A case of undifferentiated colon cancer with an abdominal wall abscess

Abstract

A 43-year-old female presented with abdominal pain, diarrhea, and fever. Abdominal CT scan revealed an abdominal wall abscess, 7cm in diameter, and a thickened descending colon encircling the lumen which continued to the abscess. Perforation of the descending colon by colon cancer with abscess formation was suspected. Despite administration of an antibiotic for 2 days, her condition deteriorated and left hemicolectomy and simultaneous abscess drainage were performed. Histopathologically, the tumor was undifferentiated carcinoma without neuroendocrine features on immunohistochemical examination. The postoperative course was uneventful and adjuvant chemotherapy was started. However, liver metastases occurred quite early, and the patient died 7 months after the operation.
Undifferentiated carcinoma of the colon is quite rare, accounting for less than 1% of all cases of colon cancer. Its prognosis is very poor. Colon cancer with an abdominal wall abscess is also rare. Most such cases reported so far are of well-differentiated adenocarcinoma or mucinous carcinoma, and this is the first report of undifferentiated colon carcinoma associated with an abdominal wall abscess.