Distant Peritoneal Cecal Cancer Metastasis to a Mesh-plug Prosthesis

Abstract

A 74-year-old woman had a history of right femoral hernioplasty with mesh implantation almost 9 years earlier. More than 4 years earlier, she underwent laparoscopic right hemicolectomy (D3 dissection) for cecal cancer, pStage IIIb, followed by postoperative adjuvant chemotherapy. One year earlier, abdominal CT showed a mass in the right inguinal region, which gradually increased in size. Three months earlier, right inguinal pain appeared, and PET-CT showed FDG accumulation in the same area. Suspecting recurrence of cecal cancer, laparoscopic anterior right inguinal mass resection was performed. There was a 40-mm mass located in the abdominal wall near the center of the mesh. There were no findings of intraperitoneal dissemination. Histopathologically, it was a well to moderately differentiated tubular adenocarcinoma, suggesting recurrence of cecal cancer. The tumor adhered to the mesh from the abdominal wall side, and it was considered to be a hematogenous metastasis rather than a peritoneal metastasis. It also appeared that the mesh may have been involved in the recurrence of the resected cecal cancer 4 years after its placement.