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CASE REPORT article

Front. Med.

Sec. Gastroenterology

Case Report: A Rare Solitary Peroneus Longus Metastasis from Rectal Cancer Managed with Multimodal Therapy

  • Jiujiang City Key Laboratory of Cell Therapy, Jujiang, China

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Abstract

Solitary skeletal muscle metastasis from rectal cancer is exceptionally rare and carries a generally poor prognosis, with no established treatment guidelines currently available. We present a case of a patient with advanced rectal cancer (T3cN2bM0) who refused recommended neoadjuvant chemoradiotherapy and underwent laparoscopic radical resection alone. Subsequently, the patient developed an isolated metastasis to the left peroneus longus muscle merely three months postoperatively. The metastasis presented as a painful mass, and 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) revealed its hypermetabolic nature, suggesting malignancy. This suspicion was confirmed histopathological, establishing the diagnosis of skeletal muscle metastasis from rectal adenocarcinoma. Following a combined treatment of surgical resection and systemic chemotherapy, the patient remarkably remained free of local recurrence or further metastasis throughout a 30-month follow-up period. This case underscores the importance of clinical alertness for rare skeletal muscle metastases and highlights that individualized treatment is essential for improving patient prognosis.

Summary

Keywords

case report, Disease-Free Survival, multimodal therapy, rectal cancer, Solitary peroneus longus metastasis

Received

12 November 2025

Accepted

16 February 2026

Copyright

© 2026 Liao and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Junjun Yan

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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