Uyluk cildine metastaz yapmış rektum adenokarsiomu: Olgu sunumu

Yetmiş iki yaşındaki erkek hastada, rektum 1/3 alt kısmını dolduran ve anal kanala uzanan adenokarsinom nedeniyle Miles ameliyatı yapıldı. Adjuvan radyoterapi uygulanan hasta, ameliyattan 54 ay sonra sağ supraklaviküler 2 cm çaplı fikse lenfadenopati, sağ bacakta şişlik yakınmalarıyla tekrar başvurdu. Klinik ve patolojik değerlendirmede sağ supraklaviküler lenf nodu, akcişğr, kemik ve pelvik lenf nodu metastazları bulunan hastaya palyatif radyoterapi ve kemoterapi uygulandı. Kemoterapinin dördüncü kürü sonunda, sağ uyluk 1/3 orta ön kısım cildinde papüler lezyonların geliştiği görüldü. Cilt biyopsisinde karsinom metastazı belirlendi. Kemoterapi rejimi değiştirilen ve cilt lezyonlarına yönelik palyatif radyoterapi uygulanan hasta, nüks belirmesinden sekiz ay sonra hastalığın ilerlemesi sonucu kaybedildi.

Cutaneous metastasis to the thigh from rectal adenocarcinoma: A case report

A 72-year-old man underwent Miles operation for curative excision of adenocarcinoma infiltrating 1/3 distal part of the rectum and extending to the anal canal. He received adjuvant radiotherapy postoperatively. Fifty-four months after the operation, he presented with right supraclavicular lymphadenopathy 2 cm in diameter and a swelling in the right lower extremity. Clinical and pathological evaluations showed metastatic involvement of the right supraclavicular lymph node, lung, bone, and pelvic lymph nodes. Chemotherapy and palliative radiotherapy were initiated. Papular skin lesions were noted in the 1/3 middle part of the right thigh after the fourth cycle of chemotherapy. Pathologic examination of the skin lesions showed metastasis of adenocarcinoma, for which second-line chemotherapy and palliative radiotherapy were initiated. The patient died of disease progression eight months after recurrence.

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