2024 Volume 77 Issue 7 Pages 401-406
A 49-year-old man came to our hospital because of melena and was suspected to have advanced descending colon cancer by contrast-enhanced CT of the abdomen. Two days later, he was brought to the emergency department with fever and severe abdominal pain. A simple CT scan of the abdomen showed gas outside of the mass, which was diagnosed as a penetration into the retroperitoneum. Later, colonoscopy revealed a submucosal mass-like lesion with ulceration in the descending colon, which did not pass the scope, and biopsy showed no obvious malignancy. Since the colon was almost obstructed and also penetrated, we decided on a policy of surgery. After preoperative placement of an ICG fluorescent left ureteral stent, a laparoscopic left-hemi colectomy was performed. Though the left ureter was preserved, which was confirmed by a fluorescent stent, the left gonadal artery/vein was resected. because of direct invasion of the tumor. Histopathological examination revealed adenosquamous carcinoma, pT3N1a, Stage IIIb. Adenosquamous carcinoma of the colon is rare, and this is the first report of a similar case.
