2018 年 43 巻 4 号 p. 665-670
Background
Synchronous neoplasms of the colorectum and kidney rarely occur. This paper is the second report on synchronous sigmoid colon and renal cancers treated laparoscopically. In this report, we describe synchronous cT4b sigmoid colon and left renal cancers treated laparoscopically simultaneously, along with the summary and review of reported cases.Case presentation
A 45-year-old male presented with high fever and left lower abdominal pain. Computed tomography showed a solid sigmoid colon tumor that was 7cm in diameter and perforated its mesentery. Colon cancer was suspected to infiltrate the adjacent organs including the abdominal wall. In addition, a 5-cm tumor on the left kidney was accidentally discovered, which was suspected to be renal cancer. Colonoscopy showed a circumferential tumor at the sigmoid colon that was 25cm from the anal verge. There was no evidence of distant metastasis. After intravenous antibiotics therapy, we planned laparoscopic left hemicolectomy and nephrectomy. The sigmoid colon cancer adhered to the abdominal wall, small bowel, and appendix; therefore, we performed en bloc resection of the tumor and the adjacent organs. After colectomy, we performed left nephrectomy. Postoperative course was good. The patient was discharged 12 days after the operation.Conclusion
Laparoscopic synchronous resection is a feasible and curable procedure providing several benefits for the patient. Furthermore, left hemicolectomy and radical left nephrectomy can be a good indication of synchronous resection because both include the same procedure such as mobilization of the splenic flexure. For cT4b colon cancer like in our case, en bloc resection without touching the adhesion can be a curable procedure.
