Background/Aim: Stomal metastases from a primary rectal adenocarcinoma are rare, therefore, clear guidelines on treatment options are limited. We performed a systematic review including a case report on this subject with the primary objective of identifying the total number of cases in the literature. The secondary objective was to assess median survival. Materials and Methods: A 59-year-old woman presented to our institution with anal incontinence to mucus leakage. Flexible sigmoidoscopy identified a carpet adenoma from the dentate line to the rectosigmoid junction. An abdomino-perineal resection (APR) was performed using the transanal total mesorectal excision technique (TaTME). No adjuvant chemotherapy was offered. Twenty-one months following the operation a stomal recurrence was identified. Palliative radiotherapy was commenced and the patient is alive 6 months later with no visible recurrence at the site of the stoma. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results: The systematic review identified 19 individual cases of either metachronous or true metastatic recurrence, including our own case. Median survival was 30 months in the 8 cases where further treatment was offered and accepted. Conclusion: Stomal metastases or metachronous colorectal cancer is uncommon. The causes for this pattern of spread are not clear. Long-term survival from cutaneous recurrence is generally poor. For carefully selected patients, redo surgery is an option with satisfactory results.

中文翻译：

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根治性直肠癌手术后结直肠癌皮肤造口复发——病例报告及系统评价

背景/目的：原发性直肠腺癌的造口转移是罕见的，因此，关于治疗选择的明确指南是有限的。我们进行了系统评价，包括关于该主题的病例报告，主要目的是确定文献中的病例总数。次要目标是评估中位生存期。材料和方法：一名 59 岁的女性因粘液渗漏导致肛门失禁就诊于我们的机构。柔性乙状结肠镜检查发现从齿状线到直肠乙状结肠交界处的地毯状腺瘤。使用经肛门全直肠系膜切除术 (TaTME) 进行腹会阴切除术 (APR)。没有提供辅助化疗。术后 21 个月发现造口复发。开始姑息性放射治疗，6 个月后患者存活，造口部位没有明显复发。根据系统评价和元分析 (PRISMA) 指南的首选报告项目进行了系统评价。结果：系统评价确定了 19 例异时性或真正转移性复发的个体病例，包括我们自己的病例。在提供和接受进一步治疗的 8 例中，中位生存期为 30 个月。结论：造口转移或异时性结直肠癌并不常见。这种传播模式的原因尚不清楚。皮肤复发的长期存活率通常很差。对于精心挑选的患者，重做手术是一种效果令人满意的选择。