Abstract

The most common distant and local metastasis of colorectal cancer is to liver and small pelvis respectively. The isolated metastasis of colorectal cancer in the atypical localization can be seen at the time of diagnosis or at postoperative follow-up period. Multiple factors such as surgical technique, stage of cancer, and natural history of the disease are vital components of the process, however majority of them are due to tumor colonization. However local recurrence due to tumor exfoliation rarely encountered, indetermination of surgical technique is the most accused reason. Parastomal hernia was detected in a 72 years old female patient two years after her APR (Abdominoperineal resection) operation in 2012 for moderately differentiated distal rectal adenocarcinoma (T1N0M0) that developed over tubulovillous adenoma. We found a suspicious mass within the abdominal wall closed to parastomal hernia in the operation. The mass was excised and reported as adenocarcinoma after pathological examination. Re-operation was planned and wide resection was performed with appropriate surgical margin including 15 cm of colon loops with skin of colostomy site. We aimed to emphasize that isolated metastasis of colorectal cancer can be seen during follow-up period so that any mass at atypical localization must be evaluated carefully.