Isolated Metastases to Multiple Genital Organs: a Curious Case of Metachronous Spread of Carcinoma Colon

  • Saheer N
  • Prasanth PenumaduEmail author
  • Ashwani Kumar Sachdeva
  • Pavneet Singh Kohli
Case Report


Gastrointestinal malignancy accounts for the most common cause of extragenital primary spreading to female genital tract with colorectal carcinoma leading among them [1]. Ovary and vagina are the most common sites for spread. Synchronous presentation occurs more frequently than metachronous lesions [2]. Isolated tumor deposit to one or more genital organs is rare. The present case discusses regarding the metachronous presentation of carcinoma colon to multiple genital organs.

Case Report

A 58-year-old well preserved post-menopausal lady (BSA of 1.72), with no family history of colonic or genital malignancies and no known comorbidities, was diagnosed with adenocarcinoma of the sigmoid colon 5 years back for which she underwent anterior resection. Post-operative histopathology revealed adenocarcinoma, moderately differentiated, pT3N0M0. Patient received 12 cycles of adjuvant chemotherapy (FOLFOX regimen). After 5 years, she presented with post-menopausal bleeding with no...


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Mutter GL, Prat J (2014) Pathology of the female reproductive tract. Elsevier Health Sciences 2821 pGoogle Scholar
  2. 2.
    Garrett CR, George B, Viswanathan C, Bhadkamkar NA, Wen S, Baladandayuthapani V, You YN, Kopetz ES, Overman MJ, Kee BK, Eng C (2012 Sep) Survival benefit associated with surgical oophorectomy in patients with colorectal cancer metastatic to the ovary. Clin Colorectal Cancer 11(3):191–194CrossRefGoogle Scholar
  3. 3.
    Riihimäki M, Hemminki A, Sundquist J, Hemminki K (2016) Patterns of metastasis in colon and rectal cancer. Sci Rep 6:29765CrossRefGoogle Scholar
  4. 4.
    Omranipour R, Abasahl A (2009) Ovarian metastases in colorectal cancer. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 19(9):1524–1528CrossRefGoogle Scholar
  5. 5.
    Segelman J, Flöter-Rådestad A, Hellborg H, Sjövall A, Martling A (2010) Epidemiology and prognosis of ovarian metastases in colorectal cancer. Br J Surg 97(11):1704–1709CrossRefGoogle Scholar
  6. 6.
    Marchal F, Leroux A, Hoffstetter S, Granger P (2006) Vaginal metastasis revealing colon adenocarcinoma. Int J Colorectal Dis 21(8):861–2.
  7. 7.
    Kumar NB, Hart WR (1982 Nov) Metastases to the uterine corpus from extragenital cancers. A clinicopathologic study of 63 cases. Cancer 50(10):2163–2169CrossRefGoogle Scholar
  8. 8.
    Matsuura M, et al (2014) Metastatic carcinoma of the uterine cervix from rectal carcinoma: a case report and review of the literature. Open Journal of Obstetrics and Gynecology 4:617–620Google Scholar
  9. 9.
    JK-PRACTITIONER JAN-MAR 2011 - jabt11i1p99.pdfGoogle Scholar
  10. 10.
    Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. 2004 Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350(23):2335–42.
  11. 11.
    Van Cutsem E, Köhne C-H, Láng I, Folprecht G, Nowacki MP, Cascinu S, et al. (2011) Cetuximab Plus Irinotecan, Fluorouracil, and leucovorin as first-Line treatment for metastatic colorectal cancer: updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol 29(15):2011–9. Available from: Accessed 23 Nov 2018
  12. 12.
    Chung KY, Shia J, Kemeny NE, Shah M, Schwartz GK, Tse A, et al. (2005) Cetuximab shows activity in colorectal cancer patients with tumors that do not express the epidermal growth factor receptor by immunohistochemistry. J Clin Oncol 23(9):1803–10. Available from: Accessed 23 Nov 2018
  13. 13.
    Rowland A, Dias MM, Wiese MD, Kichenadasse G, McKinnon RA, Karapetis CS, et al. 2015 Meta-analysis of BRAF mutation as a predictive biomarker of benefit from anti-EGFR monoclonal antibody therapy for RAS wild-type metastatic colorectal cancer. Br J Cancer 112(12):1888–94. Available from: Accessed 23 Nov 2018
  14. 14.
    Holch JW, Ricard I, Stintzing S, Modest DP, Heinemann V 2017 The relevance of primary tumour location in patients with metastatic colorectal cancer: a meta-analysis of first-line clinical trials. Eur J Cancer 70:87–98. Available from: Accessed 23 Nov 2018
  15. 15.
    Overman MJ, McDermott R, Leach JL, Lonardi S, Lenz H-J, Morse MA, et al. 2017 Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer (CheckMate 142): an open-label, multicentre, phase 2 study. Lancet Oncol 18(9):1182–91. Available from: Accessed 23 Nov 2018
  16. 16.
    Sartore-Bianchi A, Trusolino L, Martino C, Bencardino K, Lonardi S, Bergamo F, et al. 2016 Dual-targeted therapy with trastuzumab and lapatinib in treatment-refractory, KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (HERACLES): a proof-of-concept, multicentre, open-label, phase 2 trial. Lancet Oncol 17(6):738–46. Available from: Accessed 23 Nov 2018
  17. 17.
    Jia S, Zhang R, Li Z, Li J (2017) Clinical and biological significance of circulating tumor cells, circulating tumor DNA, and exosomes as biomarkers in colorectal cancer. Oncotarget 8(33):55632–45. Available from: Accessed 23 Nov 2018
  18. 18.
    Steinert G, Schölch S, Koch M, Weitz J (2012) Biology and significance of circulating and disseminated tumour cells in colorectal cancer. Langenbeck’s Arch Surg 397(4):535–42. Available from: Accessed 23 Nov 2018

Copyright information

© Indian Association of Surgical Oncology 2019

Authors and Affiliations

  1. 1.Department of Surgical OncologyJIPMERPuducherryIndia
  2. 2.Balco Cancer CentreRaipurIndia

Personalised recommendations