Metastasis at the colostomy site: a rare case report

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Colostomy site metastasis is an uncommon complication following colorectal cancer surgery.
• Previous reports often link these metastases to patients who have undergone abdominoperineal resection and present with late-stage metastasis.

Observation:

• A patient developed metastasis at the colostomy site within a short interval between rectal cancer surgery and stoma closure.
• This presentation differed from typical cases, suggesting an alternative mechanism of spread.

Findings:

• The metastasis was likely caused by cancer cell reflux and seeding from the obstruction during the decompressive colostomy procedure.
• This contrasts with the more common routes of local, lymphatic, or hematogenous spread.

Implications:

• Histologic analysis is crucial for obstructive colorectal cancer patients undergoing decompressive colostomy to exclude polyps and metachronous cancer.
• This case highlights a potential, previously uncertain risk of colostomy site metastasis during staged colorectal cancer surgery, warranting further investigation.