Abdomino-Perineal Recto- Sigmoidectomy with Pelvic and Para-Aortic Lymph Node Dissection for Synchronous Anal and Rectal Tumor.

Colorectal cancer represents the third most encountered malignancy worldwide and the third cause of death in United States of America. A special subgroup is represented by the patients presenting an association of a colic tumor and intraluminal colo-rectal metastases. In these cases the distal tumor is believed to be rather a distant metastasis originating from the proximal one. Another significant mechanism which can lead to the apparition of synchronous tumors is related to the possibility of lymphatic dissemination, which is supported by the presence of positive lymph-nodes surrounding of the most important blood vessels collectors such as the inferior mesenteric vein. We present the case of a 67 year old patient diagnosed with synchronous sigmoidian and inferior rectal tumor associated with enlarged para-aortic lymph nodes in whom we performed an abdomino-perineal rectosigmoidectomy with pelvic and para-aortic lymph node dissection.