Metastatic Disease and Contiguous Spread

Metastases can affect the colon by contiguous spread, lymphatic spread, intraperitoneal seeding, along mesenteric fascial planes, or embolus through the blood circulation. Metastases usually cannot be differentiated from primary tumors on imaging. The involved area will show narrowing, serosal plaques, bowel wall thickening, spiculation, separation of folds, and angulations.