Abstract
A 60-year-old man visited our hospital due to right lower quadrant pain that had developed three months earlier. A protrusion was observed on the right side of the abdomen. A tumor or an abscess having a massive lumen communicating with the transverse colon was suspected, and surgery was performed on a semi-emergency basis. Laparotomy showed a tumor that occupied almost the entire area of the right mesocolon from the ascending colon to the transverse colon, with partial invasion into the duodemum, and many nodular peritoneal metastases were found on the tumor surface and within the abdominal cavity. Right hemicolectomy, partial duodenectomy, and gastrojejunostomy were performed. On macroscopic examination of the resected sample, the tumor was 20 cm × 15 cm in size, and a perforation, 1.5 cm in diameter, was found in the transverse colon. The histopathological diagnosis was mucinous adenocarcinoma originating in the transverse colon, cT4b(duodenum)pNXcM1a(P3), Stage IV. The patient died of the primary disease one year and six months postoperatively.
The present case is the 10th case of extramural growth-type mucinous adenocarcinoma of the colon reported in Japan. Extramural growth-type mucinous adenocarcinoma of the colon is characterized by a high incidence in the transverse colon and a low frequency of lymph node metastases.
