Multiple Visceral Resections for Synchronous Left and Transverse Colon Adenocarcinoma with Gastrocolic-cutaneous Fistula – Case Report and Literature Review

Abstract

Synchronous adenocarcinomas of the colon represent a rare situation, characterized by the presence of at least two colonic malignancies separated by at least 4-cm distance, in the absence of submucosal spread. Gastrocolic-cutaneous fistulas also represent a rare complication associated with the presence of colonic or gastric adenocarcinomas. We present the case of a 61-year-old patient who presented for abdominal pain, vomiting, weight loss and cutaneous exteriorization of purulent liquid. Intraoperatively, a large centro-abdominal tumor with gastroduodenal, pancreatic and colonic invasion was found in association with a synchronous left colonic tumor. The tumors were resected en bloc with distal gastrectomy, cephalic pancreatoduodenectomy, segmental enterectomy, subtotal colectomy and upper abdominal lymph node dissection. The histopathological studies revealed the presence of two synchronous colonic tumors: one located on the transverse colon, with pancreatic, duodeno-jejunal and gastric invasion and gastrocolic-cutaneous fistula, and a second one located on the left colon. Both tumors proved to be moderately differentiated colonic adenocarcinomas. At 1-year follow-up the patient remains free of any recurrent disease.

Gastrocolic fistula caused by transverse colon cancer: a case report

“…We searched for the keywords “gastrocolic fistula” and “colon cancer” in PubMed, and we found 16 surgical resection cases written in English that were included in our evaluation here, in addition to our case (Table 1 ) [ 1 – 3 , 6 , 9 , 10 , 13 – 21 ]. The ratio of men to women was 9:7.…”

Right‑sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience

“…If the duodenal sidewall is affected, with papilla of Vater free of invasion, a surgeon may take into consideration limited duodenal resection, especially in patients with high perioperative risks and comorbidities (15). No certain evidence exists that survival in regards to limited duodenal resections is worse than in DP, since randomized studies are absent and scientific data are limited to several case reports and case series (15,(30)(31)(32)(33). Nonetheless, the procedure of limited duodenal resection has been described since 1963 (34).…”