Abstract
A 73-year-old man with a chief complaint of defecation difficulty was examined in detail, and diagnosed with rectosigmoid colon cancer, cT4N0M0 cStage II, complicated by vesicocolonic fistula. Radical surgery was deemed to necessitate total cystectomy, so we elected for a strategy of preoperative chemotherapy aimed at sparing the bladder. A double-barrel colostomy in the sigmoid colon was followed by nine courses of a FOLFIRI+Bevacizumab (10 mg/kg) regimen and three courses of a FOLFIRI regimen. Abdominal computed tomography (CT) showed a reduction in bladder invasion and disappearance of the vesicocolonic fistula, and cystoscopy showed normalization of the mucosa, so sparing the bladder was deemed possible, and surgery was performed. Surgical findings revealed a reduction in the invasion range, and high anterior rectal resection+partial cystectomy yielded pathological radical treatment. We report herein a case in which preoperative chemotherapy was performed for rectosigmoid colon cancer complicated by bladder invasion and total cystectomy was successfully avoided.
