Sites of Metastases From Carcinoma of the Anus, Rectum and Sigmoid Colon

Except for a few individual reports, comparatively little has been written on the occurrence of metastases from malignant growths in the lower portion of the large bowel. For this reason, in order to discuss this subject on a factual basis, we have reviewed the records from the radiologic department of the Philadelphia General Hospital for the ten year period ending with 1936. In 318, or 77.7 per cent, of a series of 409 cases of malignant process of the large bowel in which there was metastasis to one or more organs, as evidenced by biopsy, celiotomy, roentgenograms or necropsy, the primary site was in the anus, rectum or sigmoid colon. This confirms the observations of Larson and Nordland,1Heyd2and Rankin3that metastasis is encountered more frequently with malignant growths in these parts than with such growths in the upper portion of the large bowel. In our