Abstract
This paper presents a long-term survivor with three operations for pulmonary metastases following resection of colon cancer. The patient was a 68-year-old man. There was a previous history of undergoing a colostomy for ileus duo to cancer of the sigmoid colon, followed by sigmoidectomy on February 14, 1992. He had no liver metastasis, and pathologically it was moderately differentiated adenocarcinoma, without lymph node metastasis.
Sixteen months later after the sigmoidectomy, a CT scan showed a coin lesion, 30mm in diameter, in the S4 area of the left lung, for which wedge resection was performed. Pathological findings showed metastatic adenocarcinoma from the colon cancer.
Eight months after the thoracotomy, metastases were found in the S8 and S4 areas of the right lung. They were resected by wedge/segmentectomy. The pathological findings again showed metastases from colon cancer.
Sixteen months after the second thoracotomy, a mass lesion was detected in the right lower lobe. A right middle and lower lobectomy and a resection of the part of the diaphragm were performed. The metastatic tumor of the middle lobe was 25mm in diameter, and that of the lower lobe was 70mm in diameter. Both were confirmed to be metastases from the colon cancer.
The patient is alive without any signs of recurrence, 7 years following the initial surgery. It is desirable to perform repeatal thoracotomies aggresively for repeatal pulmonary metastases of colorectal cancer, which might promise good outcomes. Some bibliographical comments are also presented.
