Abstract
A 64-year-old man was admitted to our hospital for abdominal pain and diarrhea. Colonofiberscopy revealed a type 2 elevated lesion in the transverse colon. Gastrointestinal fiberscopy revealed a mass in the second portion of the duodenum and a fistula between the duodenum and the colon. Computed tomography (CT) findings showed that the tumor was adjacent to the pancreatic head. Transverse colon cancer with direct invasion to the duodenum and pancreas was diagnosed, and we conducted right hemicolectomy and pylorus-preserving pancreaticoduodenectomy, and partial hepatectomy. The pathological findings were SI (duodenum), N1 (1/25), stage IIIa. There have been no signs of recurrence and the patient is living and well, as of 51 months after the operation. Although colon cancer with invasion to the duodenum is a rare condition, we experienced a case of transverse colon cancer with duodenocolic fistula with long-term survival after en bloc radical surgery. We evaluated the clinical course and outcome in six patients of colon and rectal cancer with invasion to the duodenum, and patients treated with curability A achieved long-term survival. In such cases, we believe that we should try to perform en bloc resection if curative resection is possible.
