Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. May 15, 2017; 8(2): 96-99
Published online May 15, 2017. doi: 10.4291/wjgp.v8.i2.96
Late onset pulmonary metastasis more than 10 years after primary sigmoid carcinoma
Anne M Daniels, Jeroen F J Vogelaar
Anne M Daniels, Jeroen F J Vogelaar, Department of Surgery, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
Author contributions: Daniels AM was responsible for sample collection, acquisition of patient data, drafting and revising of the manuscript; Vogelaar JFJ planned the study and revised the manuscript.
Institutional review board statement: Approval from the Local Ethical Committee for this study was granted.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: Both authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anne M Daniels, BSc, Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands. annedaniels1991@gmail.com
Telephone: +31-77-320555 Fax: +31-77-325309
Received: October 25, 2016
Peer-review started: October 27, 2016
First decision: December 1, 2016
Revised: January 3, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: May 15, 2017
Processing time: 203 Days and 4.8 Hours
Abstract

According to current guidelines, follow-up of patients with colorectal cancer is ended after five years. Also, chest X-ray is not part of standard investigation during follow-up. We describe a case of a 74-year-old patient, more than ten years after a sigmoid resection because of carcinoma of the sigmoid. No recurrence was detected during intensive follow-up. However, ten years after resection of the sigmoid adenocarcinoma, complaints of coughing induced further examination with as result the detection of a solitary metastasis in the left lung of the patient. Within half-a-year after metastasectomy of the lung metastasis, she presented herself with thoracic pain and dyspnea resulting in discovering diffuse metastasis on pulmonary, pleural, costal and muscular level. Five year follow-up of colorectal carcinoma without chest X-ray can be questioned to be efficient. The growing knowledge of tumor biology might in future adjust the duration and frequency of diagnostic follow-up to prevent (late) recurrence in patients with colorectal carcinoma.

Keywords: Colorectal cancer; Metastasis; Tumor biology; Tumor dormancy; Follow-up

Core tip: This case report presents a case of a woman with pulmonary metastases 10 years after a sigmoid resection. No recurrence of the primary intestinal tumor was detected during follow-up. Upcoming knowledge on tumor behavior based on its biology might give new insights in late-onset metastases. Therefore, follow-up protocols and current therapy guidelines might have to be re-evaluated.