title: Metastasis of a cecal adenocarcinoma to the prostate five years after a right hemicolectomy: a case report.
abstract: BACKGROUND
  Prostatic metastasis from a primary bowel adenocarcinoma has been only rarely reported in the medical literature. The case reported here is rare in the fact that the primary tumor was from a right-sided bowel adenocarcinoma. It is unusual because initial immunostaining was not fully conclusive, and so a relatively new method of immunostaining, CDX2, was used to ascertain its histopathology.
  
  
  METHODS
  We describe the case of a 54-year-old Caucasian man who had a right hemicolectomy for a primary cecal adenocarcinoma, which was completely excised. Following the procedure, he received adjuvant chemotherapy. Computed tomography scans showed no evidence of local recurrence or metastatic disease. Then, five years later, he presented to his general practitioner with urinary symptoms. An abnormal prostate was palpated on digital rectal examination. Trans-rectal prostatic biopsies were performed, which showed colorectal metastases within the prostate gland. This was confirmed with CDX2 immunohistochemistry. There was no further evidence of distant metastases on positron emission tomography-computed tomography scans.
  
  
  CONCLUSIONS
  This case demonstrates a rare isolated hematogenous spread to the prostate from a primary cecal adenocarcinoma, several years after definitive treatment and excision. This highlights the importance of accurate immunohistochemistry and imaging in planning further management and treatment.
authors.affiliation: Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. fyoussef@gmail.com.
authors.forename: Fady R
authors.initials: FR
authors.lastname: Youssef
authors.forename: Leanne
authors.initials: L
authors.lastname: Hunt
authors.forename: Pieter D
authors.initials: PD
authors.lastname: Meiring
authors.forename: Danesh R
authors.initials: DR
authors.lastname: Taraporewalla
authors.forename: Robin
authors.initials: R
authors.lastname: Gupta
authors.forename: Mike J
authors.initials: MJ
authors.lastname: James