Urethral metastasis from a sigmoid colon carcinoma: a quite rare case report and review of the literature

Abstract

BackgroundUrethral metastatic adenocarcinoma is extremely rare. Moreover, only 9 previous cases with metastases from colorectal cancer have been reported to date, and not much information on urethral metastases from colorectum is available so far.Case presentationWe report our experience in the diagnosis and the management of the case with urethral metastasis from a sigmoid colon cancer. A 68-year-old man, who underwent laparoscopic sigmoidectomy for sigmoid colon carcinoma four years ago, presented gross hematuria with pain. Urethroscopy identified a papillo-nodular tumor 7 mm in diameter in the bulbar urethra. CT-scan imaging revealed the small mass of bulbous portion of urethra and solitary lung metastasis. Histological examination of the tumor obtained by transurethral resection showed moderately differentiated adenocarcinoma, which was diagnosed as a metastasis of a sigmoid colon carcinoma pathologically by morphological examination. Immunohistochemical analysis of the urethral tumor revealed the positive for cytokertin 20 and CDX2, whereas negative for cytokertin 7. These features were consistent with metastatic adenocarcinoma of the sigmoid colon cancer. As the management of this case with urethral and lung metastasis, 6-cycle of chemotherapy with fluorouracil with leucovorin plus oxaliplatin was administered to the patient, and these metastases were disappeared with no recurrence of disease for 34 months.ConclusionUrethral metastasis from colorectal cancer is a very rare occurrence. However, in the presence of urinary symptoms, the possibility of the urethral metastasis should be considered.

Rare Case of Metastatic Colorectal Cancer to Uretral Meatus with Rapid Progression and Fatal Outcomes

“…Moreover, it is interesting to detect asymptomatic intraluminal urethral lesion. Because of the location of the metastasis on the urethral meatus in our patient, the diagnosis was made clinically and confirmed by pathology (Seo 2011, Kazama 2014). MRI was not performed in our patient because its general condition quickly deteriorated.…”

“…A multidisciplinary and individualized therapeutic approach should be carried out for each patient, depending on the symptoms and the extent of their disease. Treatment modalities are local surgery, systemic chemotherapy and local radiotherapy (Kazama, 2014). Local surgical excision is the treatment of choice for solitary urethral lesion (Okaneya,1991 ;Zhang 2015) but it should be made based on each patient's symptoms and the findings.…”

“…In the case of multiple metastasis, there is no evidence that there is a survival advantage from urethral resection, but resection of the urethral lesion is effective in preventing lower urinary tract complications such as retention (Karakose 2014, Chitale 2004, Kazama 2014. In general, patients are treated with palliative chemotherapy as recommanded for the treatment of metastatic colorectal cancer based on 5 FU, oxaliplatin, Irinotecan and biotherapy like Bevacizumab.…”

Penile metastasis from rectal adenocarcinoma: a case report

“…Metastasis to the penis are very uncommon, and they are encountered in patients with advanced primary tumors. The vast majority of reported cases has presented with metachronous metastasis and had a history of known primary tumors [ 1 – 3 , 8 , 9 ]. The clinical presentation was usually an ulcerated or a hard mass located on the glans, the penis shaft or the penis root.…”

Ampulla Vatere kolon kanseri metastazı

“…Metastasis from colon cancer usually occurs in the liver and lung parenchyma 1 . Metastasis from colon cancer rarely occurs in the thimic, vaginal, urethral, breast and penis 2,3 . Ampullary cancers are 0.2% of gastrointestinal cancers 4 .…”