YO4 - Atypical metastatic sites of colon cancer : report of 4 cases

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Colon and Rectal Cancer
Presenter djihed Belabdi
Authors D. Belabdi1, F. Hadjam1, M. Oukkal2
  • 1Médical Oncology, CHU Beni-Messous, 16000 - Alger/DZ
  • 2Médical Oncology, CHU Beni-Messous, Alger/DZ


Case Summary

Background: Colic cancer metastatic localizations are dominated by the liver and the lungs.Their occurring in other sites is rare and represents only 5% of patients. These atypical localizations occur most frequently in a muli metastatic table; they seldom do in an isolated way.

Methods: These are case reports of 4 patients followed for colon cancer, who had atypical metastatic localizations : bone tissue, brain, vagina, testis and seminal vesicle.


Case 1: 50 years old male patient who had surgery and adjuvant therapy in 2011 for a stage 3 right colon cancer. 3 years later, he has a testicular mass whose pathological analysis indicates a secondary location of a colon cancer. Further staging revealed a seminal vesicle localization that has been treated with surgery and chemotherapy.

Case 2: 42 years old female patient who had surgery and adjuvant therapy in 2010 for a stage 3 sigmoid colon cancer. 2 years later, a swelling of her right ankle turned out to be a secondary location of colon cancer. The patient then developed multiple brain and skeletal secondary locations during chemotherapy, and died after 10 months of treatment.

Case 3: 68 years old male patient who underwent surgery for a stage 3 colon cancer in 2014. 2 months after the completion of an adjuvant therapy, bony secondary locations were discovered during the investigation of back pain. The patient was treated by chemotherapy. He died after 3 months of treatment.

Case 4: A female patient of 50, who had surgery in 2014, followed by adjuvant therapy for a stage 3 sigmoid colon cancer. 6 months later the patient presented metrorrhagia. A hysteroscopy revealed a process of the nympho-hymeneal groove, infiltrating the lower third of the vagina. The analysis of the biopsy points to a metastasis of colon cancer. The patient was treated with surgery and chemotherapy.

Conclusion: Atypical secondary localizations of colon cancers are a rare occurrence in clinical practice. Their diagnosis should be considered when facing any atypical symptom. The prognosis of brain and bone lesions is poor and systemic treatment is mainly used. For vaginal and testicular localizations surgery and adjuvant chemotherapy are recommended in the absence of other localizations.

Keywords : colic cancer , atypical metastases , prognosis.