Concomitant Occurrence of Facial Cutaneous and Parotid Gland Metastases from Rectal Cancer after Preoperative Chemoradiotherapy

Publisher: Karger

E-ISSN: 2296-5262|30|6|324-326

ISSN: 2296-5270

Source: Oncology Research and Treatment, Vol.30, Iss.6, 2007-05, pp. : 324-326

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Abstract

Unusual sites of metastasis to the parotidgland and face are reported in patients with colorectalcancer, but the localization to both sites at the same timehas never been described so far. Case Report: Here, wedescribe the case of a 76-year-old woman with a T3N1M0G2 rectal adenocarcinoma, treated with preoperativechemoradiotherapy performed at suboptimal dosagesdue to unacceptable toxicity. At the end of the program,the re-staging demonstrated the presence of metastasisin both the left parotid gland and subcutaneously on thefrontal region of her face while the primary locoregionaltumour manifestation was radiologically down-staged(reduction in N staging from N1 to N0). The patient didnot respond to any other treatment and died due to diseaseprogression 15 months after the diagnosis. Conclusions:Metastatic tumours in the parotid gland are uncommonwith a higher incidence of primary sites of thehead and neck. Parotid involvement of rectal adenocarcinomais also extremely rare, and concomitant involvementof both the parotid gland and the face was not previouslydescribed. In this case, we cannot rule out thehypothesis that the delay of surgical removal of the primarytumour and/or a specific action of concomitantchemoradiotherapy on the tumour cell phenotype couldpromote cancer cell spreading to unusual sites.