gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2025-35-5-100-111gastro-j-1690Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESСерия случаев метастазирования рака предстательной железы в брыжейку сигмовидной кишки у пациентов с первично-множественным ракомA Case Series of Prostate Cancer Metastases to the Sigmoid Mesocolon in Patients with Colorectal Cancerhttps://orcid.org/0000-0002-6386-9235НикишинаА. В.NikishinaA. V.

Никишина Анна Вячеславовна — студентка 5-го курса Клинического института детского здоровья им. Н.Ф. Филатова

119435, г. Москва, ул. Погодинская, 1, стр. 1

Anna V. Nikishina — Student, N.F. Filatov Clinical Institute of Children's Health

119435, Moscow, Pogodinskaya str., 1, build. 1

anna.nikishina.15@bk.ruhttps://orcid.org/0000-0002-8550-1909ИгнатовИ. С.IgnatovI. S.

Игнатов Иван Сергеевич — кандидат медицинских наук, ассистент кафедры хирургии Института клинической медицины им. Н.В. Склифосовского; врач-онколог, колопроктолог отделения онкологической колопроктологии Университетской клинической больницы № 2

119435, г. Москва, ул. Погодинская, 1, стр. 1

Ivan S. Ignatov — Cand. Sci. (Med.), Teaching Assistant at the Department of Surgery

119435, Moscow, Pogodinskaya str., 1, build. 1

ignatov.mac93@mail.ruhttps://orcid.org/0000-0002-7226-4641БалабанВ. В.BalabanV. V.

Балабан Владимир Владимирович — доктор медицинских наук, профессор кафедры хирургии Института клинической медицины им. Н.В. Склифосовского; заведующий отделением колопроктологии Университетской клинической больницы № 2

119435, г. Москва, ул. Погодинская, 1, стр. 1

Vladimir V. Balaban — Dr. Sci. (Med.), Professor at the Department of Surgery

119435, Moscow, Pogodinskaya str., 1, build. 1

balaban_v_v@staff.sechenov.ruhttps://orcid.org/0000-0002-4825-4830КретоваН. В.KretovaN. V.

Кретова Наталья Валерьевна — врач-патологоанатом научно-клинического центра, аналитик лаборатории молекулярной генетики заболеваний человека Института клинической морфологии и цифровой патологии

119435, г. Москва, ул. Погодинская, 1, стр. 1

Natalia V. Kretova — Pathologist of the Clinical Science Center, Analyst at  the  Laboratory  of  Molecular  Genetics of  Human  Diseases

119435, Moscow, Pogodinskaya str., 1, build. 1

prozector76@mail.ruhttps://orcid.org/0000-0002-6404-389XТулинаИ. А.TulinaI. A.

Тулина Инна Андреевна — кандидат медицинских наук, доцент кафедры хирургии Института клинической медицины им. Н.В. Склифосовского

119435, г. Москва, ул. Погодинская, 1, стр. 1

Inna A. Tulina —  Cand.  Sci.  (Med.),  Associate  Professor at the Department of Surgery, N.V. Sklifosovsky Institute of Clinical Medicine

119435, Moscow, Pogodinskaya str., 1, build. 1

inna.tulina@gmail.comhttps://orcid.org/0000-0002-9194-6744СтецюкА. Н.StetsyukA. N.

Стецюк Андрей Николаевич — врач-онколог онкологического отделения хирургических методов лечения Университетской клинической больницы № 1

119435, г. Москва, ул. Погодинская, 1, стр. 1

Andrey N. Stetsyuk — Oncologist at the Oncological Department of Surgical Treatment methods, University Clinic No. 1

119435, Moscow, Pogodinskaya str., 1, build. 1

drstetsyuk@mail.ruhttps://orcid.org/0000-0001-7070-5303ЛернерЮ. В.LernerYu. V.

Лернер Юлия Владимировна — ассистент Института клинической морфологии и цифровой патологии, врачпатологоанатом научно-клинического центра

119435, г. Москва, ул. Погодинская, 1, стр. 1

Yulia V. Lerner — Assistant, Institute of Clinical Morphology and Digital Pathology, Pathologist of the Clinical Science Center

119435, Moscow, Pogodinskaya str., 1, build. 1

julijalerner@inbox.ruhttps://orcid.org/0000-0002-7134-6821ЦарьковП. В.TsarkovP. V.

