A 79-year-old man undergoing a right hemicolectomy for ascending colon cancer in August 1992, of which histopathological diagnosis was mucinous carcinoma, had been followed in the clinic after oneyear oral administration of anti-cancer drugs.
He had been recurrence free for ten years, until he developed diarrhea and body weight loss in November 2002. The level of serum CEA was elevated markedly. Upper gastrointestinal endoscopy and total colonoscopic findings showed no recurrence or other primary lesions. Chest and abdominal CT scans showed lymph nodes swelling at the para-aorta and mediastinal space. Fine needle aspiration biopsy (FNAB) of the supraclaviclar lymph node swelling showed class V. Because ductal formation and mucinous component were found out in the biopsied specimen, recurrence of the colon carcinoma was diagnosed.
Systemic chemotherapy was started in December 2002, but it was not effective. The patient died of cachexia in May 2003.
It is rare that for advanced colon cancer recurs after a long cancer-free period following an absolute curative surgery, and such a case has not been reported in the literature. This paper presents the case with bibliographical comments.