A Case of Pararectal Lymph Node Metastasis from Pelvic Peritoneal Dissemination in Which Curative Resection of Transverse Colon Cancer Resulted in Long-Term Survival after Preoperative Systemic Chemotherapy and Surgery

Abstract

The patient was a 75-year-old male who underwent laparoscopy-assisted left hemicolectomy for transverse colon cancer at age 72 years. The pathological diagnosis was pT2N1, tub2, ly1, v2, pStage IIIa. After 6 courses of UFT/UZEL as adjuvant therapy, there was no recurrence. However, 2 years and 11 months after surgery, recurrence of pelvic peritoneal dissemination was diagnosed by CT. After 12 courses of TEGAFIRI+Bev, the disease stabilized and the metastatic nodule was resected. A nodule on the serosal surface of the anterior rectum was found in surgery, and low anterior resection was performed. Histopathologic findings showed peritoneal metastasis of transverse colon cancer to the pararectal node. Two metastatic lymph nodes were found in the No. 251 lymph node, leading to diagnosis of lymphatic metastasis from a peritoneal dissemination nodule. Three courses of XELOX were administered postoperatively as adjuvant therapy and the patient has been recurrence-free for 9 years.