Abstract
A woman in her 40s visited our department with a chief complaint of abdominal pain. On computed tomography (CT), perforation of sigmoid colon cancer and hydronephrosis due to left ovarian and retroperitoneal infiltration were suspected. Emergency surgery was performed, but infiltration into the retroperitoneum was severe, and radical resection was judged to be difficult. Transverse colostomy was therefore performed. A total of six courses of the FOLFOX4 regimen were given postoperatively with the objective of shrinking the tumor. CT following chemotherapy showed shrinkage of the lesion, with the efficacy evaluated as partial response (PR). Radical resection was the next objective, and sigmoidectomy and left adnexectomy were performed. On histopathological examination, the efficacy of chemotherapy was evaluated as grade 1b. The pathological diagnosis was si(ov), ly3, v0, n0, P0, H0, fStage II. Adjuvant therapy using capecitabine was given, and no signs of recurrence have been seen as of four years postoperatively. This case of locally advanced sigmoid colon cancer that presented with perforative peritonitis, in which it was possible to perform curative resection in two stages by achieving shrinkage using chemotherapy following palliative surgery, is reported in the context of the current literature.
