We report an unusual case of recurrent colon cancer metastasizing to gastric regional lymph nodes. A 66-year-old man undergoing right hemicolectomy for advanced transverse colon cancer experienced bowel obstruction on May 19, 1989. In hospitalization after surgery, CEA gradually increased from May 1995, and a neoplastic lesion considered to a gastric submucosal tumor was recognized from January 1996. Follow-up showed that the lesion had enlarged, so we conducted surgery on November 19, 1996, based on a diagnosis of cancer recurrence after additional special examinations such as abdominal CT and angiography. In operative findings, a recurrent tumor was found in lymph node metastasis to gastric regional nodes classified to No. 4d and No. 6, and resected in distal gastrectomy. The patient was discharged without complications and is doing well with no evidence of recurrence 6 years and 7 months (79 months) after his second surgery. It is rare that recurrent foci of transverse colon cancer are found only in gastric regional lymph nodes more than 5 years after radical dissection, so we reported here with documentary consideration on its pathophysiology.
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