A CASE OF COLONIC CANCER ASSOCIATED WITH COLONIC TUBERCULOSIS

Abstract

A 74-year-old woman was seen at the hospital because of a right lower abdominal pain. Barium enema revealed a narrowing of the hepatic flexure and remarkable shortenig with pseudo diverticula formation of the ascending colon. Colonoscopy demonstrated a whole circumferential stricture in the hepatic flexure and old inflammation in the anal side area from the stricture. Since an biopsy yielded moderated differentiated adenocarcinoma, right hemicolectomy was performed. The resected specimen showed that the tumor was categorized as carcinoma of Borrmann 2 type. A few the scarred area with discoloration was observed in the shortened ascending colon, and so we recognized this change as the old colonic tuberculosis. This case and 51 cases of colonic tuberculosis with a colonic cancer seen in the Japanese literature were reviewed. It took about 30 years to develop colonic cancer in the cases which actually had a previous history of tuberculosis. The causal relation between colonic tuberculosis and colonic cancer is not indisputably interpretated. But it is assessed that colonic cancer affected with tuberculosis may be exist, because macroscopically atypical carcinoma type was frequently observed and “dysplasia” around the cancer was revealed in about 19% of all cases.