A Case of Right External Iliac Lymph Node Recurrence from Ascending Colon Cancer

Abstract

This is a report of our experience with a rare case of isolated right external iliac lymph node recurrence following surgery for ascending colon cancer. The patient was a 73-year-old woman who was diagnosed with ascending colon cancer and underwent a laparoscopic-assisted right hemicolectomy in April 2012. The patient was treated with UFT/LV as postoperative adjuvant chemotherapy, but isolated right external iliac lymph node metastases and lung metastases were noted 4 months later. Her treatment was changed to mFOLFOX6+bevacizumab (7 courses). After 4 months, the lung metastatic lesions had shrunk, but para-aortic lymph node metastases had developed. Eight months after the initial surgery, the isolated right external iliac lymph nodes and para-aortic lymph nodes were dissected. Pathological analysis led to a diagnosis of lymph node recurrence of ascending colon cancer. Recurrence was observed in multiple para-aortic lymph nodes 2 months after the surgery to treat recurrence. The patient was treated with FOLFIRI+bevacizumab as postoperative chemotherapy, and the patient passed away 30 months after the initial surgery. This case was considered to be of interest because local lymphatic flow was likely affected, as there was metastasis to the retroperitoneal lymph nodes and extensive colon cancer invasion with cecal involvement and severe lymph duct invasion.