Abstract

Abstract Due to fecal occult blood screening, more patients undergo endoscopic polypectomy for T1 rectal cancer. Active surveillance is more favorable for patients with a low risk of lymph node metastasis. In general, lymph node metastases occur in the mesorectum or alongside the inferior mesenteric artery. The incidence of lateral pelvic lymph node (LPLN) metastasis in patients with T1 rectal cancer is very low. We experienced a case of LPLN recurrence 42 months after polypectomy for T1 lower rectal cancer. There are no guidelines for treating patients with isolated LPLN metastatic recurrence. Lateral lymph node dissection can be performed with curative intent. Adjuvant radiotherapy and chemotherapy are reasonable.

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