1996 Volume 49 Issue 1 Pages 57-63
We encountered a case of primary diffuse infiltrative carcinoma with unusual extra-peritoneal metastasis.
A 81-year-old man visited our hospital because of manifest anemia and macrooptic bloody stool. Barium enemia examination revealed long apple-core stenosis at descend-sigmoid colon. Colonoscopy was performed and showed a circular edematous and granular mucosal constriction at the site of stenosis in the roentgenogram.
The biopsy revealed no evidence of carcinoma. Also, we palpated a smallfinger-head sized tumor in his right abdominal rectal muscle beside the unbilicus. Operative procedure demonstrated the stenotic lesion was conformed from Linitis Plastica of the descend-sigmoid colon which microscopically had been occupied at whole layer of the colon wall by well differentiated adenocarcinoma infiltrating into lymphatic system.
Also, the abdominal tumor in the rectal muscle was revealed microscopically the same carinoma cell proliferating through lymphatic system.
The 3-months later, he re-admitted because of emarciation and abdominal distension, we found dark-reddish miliary tumors at his anterior chest skin. That biopsy specimen demonstrated the same carcinoma cell proliferating in subcutaneous tissue through lymphatic system. The patient died within 2 weeks.
Diffuse infiltrative colorectal carcinoma is highly lethal, but the report about the case with the extraperitoneal metastasis is very rare except our report.
