title: [Recurrence of Rectal Cancer with Submucosal Invasion in the Bone and Lymph Nodes 89 Months after Surgery--A Case Report].
abstract: A woman in her 60s showed positive results on a fecal occult blood test and consulted her doctor. Early-stage cancer of the lower rectum was diagnosed, and a transanal local excision was performed. Histopathological examination revealed that the depth of submucosal invasion was ≧1,000 mm, and the submucosal invasive part of the tumor was a poorly differentiated adenocarcinoma. Therefore, she was referred to our hospital for additional resection. Intersphincteric resection was performed 11 months after the initial operation. The cancer stage was T1N0M0, Stage Ⅰ(UICC 7th edition), and the cancer did not recur. The patient visited our hospital again, 78 months after the additional resection, because of left hip-joint pain. Positron-emission tomography revealed fluorodeoxyglucose uptake in the left acetabulum, para-aortic lymph nodes, and left external iliac lymph nodes; these findings indicated recurrence of the rectal cancer. The patient received radiation therapy (57 Gy) and FOLFIRI; bevacizumab was added from the third course onward. The therapy reduced the size of the tumor recurrence in the bone. This was a rare case of rectal cancer with submucosal invasion that showed recurrence in the bone and lymph nodes 78 months after the additional resection.
authors.affiliation: Dept. of Gastroenterological Surgery, Saitama Cancer Center.
authors.forename: Takashi
authors.initials: T
authors.lastname: Takenoya
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Masako
authors.initials: M
authors.lastname: Asayama
authors.forename: Michitoshi
authors.initials: M
authors.lastname: Takano
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mori
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuda
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kazama
authors.forename: Katsumi
authors.initials: K
authors.lastname: Amikura
authors.forename: Yu
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Masashi
authors.initials: M
authors.lastname: Kurozumi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D059248:Chemoradiotherapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D002955:Leucovorin / Q000008:administration & dosage; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy; D012008:Recurrence; D013997:Time Factors
chemical_list: D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin