2021 Volume 74 Issue 8 Pages 509-514
Colonoscopy revealed cancer in the sigmoid colon of a 53-year-old woman, and the biopsy result was moderately differentiated adenocarcinoma. Abdominal computed tomography and magnetic resonance imaging revealed swelling of the lymph nodes and bilateral ovaries and irregular nodules in the right inguinal region. A tumor of the sigmoid colon cancer with abdominal wall metastasis of the inguinal region and ovarian metastasis was diagnosed. Sigmoidectomy was conducted and followed by D3 lymph node dissection, bilateral ovariectomy, and right inguinal tumor resection. During the operation, a mass was found in the inguinal canal, and it was deemed to be a round ligament tumor. Pathological examination revealed that both the ovarian and uterine cord tumors were metastases of the sigmoid colon cancer. Following postoperative adjuvant chemotherapy, multiple recurrences were observed in the left inguinal canal and pelvis 19 months after the operation, and the patient is currently undergoing chemotherapy. Round ligament metastasis of colorectal cancer is rare. A lymphatic route from around the uterus to the inguinal canal along the round ligament has been reported, which might have caused metastasis in this case. In colorectal cancer with ovarian metastasis, it is necessary to consider the possibility of inguinal round ligament metastasis.
