Hematogenous umbilical metastasis from colon cancer treated by palliative single-incision laparoscop

来源 :World Journal of Gastrointestinal Surgery | 被引量 : 0次 | 上传用户:WANGYUEWANG
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Sister Mary Joseph’s nodule(SMJN)is a rare umbilical nodule that develops secondary to metastatic cancer.Primary malignancies are located in the abdomen or pelvis.Patients with SMJN have a poor prognosis.An 83-year-old woman presented to our hospital with a1-month history of a rapidly enlarging umbilical mass.Endoscopic findings revealed advanced transverse colon cancer.computer tomography and fluorodeoxyglucose-positron emission tomography revealed tumors of the transverse colon,umbilicus,right inguinal lymph nodes,and left lung.The feeding arteries and drainage veins for the SMJN were the inferior epigastric vessels.Imaging findings of the left lung tumor allowed for identification of the primary lung cancer,and a diagnosis of advanced transverse colon cancer with SMJN and primary lung cancer was made.The patient underwent local resection of the SMNJ and subsequent single-site laparoscopic surgery involving right hemicolectomy and paracolic lymph node dissection.Intra-abdominal dissemination to the mesocolon was confirmed during surgery.Histopathologically,the transverse colon cancer was confirmed to be moderately differentiated tubular adenocarcinoma.We suspect that SMJN may occur via a hematogenous pathway.Although chemotherapy for colon cancer and thoracoscopic surgery for the primary lung cancer were scheduled,the patient and her family desired home hospice.Seven months after surgery,she died of rapidly growing lung cancer. Sister Mary Joseph’s nodule (SMJN) is a rare umbilical nodule that develops secondary to metastatic cancer. Primate malignancies are located in the abdomen or pelvis. Patients with SMJN have a poor prognosis. An 83-year-old woman presented to our hospital with a1 -month history of a rapidly enlarging umbilical mass. Endoscopic findings of advanced transverse colon cancer.computer tomography and fluorodeoxyglucose-positron emission tomography revealed tumors of the transverse colon, umbilicus, right inguinal lymph nodes, and left lung. The feeding arteries and drainage veins for the SMJN were the inferior epigastric vessels. Imaging findings of the left lung tumor allowed for identification of the primary lung cancer, and a diagnosis of advanced transverse colon cancer with SMJN and primary lung cancer was made. The patient underwent local resection of the SMNJ and subsequent single-site laparoscopic surgery involving right hemicolectomy and paracolic lymph node dissection. Intra-abdominal distension seminal to the mesocolon was confirmed during surgery. Histopathologically, the transverse colon cancer was confirmed to be moderately differentiated tubular adenocarcinoma. We suspect that SMJN may occur via a hematogenous pathway. Despite chemotherapy for colon cancer and thoracoscopic surgery for the primary lung cancer were scheduled , the patient and her family desired home hospice. Seven months after surgery, she died of rapidly growing lung cancer.
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