A rare case of repeated anastomotic recurrence due to tumor implantation after curative surgery for sigmoid colon cancer.
BACKGROUND
Anastomotic recurrence is often experienced at colocolic or colorectal anastomoses. Tumor cell implantation has been reported as the mechanism of anastomotic recurrence. However, anastomotic recurrence occurring repeatedly after curative surgery is rare. We herein report a rare case of repeated anastomotic recurrence after curative surgery for sigmoid colon cancer.


METHODS
A 51-year-old man underwent radical surgery for sigmoid colon cancer. However, anastomotic recurrence developed three times during three years and six months after the initial operation in spite of irrigation with 5% povidone-iodine before anastomosis. The serum carcinoembryonic antigen (CEA) level had been within normal limits after sigmoidectomy. Finally, the patient underwent abdominoperineal resection. The clinico-pathological findings revealed that possible tumor cell implantation caused these anastomotic recurrences. The patients survived without recurrence during the follow-up period of seven years and nine months.


CONCLUSIONS
We experienced a rare case of repeated anastomotic recurrence due to possible tumor implantation after curative surgery for sigmoid colon cancer; however the prognosis was ultimately very good. CEA monitoring was insensitive for detection of anastomotic recurrence in this case.
Division of Gastroenterological Surgery, Toho University Omori Medical Center, Tokyo, Japan. kingkong@med.toho-u.ac.jp.
Kimihiko
K
Funahashi
Junichi
J
Koike
Naoyasu
N
Saito
Hiroyuki
H
Shiokawa
Kentaro
K
Shirasaka
Tatsuo
T
Teramoto