2019 Volume 44 Issue 1 Pages 70-76
A 78-year-old woman was admitted to our hospital with a suspected abdominal wall hernia. Abdominal enhanced computed tomography showed an abdominal wall abscess and showed findings suggestive of invasion of the duodenal wall by the transverse colon cancer. Colonoscopy revealed a circumferential type 1 lesion of the transverse colon, and we could not insert though the oral canal. An upper gastrointestinal endoscopy revealed a type 2 lesion of the inferior duodenal flexure. The pathological diagnosis of both lesions was moderately differentiated adenocarcinoma. We performed drainage of the abscess and administered antibiotics, and 10 days later, performed a right hemi-colectomy combined with resection of the duodenal wall and abdominal wall. On histopathological examination, the lesion was diagnosed as SI, N0, Stage II, and curability A. There was no evidence of recurrence until 12 months after the surgery, but unfortunately, the patient died of aspiration pneumonia at 12 months after the surgery. We evaluated the clinical course and outcome in 28 patients of colon cancer showing invasion of the duodenum, and long-term survival was achieved in patients in whom underwent curability A resection was achieved. In such cases, we believe that en bloc resection should be attempted if curative resection is possible.
