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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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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 |
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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 |
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