A 60-year-old woman was seen at the hospital because her stool was positive for occult blood. Hematological study showed anemia, Hb level of 9.4g/dl, but she was able to take meals orally. Barium enema study visualized a narrowing at the ascending colon, but abdominal plain x-ray examination revealed no ileus findings. Colonofiberscopy showed a depressed lesion completely encircling the ascending colon, which was Ggroup 4, suspicious of adenocarcinoma on biopsy. Abdominal CT scans showed a low density area in the S5 of the liver. Cancer of the ascending colon with hepatic metastasis was diagnosed and the patient was operated on. Upon laparotomy the ascending colon had involved the ileum to form a mass, and invasion into and communication with the ileum were suspected. Right hemicolectomy with associated resection of the ileum and radiofrequency ablation for the hepatic metastasis were carried out. Grossly the cancer foci invaded the ileum to form fistula. Histological diagnosis was well differentiated adenocarcinoma, si, lyl, v2, and n (-). Ileocolic fistula caused by colonic cancer is relatively rare, and 36 domestic cases including ours have been reported as far as we could review. This paper presents this case together with a review of the literature.

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