Hematogenous intestinal metastases from sigmoid colon cancer presenting as iliopsoas abscess and bowel obstruction

We report a case of intestinal metastases from sigmoid colon cancer that presented as iliopsoas abscess and ileus. A 78-year-old man who had undergone sigmoidectomy for sigmoid colon cancer 5  years ago was referred to our hospital with recurrent ileus and fever. Abdominal computed tomography showed a left iliopsoas abscess and a mass near the abscess that had ostensibly caused ileus. The patient underwent segmental resection of the jejunum including the mass. Histopathological examinat ion of the resected specimen revealed moderately differentiated adenocarcinoma proliferating mainly in the submucosal and muscular layers, which was pathologically identical to the colon cancer resected 5 years ago. He died 18 months after the surgery because of liver metastases. This case report highlights the delayed occurrence of colorectal metastases at unusual sites, such as the small bowel, more than 5 years after the resection of the primary cancer. Intestinal metastases should be considered in patients with a history of colon cancer, particularly in those with recurrent ileus or abd ominal abscess with no obvious cause.
Source: International Cancer Conference Journal - Category: Cancer & Oncology Source Type: research