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Updated: May 28, 2025
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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
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[A Case of Rectal Cancer with Left Axillary Lymph Node Metastasis]
Masato Fujino1, Kana Murakami, Keigo Sudo
1Dept. of Surgery, Tokyo-Kita Medical Center.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|February 14, 2025
Summary
Metastasis of rectal cancer to axillary lymph nodes is a rare occurrence. This case highlights a 61-year-old woman diagnosed with rectal cancer that spread to her left axillary lymph nodes, confirming colorectal cancer metastasis.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Pathology
Background:
- Metastasis to axillary lymph nodes from gastrointestinal malignancies is exceptionally rare.
- Axillary lymph node involvement typically suggests breast cancer or lymphoma.
Purpose of the Study:
- To report a rare case of rectal cancer with metastasis to the left axillary lymph nodes.
- To discuss the diagnostic challenges and pathological confirmation of unusual metastatic patterns.
Main Methods:
- Contrast-enhanced CT scan for initial staging.
- Fine-needle aspiration cytology and core needle biopsy for lesion characterization.
- Laparoscopic low anterior resection with D2 dissection and axillary lymph node biopsy.
- Postoperative histopathological and immunohistochemical analysis.
Main Results:
- Initial imaging suggested rectal cancer with extensive lymph node involvement and possible peritoneal dissemination.
- Preoperative imaging raised suspicion for synchronous breast cancer due to axillary lymphadenopathy.
- Pathological examination confirmed adenocarcinoma in the axillary lymph node consistent with rectal origin, not breast cancer.
- The patient was diagnosed with Stage IV rectal cancer with left axillary lymph node metastasis.
Conclusions:
- This case underscores the possibility of rare metastatic pathways from colorectal cancer.
- Accurate pathological and immunohistochemical analysis is crucial for diagnosing unusual metastatic sites.
- Early identification and appropriate treatment, including chemotherapy, are vital for managing Stage IV colorectal cancer with distant metastasis.
