Skip to main content
Erschienen in: World Journal of Surgical Oncology 1/2011

Open Access 01.12.2011 | Case report

Prostate cancer metastases to the rectum: A case report

verfasst von: Tariq O Abbas, Abdulla R Al-Naimi, Rafie A Yakoob, Issam A Al-Bozom, Abdulkader M Alobaidly

Erschienen in: World Journal of Surgical Oncology | Ausgabe 1/2011

download
DOWNLOAD
print
DRUCKEN
insite
SUCHEN

Abstract

Prostate cancer rarely metastasis to the rectum. Findings in the patient reported here emphasize the importance of the relationship between urinary and gastrointestinal symptoms in detecting prostatic neoplasms in older male patients.
Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-9-56) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

TA carried out the history, physical examination and the provisional draft.
AAN participitate in the sequence alignment and drafted the manuscript again. IAB carried out the histopathology.
RY carried out the colonoscopy and the re ctal biopsy.
AA involoved in the patient management and data collection.
All authors read and approved the final manuscript.

Background

Prostate cancer has the potential to advance loco-regionally to adjacent organs. This spread can take place via different routes, including direct invasion and through lymphatic channels. It is very rare for prostate cancer to metastasize to nearby organs, including the rectum. We describe here a patient presenting with prostate cancer metastasizing to the rectum.

Case report

A 60-year-old man was referred to our urology facility after experiencing severe weight loss (30 kg in 3 months) and bleeding from the rectum, together with upper abdominal pain and vomiting. Over the previous year, he had experienced painless hematuria and voiding difficulty.
He was thoroughly examined, including undergoing a colonoscopy, which revealed a distal rectal sessile mass lying about 15 cm from the anal verge [Figure 1]. Histopathologic examination of the biopsy showed that it was a metastatic prostatic adenocarcinoma [Figure 2].
A CT scan of his abdomen showed that the prostatic mass had invaded the urinary bladder wall and that the biopsied mass was separate from the rectum [Figure 3]. His serum PSA concentration was high (983 ng/ml). In addition, TC-99 MDP bone scintigraphy showed widespread bone metastatic lesions [Figure 4].
He was started on hormone therapy and followed up by the oncology department.

Discussion

Prostate cancer is a slowly growing neoplasm that can easily be missed during its early stages. Patients not previously diagnosed with prostatic adenocarcinoma may present initially with metastases [1]. In contrast, PSA may not be expressed in all patients with prostatic adenocarcinoma [2].
Prostate cancer extension to colorectal tissue can occur through at least 3 potential routes. The first is direct invasion through Denonvilliers fascia and infiltration into the rectum. The second is through lymphatics, since the prostate and rectum share some lymphatic drainage to groups of pelvic lymph node [3]. Third, prostate cancer cells can spread through needle biopsy, by seeding into peri-rectal or rectal tissue along the needle biopsy; this, route, however, is extremely rare [4, 5].
Prostate cancer metastasis to the recto-sigmoid region can occur by subserosal metastatic implant of the malignant tissues [6]. The incidence of rectal infiltration by prostatic adenocarcinoma is extremely rare, being encountered on average once every two years by a busy colorectal practice [7].

Conclusion

Findings in the patient reported here emphasize the importance of the relationship between urinary and gastrointestinal symptoms in detecting prostatic neoplasms in older male patients. Careful immunohistochemical examination of specimens can prevent major surgical interventions in favor of hormonal and radiological therapies.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://​creativecommons.​org/​licenses/​by/​2.​0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

TA carried out the history, physical examination and the provisional draft.
AAN participitate in the sequence alignment and drafted the manuscript again. IAB carried out the histopathology.
RY carried out the colonoscopy and the re ctal biopsy.
AA involoved in the patient management and data collection.
All authors read and approved the final manuscript.
Anhänge

