Abstract
Both the thyroid and pancreas are uncommon sites for metastasis of rectal cancer, and no such cases have previously been reported in Japan. We report a case of long-term survival after resection of metachronous metastasis to the lung, the thyroid, the pancreas and the liver from the primary rectal cancer. A 71-year-old man underwent low anterior resection for rectal cancer in 1998, followed by lung resection for two lung metastases, then 6 years and 11 months after the first operation, right lobectomy and cervical lymph node dissection were performed for metastatic thyroid tumor. Distal pancreatectomy with splenectomy and regional lymph node dissection were performed for pancreatic metastasis 8 years and 2 months after the first operation. Partial hepatectomy was performed for liver metastasis 9 years and 3 months after the first operation. Histological examinations revealed that all resected specimens, showing moderately differentiated adenocarcinoma, had metastasized from the rectal cancer. Now, 12 years after resection of the primary cancer, he is doing well with no sign of recurrence. We consider that multiple metastatic tumors which are metachronous are worth trying to resect aggressively if curative resection seems possible.
