Colorectal cancer (CRC) is one of the leading causes of death and comprises a considerable percentage of cases presented with metastases. Herein, we report 81 yr-old female patient who was admitted to our clinic due to persistent nausea and vomiting. She had an eight years-history of colorectal cancer, and she had undergone a right hemicolectomy and received adjuvant capecitabine treatment. An incisional hernia was palpated around the umbilicus and confirmed by abdominal CT (computed tomography). Whole-body PET (positron emission tomography) revealed FDG (fluorodeoxyglucose)-enhanced lesions in the lungs, pancreas, and small bowel, suggesting metastases. Colonoscopy did not reveal any recurrence. Biopsies obtained from the pancreas with endosonography diagnosed colorectal cancer metastasis. During hospitalisation she has been operated due to ileus and the obstructed jejunal segment was resected. Histopathological examiation confirmed intestinal metastasis of the colorectal cancer. In conclusion, pancreas and small bowel metastases are both rare phenomena individually. Ileus caused by intestinal metastasis is also exceptional. The coexistence of these rare metastases and lung metastases in CRC can be related to the unique biologic behavior of this tumor.
