Ananthu Nandakumar, Ajil Antony

A RARE CASE OF RECURRENCE AT STOMA REVERSAL SITE FOLLOWING SURGICAL MANAGEMENT OF COLORECTAL CANCER

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Cutaneous and subcutaneous metastasis from colorectal adenocarcinoma are extremely rare. Cutaneous metastasis usually occur in less than 4% of colorectal carcinoma. The commonest site of cutaneous metastasis in colorectal cancer is the abdominal wall skin. The patient was a 61-year-old man who presented with complaints of bleeding per rectum and with history of constipation. On further evaluation for the same he was diagnosed to have carcinoma rectosigmoid. A Hartman's procedure was performed. Histopathology was well differentiated mucinous adenocarcinoma with resected margins free of tumour. Postoperatively patient received 1 cycle of chemo and 28 cycles of radiation. Prior to Hartmann reversal distal stump and proximal colon was evaluated with exible sigmoidoscopy and colonoscopy. And being normal Hartmann's reversal was done. On regular follow up patient complained of a swelling near the previous stoma site. FNAC was taken from the swelling suggestive of metastatic adenocarcinoma. Wide local excision was done and the defect was reinforced with a polypropelene mesh and closed. The histopathological report was metastasis from adenocarcinoma with mucinous differentiation with all the resected margins and overlying skin free of tumor. It is uncommon to have metastatic adenocarcinoma at the colostomy stoma site from colorectal cancer without local recurrence or distant metastases.

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