Abstract
A 74-year-old woman who complained of abdominal pain and constipation had a total colonoscopy. She had never travelled abroad. On colonoscopy, an advanced ascending colon cancer was found, and, on biopsy, a moderately differentiated adenocarcinoma was diagnosed. At that time, a whitish flattened taenia was detected at the oral side of the tumor, and tapeworm was suspected. She was admitted for surgery. Preoperative deworming was performed by the instillation of 300 ml of Gastrografin into the duodenum under radiographic guidance. This caused a living tapeworm of about 3-meters to be discharged by defecation. We diagnosed the tapeworm as Diphyllobothrium nihonkaiense from the form of the scolex and the retrieved eggs. After the deworming, a right hemicolectomy with D3 lymph node dissection was performed. The postoperative final diagnosis was tub2, SS, N3, H0, P0, M0, stage IIIb. Her postoperative course was uneventful, and she was discharged on the 14th postoperative day.
This paper describes a case of an ascending colon cancer with a tapeworm found incidentally and extirpated preoperatively by Gastrografin. This case shows the importance of preoperative deworming when intestinal tract cestodiasis is diagnosed.
