DOI: https://doi.org/10.36347/sasjs.2025.v11i12.003

Pages: 1084-1089

Introduction: Several factors determine the risk of developing metachronous colorectal cancer after primary cancer. Implying rigorous postoperative surveillance to detect a possible tumor early and propose curative treatment. Advances in the management of colorectal cancer have significantly reduced the risk of late recurrence and metachronous colorectal cancer. Prolonged surveillance beyond recommendations, with its constraints and healthcare costs, should be reserved for patients with risk factors. Case Report: In this article, we report the case of a patient who presented with late metachronous lowered colon cancer 32 years after the first rectal cancer. Discussion: The management of metachronous colorectal cancers is sometimes difficult in connection with re-operation in a scarred abdomen especially if there is a notion of previous irradiation; techniques currently under evaluation for intraoperative verification of colonic vascularization or lymph node extension could find their interest in the management of metachronous colorectal cancers in order to preserve the vascularization of the remaining colon and limit lymph node curage. Conclusion: The occurrence of recurrence and late metachronous colorectal cancer does not justify prolonged surveillance beyond recommendations in the absence of risk factors; and the management of metachronous colorectal cancer must take into account the operative difficulties and the need to preserve the vascularization of the remaining colon