Sawa Yui, Ono Yoshihiro, Takamatsu Manabu, Shimane Gaku, Baba Hayato, Ito Ryota, Sugiura Kota, Shibata Yoshiyuki, Nakano Kaoru, Mukai Toshiki, Kobayashi Kosuke, Oba Atsushi, Inoue Yosuke, Ito Hiromichi, Akiyoshi Takashi, Takahashi Yu
Division of Hepato-Biliary-Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.
Department of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0325. Epub 2025 Jul 18.
Colorectal cancer (CRC) can metastasize to various sites, including the liver, lungs, ovaries, adrenal glands, and lymph nodes. Approximately 1%-2% of patients with CRC develop para-aortic lymph node metastases. Herein, we report a case of surgical resection of an isolated, metachronous, retrocaval lymph node recurrence of rectal cancer above the renal vein.
A 77-year-old woman was diagnosed with a solitary metachronous retrocaval lymph node metastasis from rectal cancer. The patient underwent robot-assisted laparoscopic abdominoperineal resection. The pathological status was T3, N0, M0, or Stage IIA. No recurrence was observed for 13 months after the initial surgery. CT revealed a 24-mm tumor on the dorsal side of the inferior vena cava (IVC). Tumor resection was performed, including right adrenalectomy, Spiegel lobectomy, and partial resection of the IVC. Pathological findings revealed adenocarcinoma metastasis to a solitary lymph node, which invaded the IVC and Spiegel lobe.
This is the first report of a surgical resection of a retrocaval lymph node metastasis from CRC that invaded both the IVC wall and the liver.
结直肠癌（CRC）可转移至多个部位，包括肝脏、肺、卵巢、肾上腺和淋巴结。约1%-2%的CRC患者会发生主动脉旁淋巴结转移。在此，我们报告一例肾静脉上方孤立性、异时性、腔静脉后淋巴结复发直肠癌的手术切除病例。
一名77岁女性被诊断为直肠癌孤立性异时性腔静脉后淋巴结转移。患者接受了机器人辅助腹腔镜腹会阴联合切除术。病理分期为T3、N0、M0，即IIA期。初次手术后13个月未观察到复发。CT显示下腔静脉（IVC）背侧有一个24毫米的肿瘤。进行了肿瘤切除，包括右肾上腺切除术、脾脏叶切除术和IVC部分切除术。病理结果显示腺癌转移至单个淋巴结，该淋巴结侵犯了IVC和脾脏叶。
这是首例关于侵犯IVC壁和肝脏的CRC腔静脉后淋巴结转移手术切除的报告。
