Background: Cecal perforation due to neutropenic colitis is a known and described side effect of many chemother-apy regimens. We present a case of a patient with gastric adenocarcinoma who developed spontaneous cecal per-foration during chemotherapy without the classic pattern of typhlitis. Case Report: A 58-year-old woman was on chemotherapy for an adenocarcinoma of the gastric junction, when she developed a cecal perforation. There was neither evidence for leucopenia nor for typhlitis. La-parotomy was performed and cecostomy was estab-lished using the perforated bowel. Postoperative course was uneventful. The patient died from tumor progres-sion 8 months after the diagnosis was made. Conclusion: There is no evidence for a connection between this event and chemotherapy treatment but neither can it be ex-cluded. Even if unusual, colon toxicity could be a poten-tial life-threatening complication associated with more drugs than usually thought.

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