Царьков Петр Владимирович — доктор медицинских наук, профессор, заведующий кафедрой хирургии Института клинической медицины им. Н.В. Склифосовского; директор клиники колопроктологии и малоинвазивной хирургии

119435, г. Москва, ул. Погодинская, 1, стр. 1

Petr V. Tsarkov — Dr. Sci. (Med.), Professor, Head of the Department of Surgery, N.V. Sklifosovsky Institute of Clinical Medicine; Head of the Clinic of Coloproctology and Minimally Invasive Surgery

119435, Moscow, Pogodinskaya str., 1, build. 1

tsarkovpetr@gmail.comФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202530112025355100111Copyright © Никишина А.В., Игнатов И.С., Балабан В.В., Кретова Н.В., Тулина И.А., Стецюк А.Н., Лернер Ю.В., Царьков П.В., 20252025Никишина А.В., Игнатов И.С., Балабан В.В., Кретова Н.В., Тулина И.А., Стецюк А.Н., Лернер Ю.В., Царьков П.В.Nikishina A.V., Ignatov I.S., Balaban V.V., Kretova N.V., Tulina I.A., Stetsyuk A.N., Lerner Y.V., Tsarkov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1690

В данной статье представлены три редких клинических случая метастазирования рака предстательной железы в лимфатические узлы брыжейки сигмовидной кишки у пациентов с первично-множественным раком предстательной железы и сигмовидной кишки. Нам удалось найти описания всего трех подобных случаев в мировой литературе. Во всех случаях источник метастазирования был подтвержден с помощью иммуногистохимического исследования: была выявлена экспрессия биомаркеров предстательной железы и отсутствие экспрессии маркеров кишечной аденокарциномы. Кроме того, нами описан случай так называемого феномена «столкновения» (collision phenomenon) в одном из лимфоузлов. Обнаружение метастазов рака предстательной железы в брыжейке толстой кишки демонстрирует взаимосвязь лимфатических коллекторов толстой кишки и предстательной железы. Таким образом, важно проводить тщательное патоморфологическое исследование хирургического препарата, а в неоднозначных случаях показано проведение иммуногистохимических реакций для точной диагностики и планирования лечения. Необходимы дальнейшие исследования взаимосвязи путей лимфооттока от простаты и дистальных отделов толстой кишки.

This article presents three rare clinical cases of prostate cancer metastasis to the mesosigmoid lymph nodes in patients with primary multiple prostate and sigmoid colon cancer. We were able to find descriptions of only three similar cases in international literature. In all cases, the source of metastasis was confirmed by immunohistochemistry: expression of prostate biomarkers and the absence of expression of intestinal adenocarcinoma markers were detected. Furthermore, we describe a case of the so-called “collision phenomenon” in one of the lymph nodes. The detection of prostate cancer metastases to the mesocolic region demonstrates the interconnection between the lymphatic collectors of the colon and the prostate gland. Therefore, it is important to conduct a thorough pathological examination of the surgical specimen, and in ambiguous cases, immunohistochemistry is indicated for accurate diagnosis and treatment planning. Further studies are needed to investigate the relationship between lymphatic drainage pathways from the prostate and distal colon.

