The case was a 67-year-old male, who underwent right hemicolectomy+D3 LN resection for ascending colon cancer at the age of 47, and pathological diagnosis was tub1>tub2, T3, N0, M0, ly1, v1, Stage Ⅱa. 20 years after the first surgery, he visited our hospital for intermittent abdominal pain and abdominal fullness. CT scan showed stenosis and wall thickening at the anastomosis of the ileum and colon. When combining the detail examination by upper and lower gastrointestinal endoscopy and PET-CT scan, the tumor was clinically diagnosed asynchronous colon cancer, duodenal invasion. Partial resection of transverse colon and duodenal combined resection was performed. The pathological diagnosis was local recurrence of previous ascending colon cancer. Postoperative adjuvant chemotherapy was performed, but it was discontinued due to poor appetite. Currently, it has not recurred 7 months after the surgery. Recurrences more than 5 years after resection of colorectal cancer are rare, and reports of local recurrence are even rare. A long-term prognosis may be expected for early detection and treatment. Even if more than 5 years passed since the surgery, examination and treatment should be performed with recurrence in mind.

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