333 A Rare Case of Skeletal Muscle Metastasis of Colorectal Cancer

Abstract

Introduction Colorectal carcinoma is one of the most commonly diagnosed cancers. Metastasis is seen in the liver, lung, peritonium and bone. Though skeletal muscles make up a majority of our body mass, they are an extremely rare site for metastasis A 74 y/male known to have total ulcerative colitis was put on the 2WW due to change in bowel habits, weight loss and anemia. Investigations revealed a large cavitating lesion in the right colon with no evidence of metastasis. He underwent an open total pan procto-colectomy, small bowel resection and end ileostomy Histopathology showed the tumour was a completely excised adenocarcinoma During surveillance it was noted his CEA levels were high, for which he had a host of investigations including a CT scan and a PET scan, all of which had no interval changes. He mentioned that he noticed a lump in his left thigh. Orthopedicians advised an MRI scan which showed a tissue lump covering the front of the thigh, within the vastus medialis. A biopsy revealed metastatic adenocarcinoma. He also had left wrist pain. A thorough examination revealed a hard mass within the swelling. Ultrasound confirmed a solid well circumscribed mass with vascularity. Given the above information the patient felt he would be like to complete the remaining of his life with dignity and comfort at home and was fast-track discharged. Discussion Skeletal muscle metastasis of colorectal cancers is always associated with a prognosis that is somber and terminal. A high degree of suspicion is needed for diagnosis.