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Rectal adenocarcinoma presenting with thigh muscle metastasis as the only metastatic site.

Rectal adenocarcinoma presenting with thigh muscle metastasis as the only metastatic site.

Rectal adenocarcinoma presenting with thigh muscle metastasis as the only metastatic site.

BMJ Case Rep. 2019 Jan 22;12(1):

Authors: Doroudinia A, Mehrian P, Dorudinia A, Kaghazchi F

Abstract
Rectal carcinoma with metastasis to skeletal muscle is a rare finding. According to literature review, 17 cases of skeletal muscle metastasis from colorectal carcinoma have been documented where only six cases were rectal carcinomas.We discuss a case of a middle-aged man with a known history of high-grade mucinous adenocarcinoma of the rectum, status post abdominoperineal resection followed by adjuvant radiotherapy and chemotherapy. During the planned chemotherapy course, a right proximal thigh subcutaneous mass was incidentally found which on subsequent biopsy proved to be metastatic from rectal primary site. On subsequent 18F-FDG (Fluorodeoxyglucose) positron emission tomography (PET)/CT scan after completion of chemotherapy for the purpose of treatment response evaluation, only FDG-avid lesion was residual right proximal thigh metastatic mass without involvement of other common sites, such as liver and lung. In this case, the 18F-FDG-PET/CT scan was able to exclude additional metastatic sites and also evaluate the patient's treatment response.

PMID: 30674489 [PubMed - in process]

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