Asymptomatic isolated coccygeal metastasis in low rectal carcinoma
Tóm tắt
As well as being relatively rare, osseous metastases from colorectal cancer are frequently asymptomatic and represent a late manifestation of disease. We report a case of an unidentified, asymptomatic coccygeal metastasis discovered on histological processing of the resection specimen from a patient with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by radical abdomino-perineal resection with coccygectomy. The anatomical explanation for this finding may involve passage of tumour cells via the vertebral venous plexus.
Tài liệu tham khảo
Besbeas S, Stearns MW Jr (1978) Osseous metastases from carcinomas of the colon and rectum. Dis Colon Rectum 21:266–268
Kanthan R, Loewy J, Kanthan SC (1999) Skeletal metastases in colorectal carcinomas: a Saskatchewan profile. Dis Colon Rectum 42:1592–1597
Platell CF (2007) Changing patterns of recurrence after treatment for colorectal cancer. Int J Colorectal Dis 22:1223–1231
Sundermeyer ML, Meropol NJ, Rogatko A, Wang H, Cohen SJ (2005) Changing patterns of bone and brain metastases in patients with colorectal cancer. Clin Colorectal Cancer 5:108–113
Katoh M, Unakami M, Hara M, Fukuchi S (1995) Bone metastasis from colorectal cancer in autopsy cases. J Gastroenterol 30:615–618
Holm T, Ljung A, Haggmark T, Jurell G, Lagergren J (2007) Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg 94:232–238
West NP, Finan PJ, Anderin C, Lindholm J, Holm T, Quirke P (2008) Evidence of the oncologic superiority of cylindrical abdominoperineal excision for low rectal cancer. J Clin Oncol 26:3517–3522
Sugarbaker PH (1993) Metastatic inefficiency: the scientific basis for resection of liver metastases from colorectal cancer. J Surg Oncol Suppl 3:158–160
Weiss L, Voit A, Lane WW (1984) Metastatic patterns in patients with carcinomas of the lower esophagus and upper rectum. Invasion Metastasis 4:47–60
Weiss L, Grundmann E, Torhorst J et al (1986) Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol 150:195–203
Pearce JM (2006) The craniospinal venous system. Eur Neurol 56:136–138
del Regato JA (1977) Pathways of metastatic spread of malignant tumors. Semin Oncol 4:33–38
O’Connell JB, Maggard MA, Ko CY (2004) Colon cancer survival rates with the New American Joint Committee on Cancer Sixth Edition Staging. J Natl Cancer Inst 96:1420–1425