Abstract
Colon cancer rarely combines with abscess of the abdominal wall. We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy. A 58-year-old woman presented with a locally advanced right colon cancer with abdominal wall abscess and no evidence of distant metastasis. Extended right hemicolectomy was performed with en-bloc excision of the bladder dome, the right annex and full thickness removal of the anterior abdominal wall including the abscess. Abdominal wall repair was perfomed by a biological mesh (PermacolTMBiologic Implant) and to facilitate healing the patient was then treated with Vacuum-Assisted Closure (V.A.C.?) Therapy. Histology showed a mucinous moderately differentiated adenocarcinoma without nodal metastases (n = 57). Surgical margins including the abdominal wall was tumor free. The postoperative clinical course was uneventful. VA.C.? Therapy treatment reported excellent results in terms of active promotion of the granulation tissue, this allowing for a subsequent placement of a skin graft. Patient is alive and disease-free one year after surgery. The present case shows some peculiar characteristics such as the size of the initial lesion, the abdominal wall abscess and the use of innovative devices such as biological mesh and V.A.C.? Therapy. We demonstrate that extensive surgery for locally advanced colon cancer, in high-volume centers, provides favorable results in terms of survival and quality of life.
Highlights
IntroductionA subgroup of colorectal tumors that invade adjacent organs without distant metastases, account for 5% - 22% of all colorectal cancers [1]
Advanced colorectal cancers, a subgroup of colorectal tumors that invade adjacent organs without distant metastases, account for 5% - 22% of all colorectal cancers [1]
We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy
Summary
A subgroup of colorectal tumors that invade adjacent organs without distant metastases, account for 5% - 22% of all colorectal cancers [1]. Abscess formation is rare (0.3% - 4% of colonic cancers [2]); abscesses of the anterior abdominal wall as a complication of direct invasion and perforation of the colonic tumour have been described [2,3]. A radical excision was performed due to the high risks of an extensive surgery and prognosis is always poor. We here report a case of a patient with locally advanced right colon cancer and abdominal wall abscess, treated with “curative” surgery. The good final outcome was favoured by the integration of surgery with innovative medical devices such as a biological mesh and Vacuum-Assisted Closure (V.A.C.®) Therapy (KCI, San Antonio TX, USA)
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