Ileostomy Site Cutaneous Metastasis of Colorectal Carcinoma without Visceral Involvement: An Unusual Case

Abstract

Introduction: The development of cutaneous metastasis during the course of colorectal carcinoma occurs very rarely (4% of patients with rectal carcinoma) and indicates widespread disease. The abdominal wall and perineal area are frequently the sites of cutaneous metastasis. Case presentation: A 64-year-old woman who received series of daily radiotherapy over 30 days in 1974 due to cervical carcinoma underwent surgery for stage IIA sigmoid colon adenocarcinoma in 1995. In 2001, she underwent abdominoperineal resection, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and left-sided end colostomy for stage IIIC distal rectal tumor. In 2004, the colostomy site changed to the right lower abdominal quadrant due to unsuccessful parastomal hernia repair in 2003. In 2008, she underwent right hemicolectomy due to stage IIA cecal tumor with end ileostomy in the right lower quadrant. In 2015, she was hospitalized due to the development of a mass at the end ileostomy site; other organ involvement was not observed. The abdominal wall and segmental small bowel were resected and an end ileostomy in the left lower quadrant was performed. Her pathology report revealed middle dermal invasion of moderately differentiated mucinous adenocarcinoma at the ileocutaneous junction with clear margins. Conclusion: Isolated skin metastasis in colorectal cancer after primary surgery occurs rarely but it must be excluded during follow-up visits by careful examination.