Here we report a case of advanced rectal and prostate cancer with synchronous lateral lymph node (LLN) metastases that was treated with laparoscopic surgery. A 71-year-old man presented with fecal occult blood and was diagnosed with rectal cancer. A metastatic right LLN was suspected after CT examination of a 19-mm lymph node (proximal internal iliac artery region) and a 13-mm lymph node (distal internal iliac artery region) in the right lateral region. We planned neoadjuvant chemotherapy to suppress local and distant recurrence. This treatment decreased the size of the primary rectal tumor. We performed laparoscopic abdominoperineal resection and right LLN dissection. The histopathological diagnosis was LLN metastases from the rectal and prostate cancers. It is rare for synchronous metastases from rectal and prostate cancers to be observed in the LLN. It may be difficult to determine an appropriate treatment strategy in cases like this.
Asian journal of endoscopic surgery. 2018 May 10 [Epub ahead of print]
Takahisa Ishikawa, Shigenori Homma, Makoto Nishikawa, Hiroki Nakamoto, Ryoji Yokoyama, Akinobu Taketomi
Department of Surgery, Hokkaido Prefectural Welfare Federation of Agricultural Cooperatives Abashiri-Kosei General Hospital, Abashiri, Japan., Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.