Peritoneal cecal cancer metastasis to a mesh‐plug prosthesis:A case report

Abstract

We report the case of a 77-year-old man who presented to our hospital with cecal cancer, lung metastasis, and liver metastasis in January 2013. After four courses of modified infusional intravenous fluorouracil and levofolinate with oxaliplatin (mFOLFOX 6) + bevacizumab, there was no new metastatic lesion and lung metastasis reduction was observed. Ileocecal resection was performed in May, left lower lung lobectomy in August, and extended right posterior segmentectomy + S8 partial liver resection was performed in December. The tumor marker declined initially;thereafter, it gradually increased. Computed tomography (CT) performed in April 2014 revealed right inguinal mass around the mesh-plug prosthesis. A positron emission tomography-CT (PET-CT) also revealed a high 2-fluoro-2-deoxy-D-glucose (FDG) uptake at the same site. Right inguinal tumor resection was performed in July. Cancer tissues were confirmed by performing intraoperative rapid pathological diagnosis, and R0 resection could be achieved. Previous studies have reported malignant tumor metastases to the mesh-plug prosthesis, and this was believed to one of the sites that cancer cells can easily engraft. In particular, in patients with a history of advanced malignant tumors, if mass formation around the artifact insertion site is observed, the possibility of peritoneal metastasis should be considered. J. Med. Invest. 65:142-146, February, 2018.

Solitary Peritoneal Metastasis of Pancreatic Tail Cancer to a Surgical Mesh for Inguinal Hernia Repair

“…The literature search revealed 5 case reports in the English-language medical literature, and the characteristics of the cases, including ours, are summarized in Table 1. [3][4][5][6][7] In 4 of the previous 5 cases, the primary disease was colon cancer (gastric cancer was concurrent in 1 case) and malignant lymphoma in the other case. Four of the reported cases had a solitary recurrence at the hernia repair site, and 1 had lung metastasis.…”

“…4,6 Moreover, floating malignant tumor cell implantation is considered a cause of metastasis to the hernia repair mesh. 5,7 In addition, some inflammatory cytokines and growth factors such as interleukin-1 beta, interleukin-6), tumor necrosis factor-alpha, epidermal growth factor, basic fibroblast growth factor, heparin-binding epidermal growth factor-like growth factor, and 2 spliced variants of vascular endothelial-derived growth factor contribute to cancer cell implantation, adhesion, and growth at the hernia repair site. These inflammatory cytokines and growth factors are thought to be produced by chronic inflammation resulting from hernia repair mesh placement over an extended period.…”

“…A combination of the following search terms was used: “peritoneal metastasis” AND (“inguinal hernia” OR “surgical mesh”). The literature search revealed 5 case reports in the English-language medical literature, and the characteristics of the cases, including ours, are summarized in Table 1 3–7 . In 4 of the previous 5 cases, the primary disease was colon cancer (gastric cancer was concurrent in 1 case) and malignant lymphoma in the other case.…”

“…Direct cancer cell infiltration from the primary tumor to the hernia mesh has been reported as a possible cause, especially for colon cancer exposed to the peritoneum 4,6 . Moreover, floating malignant tumor cell implantation is considered a cause of metastasis to the hernia repair mesh 5,7 . In addition, some inflammatory cytokines and growth factors such as interleukin-1 beta, interleukin-6), tumor necrosis factor-alpha, epidermal growth factor, basic fibroblast growth factor, heparin-binding epidermal growth factor–like growth factor, and 2 spliced variants of vascular endothelial-derived growth factor contribute to cancer cell implantation, adhesion, and growth at the hernia repair site.…”