Abstract
We report a case of rectal cancer with a recurrence in the anal canal 9 cm from the primary lesion. A 74-year-old man underwent a laparoscopic Hartmann operation for rectal cancer. Six months after the operation, he was seen in our hospital because of proctorrhagia ; a type 1 tumor, 12 mm in diameter, was observed on the dentate line in the anterior wall of the anal canal. On pathology, an adenocarcinoma was diagnosed. The remaining rectum and anus were resected. On histopathology, an adenocarcinoma located at the submucosal layer was observed ; no atypical epithelium was present around the tumor. The tumor was diagnosed as a metastasis of the primary rectal cancer via tumor implantation or intramural metastasis. Metastasis to the anal canal 9 cm from the primary lesion is thought to be rare. This case will have meticulous follow-up.
