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Case Reports
. 2023 Aug 21;69(2):E52-E56.

Long-term Survival after Treatment of Synchronous Isolated Right External Iliac Lymph Node Metastasis from Ascending Colon Cancer: A Case Report

Yuki Okazoe  1 , Satoshi Omiya  2 , Takahiro Nakajima  1 , Atsuhiko Kishi  1 , Masahiro Kido  2 , Satoshi Suzuki  3 , Tsunenori Fujita  1 , Masakazu Ohno  1
Affiliations
Case Reports

Long-term Survival after Treatment of Synchronous Isolated Right External Iliac Lymph Node Metastasis from Ascending Colon Cancer: A Case Report

Yuki Okazoe et al. Kobe J Med Sci. .

Abstract

Background: Synchronous isolated external iliac lymph node metastasis of ascending colon cancer is extremely rare, and its treatment strategy has not been established. In this report, we present a case of long-term survival after surgical resection and adjuvant chemotherapy for ascending colon cancer with synchronous isolated right external iliac lymph node metastasis.

Clinical case: A 65-year-old woman with anorexia and anemia was referred to our hospital. Colonoscopy and computed tomography revealed a three-quarter circumferential type 2 tumor from the cecum to the ascending colon, along with regional and right external iliac lymph node swelling. We diagnosed ascending colon cancer with right external iliac artery lymph node metastasis. An open right hemicolectomy with D3 and right external iliac lymph node dissections were performed. Results of histopathological examination showed that both lymph nodes were metastasized from ascending colon cancer. The patient received eight courses of capecitabine and oxaliplatin therapy as adjuvant chemotherapy. At 60 months after surgery, the woman has not had a recurrence.

Conclusions: Surgical resection and adjuvant chemotherapy may be an effective treatment strategy for synchronous isolated right external iliac lymph node metastases from ascending colon cancer.

Keywords: Ascending colon cancer; Case report; Isolated distant lymph node metastasis; Surgical resection.

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Figures

Figure 1
Figure 1
Colonoscopy revealed a type 2 tumor in the ascending colon (a). CT scan showing wall thickening and pericolic fat stranding from the ascending colon to the cecum (b, red arrow). CT scan showing a 4.5 cm mass on the anterior side of the right external iliac vessels (c, red arrow).
Figure 2
Figure 2
The patient underwent right external iliac lymph node dissection (a, red arrow). Surgical specimen showing a type 2 tumor (95 × 75 mm) in the ascending colon and cecum (b). The right external iliac lymph node (45 × 40 mm) was stony hard (c).
Figure 3
Figure 3
HE staining of the ascending colon, pericolic lymph node, and right external iliac lymph node. HE staining revealed moderately differentiated adenocarcinoma in the ascending colon (a). HE staining revealed moderately differentiated adenocarcinoma in the pericolic and right external iliac lymph nodes (b, c).
See this image and copyright information in PMC

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