Metastasis of a cecal adenocarcinoma to the prostate five years after a right hemicolectomy: a case report

Abstract

IntroductionProstatic metastasis from a primary bowel adenocarcinoma has been only rarely reported in the medical literature. The case reported here is rare in the fact that the primary tumor was from a right-sided bowel adenocarcinoma. It is unusual because initial immunostaining was not fully conclusive, and so a relatively new method of immunostaining, CDX2, was used to ascertain its histopathology.Case presentationWe describe the case of a 54-year-old Caucasian man who had a right hemicolectomy for a primary cecal adenocarcinoma, which was completely excised. Following the procedure, he received adjuvant chemotherapy. Computed tomography scans showed no evidence of local recurrence or metastatic disease. Then, five years later, he presented to his general practitioner with urinary symptoms. An abnormal prostate was palpated on digital rectal examination. Trans-rectal prostatic biopsies were performed, which showed colorectal metastases within the prostate gland. This was confirmed with CDX2 immunohistochemistry. There was no further evidence of distant metastases on positron emission tomography-computed tomography scans.ConclusionsThis case demonstrates a rare isolated hematogenous spread to the prostate from a primary cecal adenocarcinoma, several years after definitive treatment and excision. This highlights the importance of accurate immunohistochemistry and imaging in planning further management and treatment.

Metastatic Breast Carcinoma to the Prostate Gland

“…The involvement of the prostate gland by metastasis from noncontiguous tumors is a rare occurrence reported in <1% of surgical specimens and 3% of postmortem examinations [ 10 , 11 ]. Secondary tumors of the prostate have been noted with most frequency from the digestive tract [ 12 , 13 ], lung [ 14 , 15 ], and kidney [ 16 , 17 ]. Up to 20% of patients with secondary tumors of the prostate have no evidence of metastatic disease in additional sites [ 11 ].…”

Rediscovering Secondary Tumors of the Prostate in the Molecular Era

“…2,16,23,30 Multifocal vascular invasion may often be detected, supporting the hematogenous spread of the primary tumor. 1,8,12,30 However, the identification of secondary neoplasms involving the prostate may be extremely problematic in cases with missing or unavailable clinical information and/or unknown primary malignancies. 2…”