Abstract
An 86-year-old woman who had undergone abdominoperineal resection for rectal cancer 23 years earlier was seen at the hospital because of bleeding from the colostomy site and upper abdominal pain. A type 2 tumor was identified at the colostomy site which showed findings of adenocarcinoma. Abdominal CT scan revealed the tumor invading the rectus abdominis muscle and lymph node swelling 2.0 cm in diameter at the left inguinal region. From these findings, colon carcinoma at the colostomy associated with invasion into the rectus abdominis muscle and left inguinal lymph node metastasis was diagnosed. We performed partial colectomy including the colostomy and left inguinal lymph node dissection as well as associated resection of part of the rectus abdominis muscle. The carcinoma at the colostomy site was 4.0 cm in diameter. Histopathology showed the tumor to be moderately differentiated adenocarcinoma with inguinal lymph node metastasis. Malignant neoplasms of the digestive organs with inguinal lymph node metastasis are predominantly cancers of the lower rectum or the anal canal, and colon cancers rarely involve the inguinal lymph nodes. This paper deals with clinical features of metachronous multiple colorectal carcinoma at the colostomy site reported in Japan and possible pathway of inguinal metastasis based on a review of the literature.
