title: Surgical treatment of isolated lung and adrenal metastasis from colorectal cancer. Case report.
abstract: BACKGROUND
  Up to 30% of stage I and II colorectal cancers (CRCs) treated with surgical resection alone show disease recurrence, indicating that lymph node (LN) involvement was probably underestimated. Lung is a common site of CRC metastasis, whereas adrenal glands are rarely involved.
  
  
  METHODS
  On July 2004 a 56-year old woman underwent left hemicolectomy for a stage I sigmoid cancer. Four years later a lobectomy was performed for an isolated lung metastasis; thirteen months thereafter she underwent left adrenalectomy for adrenal metastasis. No lymph node involvement has ever been demonstrated either histopathologically or radiologically. At present, the patient is alive and apparently disease-free.
  
  
  CONCLUSIONS
  The presence of LN occult metastasis, that might explain recurrence in stage I and II CRCs, has recently been investigated by means of immunohistochemistry and polymerase chain reaction; evidence of LN metastasis obtained with the latter technique is associated to a worse outcome. There have been very few cases that resemble our patient's neoplastic progression and they were either stage III neoplasms or rectal cancers. Our patient's primitive localization in the sigmoid colon makes it difficult to imagine why the liver has not been a site of metastasis. Finally, surgery has an important role in treating isolated metastasis in both lungs and adrenal glands.
  
  
  BACKGROUND
  Colorectal cancer, Lung metastasis, Solitary adrenal metastasis.
authors: Sapienza Universita di Roma, Roma, Italy.
authors: Rosanna
authors: R
authors: Cantarini
authors: Francesco
authors: F
authors: Covotta
authors: Antonio
authors: A
authors: Aucello
authors: Gioacchino
authors: G
authors: Montalto
authors: Fabio
authors: F
authors: Procacciante
authors: Adriano
authors: A
authors: Marcheggiani
authors: Alfredo
authors: A
authors: Covotta
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged