A case of local recurrence of rectal carcinoma 10 years after initial surgery

Here, we report an extremely rare case of local recurrence of rectal cancer 10 years after initial tumor resection. A 53-year-old man underwent abdominoperineal resection for advanced rectal cancer at a local hospital. The tumor was graded as pStage II (pA, pN0, pH0, pP0, pM0, curA) as per the Japanese Classification of Colorectal Carcinoma, seventh edition, and diagnosed as a moderately differentiated adenocarcinoma on histopathological examination. Subsequently, the patient received adjuvant chemotherapy for 5 years. Although the patient lived without any recurrences after adjuvant chemotherapy, unfortunately, blood examination showed a high carcinoembryonic antigen (CEA) level 10 years after the initial surgical treatment. Computed tomography (CT) and positron emission tomography (PET)/CT revealed a perineal tumor, 40 mm in size, without other distant metastases. On diagnosis of local recurrence of rectal cancer, the patient underwent surgical tumor resection at Okayama University Hospital. The tumor was determined to be a well- to moderately differentiated adenocarcinoma by histopathological examination, suggesting local recurrence of the primary rectal adenocarcinoma. Moreover, the radial margin was free of cancer. The patient is now doing well without any re-recurrence 30 months after the second surgical treatment, without any adjuvant chemotherapy.