Abstract
The patient was a 72-year-old woman who consulted a local doctor for a chief complaint of dizziness. Upon examination, she was found to have marked anemia with a hemoglobin level of 4.7g/dL, and she was then referred to our hospital for detailed examination and treatment. After examination, she was diagnosed with ascending colon cancer, and right hemicolectomy was planned. During the surgery, a lesion (sSS) was noted about 6 cm from the oral end of the ileum. A combined resection of the ileal lesion and right colon was performed. Histopathological examination revealed a type II lesion in the resected specimen of the ileum, and the patient was diagnosed as having ascending colon cancer (por1 > muc) and small intestinal cancer (muc > tub2). The ileal lesion was considered to be the primary small intestinal cancer because the mucosal lesion was the principal lesion with no exposure of the serous surface, and also because the lesion exhibited the type II form on visual inspection. The patient is alive 21 months after the surgery. Synchronous cancer of the small and large bowel is rare, with only 25 cases found in Japan.
