[A case of lymph node recurrence occurring nine years after surgery for sigmoid colon cancer]

A 64-year-old man underwent sigmoidectomy for sigmoid colon cancer 9 years ago. We attempted to discontinue surveillance, as the postoperative course was event free for 5 years; however, we continued the follow-up on the patient's request. Nine years after the operation, elevation of the serum carcinoembryonic antigen (CEA) level was detected, and positron emission tomography-computed tomography (PET-CT) showed a 35-mm mass with an abnormal signal (SUVmax 18.6 Bq/ mL). We performed an abdominal CT and magnetic resonance imaging and found the mass invading the sigmoid colon. We suspected lymph node recurrence of the sigmoid colon cancer and considered curative surgery to be appropriate as there were no other signs of recurrence. We therefore excised the tumor by sigmoidectomy. A histopathological examination revealed metastatic adenocarcinoma in the lymph node. One year after the second operation, there was no evidence of recurrence on imaging and the levels of tumor markers were within the normal limits. Few reports have documented recurrence over 5 years after surgery. We herein describe our case and report the characteristics of a recurrent lesion and also suggest a protocol for surveillance, taking into consideration the previous literature.