Abstract
A 48-year-old man had a low anterior resection of a rectal cancer in April 2006. On histopathology, a primary well-differentiated adenocarcinoma (T2N0M0 Stage I) was diagnosed. Although the serum CEA (carcinoembryonic antigen) level was found to be elevated in January 2008, abdominal computed tomography, CT gastroscopy, and colonoscopy did not reveal a recurrence. However, a positron emission tomography (PET)/CT scan showed an accumulation spot in the rectus abdominis muscle. A definitive diagnosis was made based on a CT-guided percutaneous biopsy. Neither lymph node metastases nor peritoneal dissemination were found in the abdominal cavity ; therefore an en-bloc excision of the rectus abdominis muscle was performed. The abdominal wall was reconstructed using prolene mesh (inlay mesh repair). Histopathological findings of the rectus abdominis muscle included those of a metastatic adenocarcinoma, which was consistent with the previously resected rectal cancer. Currently, after 1 year and 5 months of follow-up the patient has no signs of recurrence.
