Late recurrence of large peri-stomal metastasis following abdomino-perineal resection of rectal cancer

• Published in: World journal of surgical oncology Vol. 6; no. 1; p. 96
• Main Authors: Vijayasekar, Chandrasekar, Noormohamed, Saleem, Cheetham, Mark James
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.09.2008; BioMed Central; BMC
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - surgery; Care and treatment; Case Report; Case studies; Colectomy; Colorectal cancer; Colostomy; Diagnosis; Excision (Surgery); Female; Health aspects; Humans; Metastasis; Methods; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Patient outcomes; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Risk factors; Skin Neoplasms - pathology; Skin Neoplasms - secondary; Skin Neoplasms - surgery; United Kingdom
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/1477-7819-6-96

Cutaneous metastasis from colorectal cancer after excision of the primary is a rare occurrence and presents as cutaneous or subcutaneous nodules or as a rash commonly on the anterior abdominal wall. This is a case description of the management of a large fungating peristomal cutaneous metastasis occurring 14 years after abdomino-perineal excision of the primary cancer. The gross appearance initially suggested possibility of a true metachronous cancer with peristomal spread. But histopathology of the resected specimen showed no colonic mucosal involvement suggesting a true large cutaneous peristomal metastasis which has not been reported previously. Literature review of presentation, management and prognosis of cutaneous metastasis from colorectal cancer is described Cutaneous metastasis following colorectal cancer resection is a well-recognised entity though rare. Any unusual skin lesions especially on the abdominal wall skin, previous incision scars or near the stoma should be biopsied early to rule out metastatic disease and systematic work-up should be carried out to rule out any metachronous tumour or metastasis elsewhere in the body.