Isolated diaphragmatic metastasis originated from adenocarcinoma of the colon.
Isolated diaphragmatic metastasis arising from colorectal cancer has been reported only one case in the literature presently. Here, we presented a new case and discussed the possible pathogenesis and the treatment options. A 42-year-old male patient had received anterior resection for sigmoid colon cancer. Although the increased serum CEA level was detected 20 months after the surgery, metastatic lesion could not be detected by repeated colonoscopy, CT scan, bone scan or PET scan for 35 months. We could detect a suspicious metastatic lesion on the liver by CT scan at 56 month after the surgery. During a second-look operation, we found a solitary metastasis on the diaphragm and removed it along with the 1 cm tumor-free resection margin. Although the prognosis associated with skeletal metastasis is poor, the complete resection of isolated diaphragmatic metastasis and subsequent appropriate adjuvant chemotherapy may achieve a cure the disease provided that other metastatic lesions are absent.
Lee
Kang Hong
KH
Colorectal Clinic, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Yu
Chang Sik
CS
Namgung
Hwan
H
Kim
Hee Cheol
HC
Kim
Jin Cheon
JC
Radiat Med. 1998 Sep-Oct;16(5):363-5
9862159
Hepatogastroenterology. 1994 Oct;41(5):405-8
7851845
Cancer. 1973 Jan;31(1):226-36
4683038
Cancer. 1985 Mar 15;55(6):1284-90
3971297
Br J Surg. 1971 Jun;58(6):458-60
4932851
Dis Colon Rectum. 1988 Aug;31(8):636-52
3042304
Dis Colon Rectum. 1996 Jan;39(1):74-9
8601361