A case of lateral pelvic lymph node recurrence after TME for submucosal rectal carcinoma successfully treated by lymph node dissection with en bloc resection of the internal iliac vessels.

In Japan, lateral lymph node dissection (LLND) is generally performed for the treatment of T3-4 lower rectal carcinoma, and not for T1 lower rectal carcinoma, because of a low positive rate in patients with T1 lesion. We experienced a rare case of lateral pelvic lymph node recurrence after total mesorectal resection for T1 lower rectal carcinoma, successfully treated by LLND with en bloc resection of the internal iliac vessels. There is no guideline for the treatment of patients with isolated lateral lymph node recurrence; however, surgery should be considered for such patients.