後腹膜腔穿通から皮膚瘻孔を形成した進行大腸癌の1例

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  • A CASE OF ADVANCED COLONIC CANCER WITH A CUTANEOUS FISTULA DUE TO A PENETRATION TO THE RETROPERITONEAL CAVITY

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A 59-year-old male developed a cutaneous fistula in the right iliac region. Barium enema and computed tomography revealed that this fistula was originated from a retroperitoneal abscess due to penetration of an advanced cancer of the ascending colon. Extended radical operation comprising of right hemicolectomy with partial resection of the right abdominal wall and reconstruction with recto-abdominal musculo-cutaneous flap was performed. Postoperative clinical course was uneventful, and the patient restored a good QOL (quality of life) and acceptable social activity.<br> In general, colonic cancer is biologically characterized by local growth rather than distant metastasis except in the late stage. There have been many reports which describe a good prognosis on the cases of colonic cancer undergoing the extended resection. Consequently, we should consider to indicate the extended radical operation, for the advanced colonic cancer with invasion to the other organs, if the tumor still remains locally.<br> In this paper, we present a case of advanced colonic cancer with a cutaneous fistula and also discuss the usefulness of the extended radical operation against the advanced colonic cancer with a review of the literature.

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