Isolated omental metastasis from descending colon cancer after SEMS placement as a bridge to surgery

Abstract

We report a case of isolated omental metastasis from the descending colon cancer after self-expanding metallic stent (SEMS) placement as a bridge to surgery. The patient was a 33-year-old woman who underwent left hemicolectomy for descending colon cancer after SEMS placement in 2014. Histopathological examination revealed moderately differentiated tubular adenocarcinoma, type 2, 4.2×3.1 cm, pT3 (ss), pN0, ly1, v1, pPM0, pDM0, pStage II. She received adjuvant chemotherapy for six months. After a 2-year disease-free interval, CT and FDG-PET showed an intraabdominal tumor and abnormal uptake. Tumor resection with the surrounding omentum was performed with single port laparoscopic surgery. The histological examination showed the tumor was moderately differentiated tubular adenocarcinoma similar to the pathological findings of the previous colon cancer and the pathological diagnosis was isolated omental colon cancer metastasis. Metastasis to the omentum from colon cancer is rare and to the best of our knowledge, there have been no reports of metastasis to the omentum from colon cancer. Although the relationship between SEMS placement and omentum metastasis is unclear, acceptance of SEMS placement as a bridge to surgery has increased and more careful attention must be paid to the long-term oncologic outcome.