Abstract
Background: Pulmonary metastases from colorectal cancer (CRC) present a complex therapeutic challenge. Robotic-assisted thoracic surgery (RATS) is increasingly utilized for its precision and minimally invasive advantages. Case presentation:We report the case of a 55-year-old male diagnosed with T1N0M0 rectal adenocarcinoma, who underwent abdominoperineal resection without adjuvant chemotherapy. Fourteen months later, positron emission tomography-computed tomography (PET-CT) identified bilateral pulmonary metastases. A robotic-assisted wedge resection of the right upper lobe nodule was performed at the Thoracic Surgery Department of GHRMSA "Emile Muller", Mulhouse, France. Lymphadenectomy was not conducted, which was consistent with current evidence suggesting limited benefit in CRC metastases. The patient's overall survival was 18 months from the initial diagnosis to the first metastasectomy. Conclusion:Robotic-assisted metastasectomy offers a safe, precise and efficient option for managing pulmonary metastases from CRC. This case highlights the role of molecular profiling in prognostication and the evolving surgical approaches in metastatic CRC.