Abstract
This 70-year-old man was evaluated at our hospital for chief complaints of lower extremity edema and diarrhea. Laboratory tests showed anemia and hypoalbuminemia, and further evaluation revealed a circumferential type 2 tumor of the ascending colon at the hepatic flexure and fistula formation into the descending duodenum. CT and MRI also showed pancreatic invasion. The patient was diagnosed with ascending colon carcinoma accompanied by a duodenocolic fistula, and right hemicolectomy and pancreatoduodenectomy (PD) were performed. The histopathologic diagnosis was pT4b (pancreas, duodenum), muc>tub1, pN0, pStage II.
The patient was treated with FOLFOX4 as postoperative adjuvant chemotherapy for 6 months. Currently, 16 months after surgery, there has been no recurrence. In colon cancer, even with invasion into other organs, complete resection may be recommended. In patients with colon cancer and duodenal invasion, PD, although highly invasive, may improve the prognosis.
