Colon Cancer Perforation Research Articles

Retroperitoneal Perforation of Colon Cancer, A Rare Cause of Diagnostic Wandering, about A Case and Literature Review

Retroperitoneal Perforation of Colon Cancer, A Rare Cause of Diagnostic Wandering, about A Case and Literature Review

Absceso del psoas ilíaco secundario a un tumor de colon izquierdo fistulizado al retroperitoneo.

Los abscesos del psoas ilíaco secundarios a un tumor de colon fistulizado son excepcionales y potencialmente graves. La mayoría son adenocarcinomas de tipo mucinoso. Su tratamiento es complejo ya que, para lograr una resección oncológica pretendidamente curativa, es necesario realizar una resección ampliada con mayor morbimortalidad. Presentamos el caso de una paciente con un adenocarcinoma mucinoso de colon izquierdo fistulizado al músculo ilíaco y la pared anterolateral del abdomen en la que se realizó una resección multivisceral que incluyó el colon izquierdo, el músculo y la cresta ilíaca y parte de la pared anterolateral del abdomen.

Is neoadjuvant therapy an alternative strategy to immediate surgery in locally perforated colon cancer?

Perforations are a rare but serious complication of colorectal cancer. The current standard of treatment is emergent surgery followed by adjuvant chemotherapy. The concern with this approach is not only the uncertainty of achieving a R0 resection but also potential injury to adjacent vessels, nerves and ureters due to inflamed tissue planes. A subset of this patient population with a contained perforation who are clinically stable may have superior oncological outcomes with local sepsis control, neoadjuvant therapy followed by radical resection. The aim of this study is to report on the pre-operative safety profile for neoadjuvant therapy in the setting of an abscess from colon cancer perforation and the short-term oncological surgical quality outcomes. In this retrospective observational study, all consecutive perforated colon cancer receiving neoadjuvant therapy from Jan 2010 to Dec 2019 were included. There were 21 patients that met the inclusion criteria. The most common symptom at presentation was abdominal pain (71.4%) and most common site of perforation was sigmoid colon (61.9%). Local sepsis control was achieved with a combination of radiological or surgical drainage, diverting ostomy and/or intravenous antibiotics. Thirteen patients had long-course chemoradiation and eight patients had neoadjuvant chemotherapy. Of these, 13 (61.9%) had tumour regression, with one patient having a pathological complete response. All patients achieved a R0 resection. In a small subset of patients with colon cancer perforation, this study has demonstrated the potential safe usage of neoadjuvant therapy first before radical surgery to achieve a clear resection margin.

Differentiation between stercoral perforation and colorectal cancer perforation.

To determine the computed tomography (CT) signs associated with stercoral perforation and colorectal cancer perforation. From May 2003 to Feb. 2015, all surgically and pathologically confirmed patients with stercoral perforation (n=8, mean age 68.3 years) or colon cancer perforation (n=11, mean age 66.3 years) were retrospectively reviewed by two board-certified radiologists blinded to the proven diagnosis. The following CT findings were evaluated and recorded for each patient: wall thickness of the distal colon adjacent to perforation site, pattern of the colon wall thickening and enhancement, length of the thickened bowel wall, presence of fecaloma, degree of proximal colon dilatation, and pericolonic inflammation or presence of pericolonic abscess, and number of enlarged pericolonic lymph nodes. These findings were correlated with the pathologic diagnosis. The mean thickness of the distal colonic wall adjacent to the perforation site was 13.6 mm in patients with colorectal cancer perforation and 5.1 mm with stercoral perforation, which was statistically different. There was a significant correlation between colorectal cancer perforation and eccentric wall thickening (p<0.01). CT findings of layered enhancing wall thickening (p<0.01) and the presence of fecaloma in the proximal colon (p<0.01) were significant findings for stercoral perforation. Patients with colorectal cancer displayed more pericolonic lymph nodes (mean 2.27, p<0.05). Fecaloma in the proximal colon and layered enhancing wall thickening adjacent to perforation site are likely due to stercoral perforation. Eccentric bowel wall thickening at the distal portion of the perforation site with many enlarged pericolonic lymph nodes is most likely due to colorectal cancer perforation.

心室細動（VF）による心停止後ケア中に穿孔をきたした進行大腸癌の1例

心室細動（VF）による心停止後ケア中に穿孔をきたした進行大腸癌の1例

Localized peritoneal carcinomatosis mimicking an irreducible left inguinal hernia

Perforated colonic cancers are not rare and leave patients at risk of developing peritoneal carcinomatosis. We present a 68-year-old male patient with a perforated transverse colonic tumour who underwent emergency extended right hemicolectomy. He made an uneventful postoperative recovery, and received adjuvant chemotherapy. Unfortunately, a routine positron emission tomography-computed tomography scan 16 months later demonstrated an fluorodeoxyglucose-avid nodule in the left scrotum associated with an irreducible left inguinal hernia that contained sigmoid colon. At laparotomy, the discovery of isolated peritoneal recurrence in the hernia sac was unexpected, given the absence of local recurrence in the region of the original transverse colon cancer perforation. The etiology therefore remains uncertain, but one may speculate that cell implantation occurred within the hernia sac at the initial emergency laparotomy.

Perforation of colon cancer into a benign ovarian cyst

This case report describes a 69-year-old patient with an adenocarcinoma of the sigmoid colon perforating into a benign ovarian cyst causing an ovarian cyst abscess.This 69-year-old woman presented ...

A case of non-clostridial gas gangrene of the thigh caused by perforation of colon cancer

A case of non-clostridial gas gangrene of the thigh caused by perforation of colon cancer

Group A streptococcal necrotizing fasciitis of the psoas muscle

Group A streptococci are common colonizers of the skin and upper respiratory tract. Serious infections of the respiratory tract as well as the skin and soft tissue are common. Highly virulent Group A streptococci are not infrequently the cause of invasive, life-threatening infections. Necrotizing fasciitis is uncommon and rarely the result of Group A streptococci. Necrotizing fasciitis of the psoas from Group A streptococci has been reported as a complication in patients with colon cancer perforation or peritonitis. We report the first case of Group A streptococcal necrotizing fasciitis of the psoas muscle not associated with peritonitis or colon perforation. (Heart Lung ® 1999;28:219-21)