A Case of Advanced Descending Colon Cancer in an Adult Patient with Intestinal Malrotation

Abstract

This report presents an operative case of advanced descending colon cancer in an adult patient with intestinal malrotation. A 63-year-old Japanese male was suffering from left side abdominal pain, abdominal distension, and constipation. An endoscopic examination revealed an advanced tumor in the descending colon. Computed tomography (CT) of the abdomen revealed the thickening of the descending colon wall and superior mesenteric vein rotation. An opaque enema detected severe stenosis of the descending colon. An abdominal X-ray examination revealed the dilation of the colon and small intestine with niveau. At the insertion of an ileus tube, the C-loop of the duodenum was observed to be absent and the small intestine was located on the right side of the abdomen. After the decompression of the bowel contents, laparotomy was performed. Descending colon cancer was observed to have directly invaded the left side of the transverse colon. Left hemicolectomy, lymph node dissection, and appendectomy were performed. The patient had an uneventful recovery and was discharged from the hospital on the 16th day after surgery. This report presents a rare operative case of descending colon cancer in an adult patient with intestinal malrotation.

Laparoscopic resection of sigmoid colon cancer with intestinal malrotation: A case report

“…Eleven previously reported patients were identified and are summarized in Table 1 [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]. Non-rotation was the most frequent type and confirmed in seven patients.…”

Colorectal Carcinoma in a Patient with Situs Inversus Totalis

“…Lymph nodes with homogeneous structure and a short axis diameter up to 3 mm can contain malignant cells [20]. Brillantino et al, Nakayama et al and Donner et al reported cases of colon adenocarcinoma in T 3 stage, T 4b stage respectively, with negative regional lymph nodes in patients with intestinal malrotation [19,21,22]. Another 13 case reports of patients with intestinal malrotation and colon cancer revealed that the nonrotation type was the most common finding [21].…”

Obstructing colon mass in the setting of intestinal non‐rotation

“…Congenital non‐rotation of the intestine (incomplete rotation), is a type of malrotation that occurs secondary to a lack of normal rotation of the intestine (270 o ) during embryological development. Most frequently described in neonates and children, the prevalence in adults is low but difficult to estimate (about 0.2%) . The diagnosis can be challenging due to vague and often chronic symptoms.…”

“…The majority of reported cases are from Japan, with less than 25 cases reported in the English language literature. The majority of patients have non‐rotation (as opposed to classic malrotation, reversed rotation, or paraduodenal hernia type rotational abnormality) . Most patients are presented with right‐sided cancers .…”

“…The majority of patients have non‐rotation (as opposed to classic malrotation, reversed rotation, or paraduodenal hernia type rotational abnormality) . Most patients are presented with right‐sided cancers . There are no standardized guidelines for the management of these patients, specifically, in regards to the underlying rotational disorder.…”