title: Late recurrence of large peri-stomal metastasis following abdomino-perineal resection of rectal cancer.
abstract: BACKGROUND
  Cutaneous metastasis from colorectal cancer after excision of the primary is a rare occurrence and presents as cutaneous or subcutaneous nodules or as a rash commonly on the anterior abdominal wall.
  
  
  METHODS
  This is a case description of the management of a large fungating peristomal cutaneous metastasis occurring 14 years after abdomino-perineal excision of the primary cancer. The gross appearance initially suggested possibility of a true metachronous cancer with peristomal spread. But histopathology of the resected specimen showed no colonic mucosal involvement suggesting a true large cutaneous peristomal metastasis which has not been reported previously. Literature review of presentation, management and prognosis of cutaneous metastasis from colorectal cancer is described
  
  
  CONCLUSIONS
  Cutaneous metastasis following colorectal cancer resection is a well-recognised entity though rare. Any unusual skin lesions especially on the abdominal wall skin, previous incision scars or near the stoma should be biopsied early to rule out metastatic disease and systematic work-up should be carried out to rule out any metachronous tumour or metastasis elsewhere in the body.
authors.affiliation: Department of surgery, Royal Shrewsbury Hospital, Shrewsbury, SY3 8XQ, UK. cvijayasekar@hotmail.com
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Vijayasekar
authors.forename: Saleem
authors.initials: S
authors.lastname: Noormohamed
authors.forename: Mark James
authors.initials: MJ
authors.lastname: Cheetham
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D003082:Colectomy; D003125:Colostomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*
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