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An Unusual and Protracted Course of a Haggitt 3 Malignant Polyp Recurrence
Pratik Raichurkar1, Tae Jun Kim1, Christopher Byrne1
1Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, AUS.
Cureus
|March 25, 2024
Summary
Late colorectal cancer recurrence can occur years after initial treatment. This case highlights a 15-year recurrence, emphasizing the need for individualized surveillance strategies beyond standard guidelines for high-risk patients.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Colorectal cancer (CRC) surveillance guidelines typically recommend 5 years of follow-up post-resection.
- Data guiding surveillance beyond 5 years is limited, posing challenges for detecting late recurrences.
Observation:
- A 60-year-old female presented with locoregional recurrence 15 years after endoscopic mucosal resection of a sigmoid colon polyp.
- The recurrence was an incidental finding due to elevated alpha-fetoprotein post-liver transplant, with imaging revealing a calcified mesenteric mass.
Findings:
- Surgical pathology confirmed locoregional recurrence, despite negative surveillance colonoscopy and imaging.
- This case represents an unusually late recurrence of colorectal cancer.
Implications:
- Risk factors for late CRC recurrence warrant further investigation.
- Individualized follow-up protocols considering patient-specific risk factors may be necessary for optimal long-term management.
- Current surveillance protocols may need re-evaluation to encompass the possibility of late recurrences.
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