Authors’ original submitted files for images

Literatur
1.
Zurück zum Zitat Hematpour K, Bennett CJ, Rogers D, Head CS: Supraclavicular lymph node: incidence of unsuspected metastatic prostate cancer. Eur Arch Otorhinolaryngol. 2006, 263 (9): 872-874. 10.1007/s00405-006-0066-2.CrossRefPubMed Hematpour K, Bennett CJ, Rogers D, Head CS: Supraclavicular lymph node: incidence of unsuspected metastatic prostate cancer. Eur Arch Otorhinolaryngol. 2006, 263 (9): 872-874. 10.1007/s00405-006-0066-2.CrossRefPubMed
2.
Zurück zum Zitat Gallee MP, Visser-de Jong E, van der Korput JA, van der Kwast TH, ten Kate FJ, Schroeder FH, Trapman J: Variation of prostate-specific antigen expression in different tumour growth patterns present in prostatectomy specimens. Urol Res. 1990, 18 (3): 181-187. 10.1007/BF00295844.CrossRefPubMed Gallee MP, Visser-de Jong E, van der Korput JA, van der Kwast TH, ten Kate FJ, Schroeder FH, Trapman J: Variation of prostate-specific antigen expression in different tumour growth patterns present in prostatectomy specimens. Urol Res. 1990, 18 (3): 181-187. 10.1007/BF00295844.CrossRefPubMed
3.
Zurück zum Zitat Murray SK, Breau RH, Guha AK, Gupta R: Spread of prostate carcinoma to the perirectal lymph node basin: analysis of 112 rectal resections over a 10-year span for primary rectal adenocarcinoma. Am J Surg Pathol. 2004, 28 (9): 1154-1162. 10.1097/01.pas.0000131543.80147.3d.CrossRefPubMed Murray SK, Breau RH, Guha AK, Gupta R: Spread of prostate carcinoma to the perirectal lymph node basin: analysis of 112 rectal resections over a 10-year span for primary rectal adenocarcinoma. Am J Surg Pathol. 2004, 28 (9): 1154-1162. 10.1097/01.pas.0000131543.80147.3d.CrossRefPubMed
4.
Zurück zum Zitat Vaghefi H, Magi-Galluzzi C, Klein EA: Local recurrence of prostate cancer in rectal submucosa after transrectal needle biopsy and radical prostatectomy. Urology. 2005, 66: 881-CrossRefPubMed Vaghefi H, Magi-Galluzzi C, Klein EA: Local recurrence of prostate cancer in rectal submucosa after transrectal needle biopsy and radical prostatectomy. Urology. 2005, 66: 881-CrossRefPubMed
5.
Zurück zum Zitat Lane Z, Epstein JI, Ayub S, Netto GJ: Prostatic adenocarcinoma in colorectal biopsy: clinical and pathologic features. Hum Pathol. 2008, 39 (4): 543-549. 10.1016/j.humpath.2007.08.011.CrossRefPubMed Lane Z, Epstein JI, Ayub S, Netto GJ: Prostatic adenocarcinoma in colorectal biopsy: clinical and pathologic features. Hum Pathol. 2008, 39 (4): 543-549. 10.1016/j.humpath.2007.08.011.CrossRefPubMed
6.
Zurück zum Zitat Gengler L, Baer J, Finby N: Rectal and sigmoid involvement secondary to carcinoma of the prostate. Am J Roentgenol Radium Ther Nucl Med. 1975, 125 (4): 910-917.CrossRefPubMed Gengler L, Baer J, Finby N: Rectal and sigmoid involvement secondary to carcinoma of the prostate. Am J Roentgenol Radium Ther Nucl Med. 1975, 125 (4): 910-917.CrossRefPubMed
7.
Zurück zum Zitat Bowrey DJ, Otter MI, Billings PJ: Rectal infiltration by prostatic adenocarcinoma: report on six patients and review of the literature. Ann R Coll Surg Engl. 2003, 85: 382-385. 10.1308/003588403322520726.PubMedCentralCrossRefPubMed Bowrey DJ, Otter MI, Billings PJ: Rectal infiltration by prostatic adenocarcinoma: report on six patients and review of the literature. Ann R Coll Surg Engl. 2003, 85: 382-385. 10.1308/003588403322520726.PubMedCentralCrossRefPubMed
Metadaten
Titel
Prostate cancer metastases to the rectum: A case report
verfasst von
Tariq O Abbas
Abdulla R Al-Naimi
Rafie A Yakoob
Issam A Al-Bozom
Abdulkader M Alobaidly
Publikationsdatum
01.12.2011
Verlag
BioMed Central
Erschienen in
World Journal of Surgical Oncology / Ausgabe 1/2011
Elektronische ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-9-56

Weitere Artikel der Ausgabe 1/2011

World Journal of Surgical Oncology 1/2011 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.