феномен коллизииколоректальный ракрак предстательной железыпервично-множественный ракcollision phenomenoncolorectal cancerprostate cancermultiple primary cancerReferencesBray F., Laversanne M., Sung H., Ferlay J., Siegel R.L., Soerjomataram I., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63. DOI: 10.3322/caac.21834Bray F., Laversanne M., Sung H., Ferlay J., Siegel R.L., Soerjomataram I., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63. DOI: 10.3322/caac.21834Sidiqi B.U., Nosrati J.D., Wu V., Kobritz M., La Gamma N., Whelan R.L., et al. The prevalence and management of synchronous prostate and rectal cancer. Int J Radiation Oncol Biol Phys. 2023;117(2):e339. DOI: 10.1016/j.ijrobp.2023.06.2398Sidiqi B.U., Nosrati J.D., Wu V., Kobritz M., La Gamma N., Whelan R.L., et al. The prevalence and management of synchronous prostate and rectal cancer. Int J Radiation Oncol Biol Phys. 2023;117(2):e339. DOI: 10.1016/j.ijrobp.2023.06.2398Lakkis Z., Vernerey D., Mege D., Faucheron J.L., Panis Y., Tuech J.J., et al.; French Research Group of Rectal Cancer Surgery (GRECCAR). Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy. Br J Surg. 2019;106(8):1087–98. DOI: 10.1002/bjs.11176Lakkis Z., Vernerey D., Mege D., Faucheron J.L., Panis Y., Tuech J.J., et al.; French Research Group of Rectal Cancer Surgery (GRECCAR). Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy. Br J Surg. 2019;106(8):1087–98. DOI: 10.1002/bjs.11176Guandalino M., Dupré A., François M., Leroy B., Antomarchi O., Buc E., et al. Previous radiation for prostate neoplasm alters surgical and oncologic outcomes after rectal cancer surgery. J Surg Oncol. 2015;112(8):802–8. DOI: 10.1002/jso.24075Guandalino M., Dupré A., François M., Leroy B., Antomarchi O., Buc E., et al. Previous radiation for prostate neoplasm alters surgical and oncologic outcomes after rectal cancer surgery. J Surg Oncol. 2015;112(8):802–8. DOI: 10.1002/jso.24075Buscail E., Blondeau V., Adam J.P., Pontallier A., Laurent C., Rullier E., et al. Surgery for rectal cancer after high-dose radiotherapy for prostate cancer: Is sphincter preservation relevant? Colorectal Dis. 2015;17(11):973–9. DOI: 10.1111/codi.12962Buscail E., Blondeau V., Adam J.P., Pontallier A., Laurent C., Rullier E., et al. Surgery for rectal cancer after high-dose radiotherapy for prostate cancer: Is sphincter preservation relevant? Colorectal Dis. 2015;17(11):973–9. DOI: 10.1111/codi.12962Gandaglia G., Abdollah F., Schiffmann J., Trudeau V., Shariat S.F., Kim S.P., et al. Distribution of me tastatic sites in patients with prostate cancer: A population-based analysis. Prostate. 2014;74(2):210–6. DOI: 10.1002/pros.22742Gandaglia G., Abdollah F., Schiffmann J., Trudeau V., Shariat S.F., Kim S.P., et al. Distribution of me tastatic sites in patients with prostate cancer: A population-based analysis. Prostate. 2014;74(2):210–6. DOI: 10.1002/pros.22742Swanson G.P., Hubbard J.K. A better understanding of lymphatic drainage of the prostate with modern imaging and surgical techniques. Clin Genitourin Cancer. 2013;11(4):431–40. DOI: 10.1016/j.clgc.2013.04.031Swanson G.P., Hubbard J.K. A better understanding of lymphatic drainage of the prostate with modern imaging and surgical techniques. Clin Genitourin Cancer. 2013;11(4):431–40. DOI: 10.1016/j.clgc.2013.04.031Morgan A.D. Carcinomas of rectum and prostate metastasising of the same lymph-nodes. J Pathol. 1969;97(1):143– 5. DOI: 10.1002/path.1710970119Morgan A.D. Carcinomas of rectum and prostate metastasising of the same lymph-nodes. J Pathol. 