Abstract
We report a rare case of multiple left sided colon cancer with tumor thrombosis in the inferior mesenteric vein (IMV). A 64-year-old man was admitted for investigation of frequent diarrhea with hypokalemic myopathy and rhabdomyolysis. Colonoscopy showed rectal cancer. Preoperative enhanced computed tomography (CT) showed a tumor thrombosis in the inferior mesenteric vein. A low anterior resection with complete excision of the IMV with tumor thrombus was carried out. He also had early gastric cancer, so at the same time we conducted distal gastric resection. The sigmoid colon and rectum were fixed and hardening in the shape of a pillow for the neck. Histological findings of the superior rectum tumor showed type 3, SE, and those of the sigmoid colon showed type 4, SS. Both tumors were confirmed to be N2, (f) Stage IIIb. On pathology, it showed type 4 advanced cancers at the superior rectum and sigmoid colon.
Tumor thrombosis was demonstrated in the IMV and the length was 15 cm. Partial invasion was found in the wall of the IMV. Adjuvant chemotherapy FOLFOX4 was carried out in 6 courses, and he is currently alive with no recurrence for 3 years and 4 months after the operation.
