Curative Resection for Solitary Rectovesical Pouch Metastasis from Sigmoid Colon Carcinoma - A Case Report

Abstract

A 54-year-old man underwent sigmoidcolectomy with D3 lymph node dissection for sigmoid colon carcinoma (SS, N0, ly1, v1, P0, H0, M0, stage , R0). Sixteen months after the initial surgery, serum CEA level was elevated and a solitary rectovesical pouch lesion was detected by FDG-PET and CT; no other recurrent lesions were found. We made a diagnosis of solitary rectovesical metastasis and performed a low anterior resection. The tumor was 2 cm in size, on the peritoneum of the rectovesical pouch and adhering to the rectum. Histological diagnosis was well differentiated adenocarcinoma, which was compatible with metastasis from the previously resected colon carcinoma. The patient has been well without either complications or recurrence for 62 months since the second operation. Solitary rectovesical or rectouterine pouch metastasis after colectomy for colon carcinoma is infrequent. The CEA level and FDG-PET are useful for early diagnosis. Surgical resection may prolong the survival of patients with solitary rectovesical or rectouterine pouch metastasis from colon carcinoma.