{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:22:59Z","timestamp":1775737379555,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n General de Investigaciones de la Universidad Santiago de Cali","award":["DGI-01-2025"],"award-info":[{"award-number":["DGI-01-2025"]}]},{"name":"Direcci\u00f3n General de Investigaciones de la Universidad Santiago de Cali","award":["DGI-445-621124-760"],"award-info":[{"award-number":["DGI-445-621124-760"]}]},{"name":"Fortalecimiento de grupo GISI","award":["DGI-01-2025"],"award-info":[{"award-number":["DGI-01-2025"]}]},{"name":"Fortalecimiento de grupo GISI","award":["DGI-445-621124-760"],"award-info":[{"award-number":["DGI-445-621124-760"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background and Objective: Colorectal cancer (CRC) most commonly metastasizes to the liver and lungs; however, synchronous metastases to pelvic structures such as the vagina and urethra are extremely rare, posing a significant diagnostic and therapeutic challenge. This report describes an unusual case of sigmoid colon adenocarcinoma with synchronous metastases to the vagina and urethra, highlighting its diagnostic evaluation and the value of a multidisciplinary approach. Methods: A 59-year-old woman with a history of deep vein thrombosis treated with apixaban presented with chronic constipation and pelvic bleeding. A gynecological evaluation revealed a vaginal lesion. A colonoscopy, biopsy, pelvic magnetic resonance imaging, and molecular profiling were performed. Treatment included chemotherapy (capecitabine and oxaliplatin), panitumumab, and pelvic radiotherapy. Results: The biopsy confirmed a moderately differentiated invasive adenocarcinoma in the sigmoid colon with synchronous metastases to the vagina and urethra. Molecular profiling identified a rat sarcoma virus oncogene and BRAF (B-Raf proto-oncogene), allowing for the use of targeted therapy. The patient achieved a complete response according to RECIST 1.1 criteria and significant symptomatic improvement, including pain reduction, although dosages were adjusted for thrombocytopenia. She is currently continuing palliative treatment with good tolerance and durable symptomatic improvement. Conclusions: This case underscores the need to consider unusual metastatic sites in patients with colorectal cancer presenting with gynecological symptoms. Early diagnosis, based on imaging and histology, alongside molecular characterization, is crucial for effective personalized therapy. Multidisciplinary coordination is key to optimizing clinical outcomes in these rare metastatic presentations.<\/jats:p>","DOI":"10.3390\/diseases13080251","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:09:35Z","timestamp":1754640575000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An Uncharted Path of Metastasis: A Case Report of Sigmoid Colon Cancer with Synchronous Vaginal and Urethral Spread"],"prefix":"10.3390","volume":"13","author":[{"given":"John Fernando","family":"Montenegro","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Gen\u00e9tica, Fisiolog\u00eda y Metabolismo (GEFIME), Ciencias de la Salud Universidad Santiago de Cali, Cali 760035, Colombia"},{"name":"Programa de Especializaci\u00f3n en Medicina Interna, Facultad de Salud, Universidad Santiago de Cali, Cali 5183000, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna Patricia","family":"Rivas Tafur","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Gen\u00e9tica, Fisiolog\u00eda y Metabolismo (GEFIME), Ciencias de la Salud Universidad Santiago de Cali, Cali 760035, Colombia"},{"name":"Programa de Especializaci\u00f3n en Medicina Interna, Facultad de Salud, Universidad Santiago de Cali, Cali 5183000, Colombia"},{"name":"Departamento de Investigaci\u00f3n y Educaci\u00f3n, Cl\u00ednica de Occidente S.A., Cali 760046, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Diaz","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Fernando","family":"Alzate","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Camila","family":"Faria","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Florez","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Andr\u00e9s","family":"Acu\u00f1a","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Eduardo","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2674-8725","authenticated-orcid":false,"given":"Yamil","family":"Liscano","sequence":"additional","affiliation":[{"name":"Programa de Especializaci\u00f3n en Medicina Interna, Facultad de Salud, Universidad Santiago de Cali, Cali 5183000, Colombia"},{"name":"Departamento de Salud, Facultad de Medicina, Universidad Santiago de Cali, Cali 760035, Colombia"},{"name":"Grupo de Investigaci\u00f3n en Salud Integral (GISI), Departamento Facultad de Salud, Universidad Santiago de Cali, Cali 760035, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.4103\/jmas.JMAS_182_18","article-title":"A Case of Vaginal Recurrence Following Laparoscopic Left-Sided Colon Cancer Resection Combined with Transvaginal Specimen Extraction","volume":"15","author":"Cicek","year":"2019","journal-title":"J. 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