Abstract
Introduction
A potentially resectable bony metastasis in the context of oligometastatic colorectal cancer is uncommon. Bony metastases are usually considered a late event with poor prognosis and generally associated with liver and/or lung metastases.
Index case
A previously healthy 33-year-old gentleman, with no family history of colorectal cancer, presented with rectal bleeding and at colonoscopy had a biopsy-proven adenocarcinoma of the rectum, 7 cm from the anal verge. Imaging also showed an isolated bone metastasis in the left ischial tuberosity. Following recovery from an anterior resection and a segment 5 metastasectomy, he underwent resection of the bony metastasis with a left type 3 internal hemipelvectomy. Three years from the bony resection, there is no evidence of recurrence on imaging.
Discussion
Osseous metastases are usually treated with palliative intent with bisphosphonates or external radiation, with surgical fixation of pathological fractures in some cases. Median survival after diagnosis of bone metastases is less than 10 months. Surgery is perhaps the only way of potentially achieving cure in patients with single-site bony metastases from colorectal cancer. Reports of such surgery in the literature are however very scant.
Conclusion
Our case is unusual and ongoing follow up is required. However, current disease-free status at conventional and functional imaging is encouraging. A multidisciplinary and indeed multicentre approach may be needed, and oligometastatic disease, even to a bone, may be amenable to curative surgical intervention in highly selected cases.
References
Müller DA, Capanna R (2015) The surgical treatment of pelvic bone metastases. Adv Orthop 2015:525363
Choi SJ, Kim JH, Lee MR et al (2011) Long-term disease-free survival after surgical resection for multiple bone metastases from rectal cancer. World J Clin Oncoli 2(8):326–328
Aich RK, Diptimoy D, Jibak B et al (2014) Bone metastasis. J Cancer Res Ther 10(2):413–415
Scuderi G, Macrì A, Sfuncia G et al (2004) Sternal metastasis as initial presentation of a unknown rectal cancer. Int J Color Dis 19(Issue 3):292–293
Onesti JK, Mascarenhas CR, Chung MH et al (2011) Isolated metastasis of colon cancer to the scapula: is surgical resection warranted? World J Surg Oncol 9:137
Sheen AJ, Drake D, Langton S et al (2002) Unusual bony colorectal metastases in post-hepatometastasectomy patients. J Hepato-Biliary-Pancreat Surg 9(3):379–382
Gamblin TC, Santos RS, Baratz M et al (2006) Metastatic colon cancer to the hand. Am Surg 72(1):98–100
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cassar, N., Cresswell, A.B. & Moran, B. Oligometastatic colorectal cancer: is single-site bony colorectal metastasis a treatable condition?. Int J Colorectal Dis 32, 1229–1231 (2017). https://doi.org/10.1007/s00384-017-2780-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-017-2780-1