Simultaneous Quadruple Advanced Colorectal Cancer Synchronously Associated with Esophageal Cancer—Report of a Case—

Abstract

A 76-year-old man who had been suffering from diarrhea symptom visited a neighboring hospital because the symptom became pronounced for these 3 months. Colonoscopy revealed each one tumor growing circumferentially and almost completely encircling the rectum and the sigmoid colon, respectively. Biopsies of the tumors resulted in comparatively well differentiated adenocarcinoma. The patient was referred to our hospital for the purpose of exploration and treatment. Despite absence of apparent distant metastases on imaging studies, irregular-shaped wall-thickening images with strong enhancement effect were also confirmed in the transverse and the descending colon. We thus performed partial resection of the transverse colon and abdominoperineal resection including extensive left-sided colon. Histopathology revealed that the all tumors arisen from the four sites were of type 3, and tubular adenocarcinoma reaching the subserosa (except the rectal tumor which had exceeded the proper muscle layer). They were mainly composed of well differentiated adenocarcinoma.

We have experienced a case of simultaneous quadruple advanced cancer of the colon and the rectum, Although the definite diagnosis could not be made preoperatively, the case was of multiple cancer synchronously associated with early esophageal cancer. The patient follows a relatively favorable postoperative course. We present the case with some bibliographical comments.