1969;97(1):143– 5. DOI: 10.1002/path.1710970119Wade Z.K., Shippey J.E., Hamon G.A., Smoak R.L., Argani P., Allsbrook W.C. Jr. Collision metastasis of prostatic and colonic adenocarcinoma: Report of 2 cases. Arch Pathol Lab Med. 2004;128(3):318–20. DOI: 10.5858/2004-128-318-CMOPACWade Z.K., Shippey J.E., Hamon G.A., Smoak R.L., Argani P., Allsbrook W.C. Jr. Collision metastasis of prostatic and colonic adenocarcinoma: Report of 2 cases. Arch Pathol Lab Med. 2004;128(3):318–20. DOI: 10.5858/2004-128-318-CMOPACMurray S.K., Breau R.H., Guha A.K., Gupta R. Spread of prostate carcinoma to the perirectal lymph node basin: Analysis of 112 rectal resections over a 10-year span for primary rectal adenocarcinoma. Am J Surg Pathol. 2004;28(9):1154–62. DOI: 10.1097/01.pas.0000131543.80147.3dMurray S.K., Breau R.H., Guha A.K., Gupta R. Spread of prostate carcinoma to the perirectal lymph node basin: Analysis of 112 rectal resections over a 10-year span for primary rectal adenocarcinoma. Am J Surg Pathol. 2004;28(9):1154–62. DOI: 10.1097/01.pas.0000131543.80147.3dMourra N., Parc Y., McNamara D., Tiret E., Flejou J.F., Parc R. Lymph node metastases of prostatic adenocarcinoma in the mesorectum in patients with adenocarcinoma or villous tumor of the rectum with collision phenomenon in a single lymph node: Report of five cases. Dis Colon Rectum. 2005;48(2):384–9. DOI: 10.1007/s10350-004-0776-8Mourra N., Parc Y., McNamara D., Tiret E., Flejou J.F., Parc R. Lymph node metastases of prostatic adenocarcinoma in the mesorectum in patients with adenocarcinoma or villous tumor of the rectum with collision phenomenon in a single lymph node: Report of five cases. Dis Colon Rectum. 2005;48(2):384–9. DOI: 10.1007/s10350-004-0776-8Park I.J., Kim H.C., Yu C.S., Kim C.S., Kim J.S., Kim J.C. Lymph node metastases of prostatic adenocarcinoma in the mesorectum in patients with rectal cancer. Cancer Res Treat. 2005;37(2):129–32. DOI: 10.4143/crt.2005.37.2.129Park I.J., Kim H.C., Yu C.S., Kim C.S., Kim J.S., Kim J.C. Lymph node metastases of prostatic adenocarcinoma in the mesorectum in patients with rectal cancer. Cancer Res Treat. 2005;37(2):129–32. DOI: 10.4143/crt.2005.37.2.129Miyauchi J., Asahara F., Matsui J. Collision lymph node metastasis of rectal and prostate adenocarcinomas. Pathol Int. 2013;63(8):425–7. DOI: 10.1111/pin.12084Miyauchi J., Asahara F., Matsui J. Collision lymph node metastasis of rectal and prostate adenocarcinomas. Pathol Int. 2013;63(8):425–7. DOI: 10.1111/pin.12084Arenal J.J., Torres A., Tinoco C., Citores M.A., Benito C., Madrigal B., et al. Metastasization of mesorectal lymph nodes by a prostatic adenocarcinoma. Hum Path: Case Reports. 2015;2(2):42–4. DOI: 10.1016/j.ehpc.2014.11.010Arenal J.J., Torres A., Tinoco C., Citores M.A., Benito C., Madrigal B., et al. Metastasization of mesorectal lymph nodes by a prostatic adenocarcinoma. Hum Path: Case Reports. 2015;2(2):42–4. DOI: 10.1016/j.ehpc.2014.11.010Asahara F., Hasegawa H., Suda S., Bekku E., Hashimoto K., Sasaki A., et al. Two cases of colorectal cancer with mesenteric lymph node metastasis derived from prostatic cancer. Jpn J Gastroenterol Surg. 2020;53(1):61–8. (In Japanese). DOI: 10.5833/jjgs.2019.0014Asahara F., Hasegawa H., Suda S., Bekku E., Hashimoto K., Sasaki A., et al. Two cases of colorectal cancer with mesenteric lymph node metastasis derived from prostatic cancer. Jpn J Gastroenterol Surg. 2020;53(1):61–8. (In Japanese). DOI: 10.5833/jjgs.2019.0014Ichihara A., Ikeda T., Nagatomo K., Nanashima A., Terada N., Nakamura E. A case of rectal carcinoma with synchronous neuroendocrine differentiated prostate carcinoma that spread to the mesorectal lymph node. Jpn J Gastroenterol Surg. 2020;53(10):817–25. (In Japanese). DOI: 10.5833/jjgs.2019.0088Ichihara A., Ikeda T., Nagatomo K., Nanashima A., Terada N., Nakamura E. A case of rectal carcinoma with synchronous neuroendocrine differentiated prostate carcinoma that spread to the mesorectal lymph node. Jpn J Gastroenterol Surg. 2020;53(10):817–25. (In Japanese). DOI: 10.5833/jjgs.2019.0088Udagawa T., Suzuki Y., Ito Y., Tamate Y., Yanagawa N., Kamei T. A case of rectal cancer with lymph node metastasis of prostate cancer in the mesorectum after radical prostatectomy. Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2022;83(4):775– 9. (In Japanese). DOI: 10.3919/jjsa.83.775Udagawa T., Suzuki Y., Ito Y., Tamate Y., Yanagawa N., Kamei T. A case of rectal cancer with lymph node metastasis of prostate cancer in the mesorectum after radical prostatectomy. Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2022;83(4):775– 9. (In Japanese). DOI: 10.3919/jjsa.83.775Kato D., Kitamura C., Yamada J. A case of prostate cancer diagnosed by the discovery of pararectal lymph node metastases during sigmoid colon cancer surgery. Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2023;84(9):1515–9. (In Japanese). DOI: 10.3919/jjsa.84.1515Kato D., Kitamura C., Yamada J. A case of prostate cancer diagnosed by the discovery of pararectal lymph node metastases during sigmoid colon cancer surgery. Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2023;84(9):1515–9. (In Japanese). DOI: 10.3919/jjsa.84.1515Mino M., Sumitani D., Hashimoto K., Yoshida S., Ooka N., Shishida M., et al. Incidentally found abdominal para-aortic and inferior mesenteric root lymph node metastases of prostatic adenocarcinoma in a surgical case with sigmoid colon cancer. Hiroshima J Med Sci. 2021;70(1):23–6. DOI: 10.24811/hjms.70.1_23Mino M., Sumitani D., Hashimoto K., Yoshida S., Ooka N., Shishida M., et al. Incidentally found abdominal para-aortic and inferior mesenteric root lymph node metastases of prostatic adenocarcinoma in a surgical case with sigmoid colon cancer. Hiroshima J Med Sci. 2021;70(1):23–6. DOI: 10.24811/hjms.70.1_23Boscolo-Berto R., Siracusano S., Porzionato A., Polguj M., Porcaro A.B., Stecco C., et al. The underestimated posterior lymphatic drainage of the prostate: A historical overview and preliminary anatomical study on cadaver. Prostate. 2020;80(2):153–61. DOI: 10.1002/pros.23927Boscolo-Berto R., Siracusano S., Porzionato A., Polguj M., Porcaro A.B., Stecco C., et al. The underestimated posterior lymphatic drainage of the prostate: A historical overview and preliminary anatomical study on cadaver. Prostate. 2020;80(2):153–61. DOI: 10.1002/pros.23927Terris M.K., Wren S.M. Results of a screening program for prostate cancer in patients scheduled for abdominoperineal resection for colorectal pathologic findings. Urology. 2001;57(5):943–5. DOI: 10.1016/s0090-4295(01)00943-8Terris M.K., Wren S.M. Results of a screening program for prostate cancer in patients scheduled for abdominoperineal resection for colorectal pathologic findings. Urology. 2001;57(5):943–5. DOI: 10.1016/s0090-4295(01)00943-8Mattioli F., Masoni F., Ponti G., Rossi G., Molteni G., Alicandri-Ciufelli M., et al. “Collision” metastasis from unknown primary squamous cell carcinoma and papillary microcarcinoma of thyroid presenting as lateral cervical cystic mass. Auris Nasus Larynx. 2009;36(3):372–5. DOI: 10.1016/j.anl.2008.04.015Mattioli F., Masoni F., Ponti G., Rossi G., Molteni G., Alicandri-Ciufelli M., et al. “Collision” metastasis from unknown primary squamous cell carcinoma and papillary microcarcinoma of thyroid presenting as lateral cervical cystic mass. Auris Nasus Larynx. 2009;36(3):372–5. DOI: 10.1016/j.anl.2008.04.015

The authors declare that there are no conflicts of interest present.