Abstract
We report a patient with undifferentiated colon cancer who followed a rapidly progressing course after development of intestinal obstruction due to the cancer followed by gastrointestinal perforation.
A 90-year-old woman complaining of abdominal pain and vomiting was referred to the hospital with a suspected diagnosis of gastrointestinal perforation. An abdominal CT scan showed massive intra-abdominal free air and a tumor lesion at the ascending colon. Emergency surgery was performed ; a hard tumor was palpable in the ascending colon and an area of the colon proximal to the tumor was obstructed. An ischemic change was seen from a portion about 120 cm apart from the Treitz ligament to the ileum end, and a perforation 1 cm in diameter was identified in the cecum 5 cm proximal to the tumor. Right hemicolectomy including the ischemic small intestine and lavage with drainage were performed. The removed specimen included a 4×6 cm tumor of type 4 encircling the lumen of the ascending colon. On histopathological examinations, tumor cells comprising arypical ones dominantly proliferated in solid and honeycomb arrangement which partly exposed on the serosa, showing remarkable vascular invasion. Histologically no tubule formation and mucus production were noted, and the findings were of undifferentiated colon cancer. The patient developed general peritonitis and septicemia and died of multiple organ failure.
Undifferentiated colon cancer is extremely rare and hence this case is reported here with a review of the literature.
