Thanks to Dr. Nandita Sriram for presenting an interesting case of atypical metastatic colorectal cancer to bone and lung.

Learning Points:

– Colorectal cancer most commonly metastasizes to lung and liver, but may also metastasize to bone. When this occurs, it often presents as a mixed osteoblastic and osteolytic lesion on imaging.

– Follow up of treated colorectal cancer involves serial CEA measurements (q3-6 months for 2-3 years), annual CT of C/A/P for 3 years, and surveillance colonoscopies at year 1, year 3, then q5 years.

– Appropriate surveillance may drastically improve mortality rates of recurrent cancers, as seen in this link to the NCI’s Surveillance, Epidemiology, and End Result (SEER) program: SEER