Cargando…

Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report

INTRODUCTION: Extra-anastomotic intraluminal recurrence of the colon cancer after curative surgery was rarely reported but intraluminal ileal relapse has not been described to date. We report a case of intraluminal ileal tumor arising after curative right hemicolectomy that could be ascribed to an i...

Descripción completa

Detalles Bibliográficos
Autores principales: Clementi, Marco, Colozzi, Sara, Schietroma, Mario, Sista, Federico, Della Penna, Andrea, Chiominto, Alessandro, Guadagni, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656755/
https://www.ncbi.nlm.nih.gov/pubmed/29098076
http://dx.doi.org/10.1016/j.amsu.2017.09.009
_version_ 1783273755297972224
author Clementi, Marco
Colozzi, Sara
Schietroma, Mario
Sista, Federico
Della Penna, Andrea
Chiominto, Alessandro
Guadagni, Stefano
author_facet Clementi, Marco
Colozzi, Sara
Schietroma, Mario
Sista, Federico
Della Penna, Andrea
Chiominto, Alessandro
Guadagni, Stefano
author_sort Clementi, Marco
collection PubMed
description INTRODUCTION: Extra-anastomotic intraluminal recurrence of the colon cancer after curative surgery was rarely reported but intraluminal ileal relapse has not been described to date. We report a case of intraluminal ileal tumor arising after curative right hemicolectomy that could be ascribed to an implantation of exfoliated cancer cells. CASE REPORT: A 71-years old man was admitted with no metastatic stenotic adenocarcinoma of the hepatic flexure and submitted, without preoperative bowel preparation, to right hemicolectomy using a “no-touch” technique. Histology showed moderately differentiated adenocarcinoma without lymph nodes involvement (pT3N0). No adjuvant therapy was prescribed. First colonoscopy three months after surgery was negative but a second endoscopic examination nine months later revealed an ileal neoplasia, presenting like an ulcer 10 cm proximally to ileocolic anastomosis. A new ileo-colic resection including past anastomosis was performed with curative intent. Pathological examination showed moderately differentiated adenocarcinoma extended to peri-visceral fat tissue with 10 tumor-free lymph nodes. (pT3N0). Six courses of Capecitabine adjuvant chemotherapy was prescribed and 32 months after second surgery, the patient is alive without disease. DISCUSSION: In the present case, the relatively short time from the primary surgery and the fact that recurrence occurred outside the anastomosis suggest that implantation of exfoliated malignant cells seems to be the main pathogenetic mechanism. We suppose that the high grade of primary cancer and the occlusive condition could have promoted the cancer cells reflux through the ileocecal orifice and in the transverse colon. CONCLUSION: This case seems to confirm the intraluminal implanting capacity of exfoliated carcinoma cells.
format Online
Article
Text
id pubmed-5656755
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-56567552017-11-02 Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report Clementi, Marco Colozzi, Sara Schietroma, Mario Sista, Federico Della Penna, Andrea Chiominto, Alessandro Guadagni, Stefano Ann Med Surg (Lond) Case Report INTRODUCTION: Extra-anastomotic intraluminal recurrence of the colon cancer after curative surgery was rarely reported but intraluminal ileal relapse has not been described to date. We report a case of intraluminal ileal tumor arising after curative right hemicolectomy that could be ascribed to an implantation of exfoliated cancer cells. CASE REPORT: A 71-years old man was admitted with no metastatic stenotic adenocarcinoma of the hepatic flexure and submitted, without preoperative bowel preparation, to right hemicolectomy using a “no-touch” technique. Histology showed moderately differentiated adenocarcinoma without lymph nodes involvement (pT3N0). No adjuvant therapy was prescribed. First colonoscopy three months after surgery was negative but a second endoscopic examination nine months later revealed an ileal neoplasia, presenting like an ulcer 10 cm proximally to ileocolic anastomosis. A new ileo-colic resection including past anastomosis was performed with curative intent. Pathological examination showed moderately differentiated adenocarcinoma extended to peri-visceral fat tissue with 10 tumor-free lymph nodes. (pT3N0). Six courses of Capecitabine adjuvant chemotherapy was prescribed and 32 months after second surgery, the patient is alive without disease. DISCUSSION: In the present case, the relatively short time from the primary surgery and the fact that recurrence occurred outside the anastomosis suggest that implantation of exfoliated malignant cells seems to be the main pathogenetic mechanism. We suppose that the high grade of primary cancer and the occlusive condition could have promoted the cancer cells reflux through the ileocecal orifice and in the transverse colon. CONCLUSION: This case seems to confirm the intraluminal implanting capacity of exfoliated carcinoma cells. Elsevier 2017-09-29 /pmc/articles/PMC5656755/ /pubmed/29098076 http://dx.doi.org/10.1016/j.amsu.2017.09.009 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Clementi, Marco
Colozzi, Sara
Schietroma, Mario
Sista, Federico
Della Penna, Andrea
Chiominto, Alessandro
Guadagni, Stefano
Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title_full Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title_fullStr Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title_full_unstemmed Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title_short Intraluminal ileal tumour after right hemicolectomy for cancer: An implantation recurrence or a new cancer? A case report
title_sort intraluminal ileal tumour after right hemicolectomy for cancer: an implantation recurrence or a new cancer? a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656755/
https://www.ncbi.nlm.nih.gov/pubmed/29098076
http://dx.doi.org/10.1016/j.amsu.2017.09.009
work_keys_str_mv AT clementimarco intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT colozzisara intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT schietromamario intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT sistafederico intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT dellapennaandrea intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT chiomintoalessandro intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport
AT guadagnistefano intraluminalilealtumourafterrighthemicolectomyforcanceranimplantationrecurrenceoranewcanceracasereport