A Case of Bone Metastasis of Rectal Carcinoma Occurred Six Years after Surgery

Abstract

The case involved a 44-year-old man who underwent very low aterior resection + D3 dissection for rectal cancer, RbP, type 3, pA, pN0, cM0, pStage II, R0, and CurA, at a previous hospital. His treatment was completed after a 6-month adjuvant chemotherapy with oral UFT 600mg/day followed by a 5-year follow-up study, without having recurrence. This time when 6 years and 9 months had elapsed after the operation, the patient presented to our hospital because of lumber pain and numbness from the right gluteal region to the lower limb. As a result of a biopsy of the sacrum, metastatic bone tumor derived from rectal cancer was diagnosed, but otherwise he had no metastatic lesions. The FOLFOX + Bmab regimen was started with zoledronic acid regimen simultaneously. During the chemotherapy, his pain was aggravated, so that irradiation was conducted to alleviate the pain. His pain was alleviated and the chemotherapy was resumed. Now he has been on the chemotherapy.
The frequency of recurrence of Stage II rectal cancers developed more than 5 years after surgery is as low as 0.94%. In this case, it took about 2 months until we made the diagnosis of recurrence. It is reported that bone metastasis alone carries relatively favorable prognosis to the patients, however, early diagnosis and multimodal as well as individual therapies are important.