Aberrant single metastasis to the elbow from primary rectal cancer: a rare presentation

Abstract

Rectal adenocarcinoma usually metastasizes to the liver and lungs and when it has bone spread, it more frequently involves the vertebrae and pelvis. Thus, aberrant metastasis from a rectal adenocarcinoma to upper extremities with preservation of intra-abdominal organs is very uncommon. We present the case of an 80-year-old male patient with a diagnosis of adenocarcinoma of the rectum T4N1M1 with non-axial single bone metastases and with preservation of visceral organs. Anterior resection of rectum after neoadjuvant chemotherapy and radiotherapy were made. The bone metastasis received palliative radiotherapy and was not resected. The patient died 10 months after diagnosis. This clinical situation generally has a poor prognosis. When the patient complains of unusual bone pain it is necessary to suspect a malignant disease and even if extraordinarily rare, rectal cancer must be considered as a possible cause.

Neįprastos Lokalizacijos Metastazės Kauluose Pacientui, Sergančiam Išplitusiu Tiesiosios Žarnos Vėžiu: Klinikinis Atvejis

“…Įprastai kaulinės metastazės nustatomos ašiniame skelete: stubure, krūtinkaulyje, šonkauliuose, dubens kauluose, retais atvejais piktybinių navikų metastazės nustatomos distaliniuose galūnių ar veido kauluose [10][11][12]. Adenokarcinomos metastazės galūnių kauluose aprašomos kaip reti atvejai.…”

Isolated Skull Metastasis With Unusual Spiculated Periosteal Reaction From Rectal Cancer Resembling Osteosarcoma on FDG PET/CT

“…In patients with treated colorectal cancers, the use of FDG PET/CT is recommended in patients with clinical suspicion and/or repeated elevation of carcinoembryonic antigen levels in whom imaging studies are equivocal or negative and in patients with metachronous metastatic disease susceptible to resection with intention to cure to confirm the absence of disease at other sites 13 . FDG PET/CT findings of isolated bone metastases from colorectal cancers have been rarely reported 14,15 . This case indicates that bone metastasis from rectal adenocarcinoma should be considered in the differential diagnosis of hypermetabolic bone lesions with spiculated periosteal reactions including osteosarcoma, 7 Ewing sarcoma, 7 plasmacytoma, 16 and metastases from other malignancies 8 …”