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Session: ePoster Monitor 4-Other Neoplasia and Endoscopy 1

eP176 - Excision of Metachronous Oligometastatic Prostate Cancer Recurrence to Rectum Using Transanal Minimally Invasive Surgery Technique: A Case Report

Sunday, June 2, 2024
9:36 AM – 9:41 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Loree Beth Thornton, MD

    PGY-4 General Surgery
    University of South Alabama
    University of South Alabama
    Mobile, AL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • LG

    Leander Grimm, Jr., MD, FACS, FASCRS

    Professor of Surgery
    University of South Alabama
    Mobile, Alabama, United States

    Disclosure information not submitted.

Purpose/Background: Prostate Cancer has the potential to spread anywhere in the body; however, it will most often spread to lymph nodes and bone. Less common locations for metastatic spread are the lungs and liver. We present an unusual case of oligometastatic recurrence of prostate cancer to the rectum treated with complete surgical excision using the transanal minimally invasive surgery (TAMIS) technique.Methods/Interventions: A 75-year-old male with history of prostate cancer treated via prostatectomy in 2016 was referred to our clinic for an isolated rectal mass. During routine prostate cancer surveillance, there was noted to be an increase in PSA. PET scan showed only a mass within the rectum. Colonoscopy revealed 3 cm mass in the mid rectum. Biopsies were positive for invasive prostate cancer. MRI showed mass was isolated to rectum without extension to the other structures, including the prostate bed and seminal vesicles. Rigid proctoscopy demonstrated it was 7cm from anal verge, anteriorly located, and mobile. After multidisciplinary tumor board discussion, the patient underwent TAMIS for full resection of cancer deposit.Results/Outcomes: Utilizing TAMIS technique, we were able to obtain R0 resection of solitary prostate cancer metastases.Conclusion/

Discussion: Oligometastatic recurrence of prostate cancer to the rectum is exceptionally rare. Solitary cancer to the rectum can be confused for primary rectal cancer and it is important to obtain accurate biopsies. While treatment options for metastatic prostate cancer are evolving, they are mostly androgen deprivation or radiation based and surgical treatment is largely palliative. In this case, we were able to utilize the TAMIS technique to safely obtain R0 resection with preservation of rectum."Axial T2 MRI

Figure 4: Axial T2 MRI of isolated rectal mass
Axial Axumin PET scan

Figure 1: Axial Axumin PET highlighting isolated rectal Pathology staining: Prostate CA

Figure 6: Pathology staining of mass. Positive for NKX3.1, CK7, AE1/AE3; negative for TTF1, CDX2, CK20, P40, synaptophysin and PSA
MRI T2 axial

Figure 2: Axial T1 MRI of isolated rectal mass"