[A case of carcinoma arising in a diverticulum of the transverse colon].
A 64 year-old woman presented with advanced, transverse colon cancer arising in the diverticulum. Tumor invasion extended beyond the serosa to the anal side of the colon. Anemia and fatigue progressed after 6 months of iron administration. The hemoglobin value was 5.3 g/dL and carcinoembryonic antigen (CEA) level was elevated to 44.2 ng/mL. A palpable and tender fist-sized mass was found in the right upper abdomen. Computed tomography (CT) revealed a low-density mass in the transverse colon invading beyond the serosa to the anal side of the colon. Right hemi-colectomy with lymph node dissection was performed. The resected specimen contained multiple diverticula including the one from which the tumor arose. Histological examination revealed a well-differentiated, tubular adenocarcinoma (UICC TNM T4bN0M0) arising in a transverse colon diverticulum. There has been no recurrence for 2 years. Colon cancer arising in a diverticulum may expand to the extra-serosa and easily invade to the adjacent organ. In such cases, malignancy should be considered.
Dept. of Surgery, of Pathology, Fukuoka Tokushukai Hospital.
Masako
M
Nomi
Satoshi
S
Umemoto
Takashi
T
Kikutake
Seiji
S
Hosaka
Takahiro
T
Mase
Shunji
S
Kawamoto
Takahisa
T
Yoshida
D000230:Adenocarcinoma / Q000601:surgery*; D003082:Colectomy; D044684:Colon, Transverse / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D004241:Diverticulum, Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D014057:Tomography, X-Ray Computed