Advanced Colorectal Diverticulosis Cancer with Intestinal Obstruction：A Case Report

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  • 進行大腸憩室癌により腸閉塞を呈した1例
  • シンコウ ダイチョウ ケイシツガン ニ ヨリ チョウ ヘイソク オ テイシタ 1レイ

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Abstract

<p>A 58-year-old man visited our hospital because of abdominal pain. Abdominal computed tomography showed an approximately 5-cm tumor near the ileocecal region with intestinal obstruction. Therefore, ileocecal resection was performed. Gross examination of the surgical specimen revealed no evidence of a mucosal tumor; however, microscopic examination revealed a moderately differentiated adenocarcinoma in the colonic wall, involving a diverticulum, which was considered as the site of origin of the cancer. The patient died 1 year later of liver and lung metastases. Colorectal cancer arising in a diverticulum is rare. Our review of 32 reported cases of such cancers revealed that they are rarely diagnosed preoperatively. Over half of these patients present with acute abdominal symptoms, such as abdominal pain and melena, and almost all are treated surgically. Many of the tumors are single, located in the left colon, originate from pseudodiverticula, and are surrounded by an inflammatory reaction. Despite frequently being small at presentation, the tumors are characteristically advanced by the time of diagnosis.</p>

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