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Case Reports
. 2020 Sep-Oct;34(5):2193-2199.
doi: 10.21873/invivo.12029.

Cutaneous Stomal Recurrence of Colorectal Cancer After Curative Rectal Cancer Surgery - A Case Report and Systematic Review

Simon Davey  1 , Kathryn McCarthy  2
Affiliations
Case Reports

Cutaneous Stomal Recurrence of Colorectal Cancer After Curative Rectal Cancer Surgery - A Case Report and Systematic Review

Simon Davey et al. In Vivo. 2020 Sep-Oct.

Abstract

Background/aim: Stomal metastases from a primary rectal adenocarcinoma are rare, therefore, clear guidelines on treatment options are limited. We performed a systematic review including a case report on this subject with the primary objective of identifying the total number of cases in the literature. The secondary objective was to assess median survival.

Materials and methods: A 59-year-old woman presented to our institution with anal incontinence to mucus leakage. Flexible sigmoidoscopy identified a carpet adenoma from the dentate line to the rectosigmoid junction. An abdomino-perineal resection (APR) was performed using the transanal total mesorectal excision technique (TaTME). No adjuvant chemotherapy was offered. Twenty-one months following the operation a stomal recurrence was identified. Palliative radiotherapy was commenced and the patient is alive 6 months later with no visible recurrence at the site of the stoma. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.

Results: The systematic review identified 19 individual cases of either metachronous or true metastatic recurrence, including our own case. Median survival was 30 months in the 8 cases where further treatment was offered and accepted.

Conclusion: Stomal metastases or metachronous colorectal cancer is uncommon. The causes for this pattern of spread are not clear. Long-term survival from cutaneous recurrence is generally poor. For carefully selected patients, redo surgery is an option with satisfactory results.

Keywords: Rectal adenocarcinoma; TaTME; stomal recurrence.

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Conflict of interest statement

The Authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flowchart.
See this image and copyright information in PMC

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