Laparoscopic surgery for right colon cancer with intestinal malrotation

Abstract

Intestinal malrotation (IM) results from abnormal midgut rotation during embryogenesis and usually presents in early infancy. IM in adults is often an incidental radiological diagnosis. Right colon cancer with IM has been sparingly reported in the world literature. Only 44.7% of these documented cases underwent successful laparoscopic resection, all of which were reported from Japan. The presence of aberrant anatomy and altered vascular orientation in IM presents challenges for laparoscopic resection with adequate nodal clearance. We present the case of a 72-year-old female diagnosed with carcinoma of the ascending colon, with IM incidentally detected on pre-operative cross-sectional imaging. She underwent laparoscopic right hemicolectomy. We also reviewed the documented cases of successful laparoscopic surgery for right colon cancers with IM. Aided by accurate delineation of vascular anatomy on pre-operative cross-sectional imaging, laparoscopic colectomy in the setting of IM is safe and feasible, and should be favourably considered.

An Unusual Coexistence: Right-Sided Colon Cancer and Intestinal Malrotation in an Adult

“…Its occurrence in adults is exceptionally low, at just 0.2%, and most symptomatic cases are typically identified shortly after birth [ 2 ]. It's unusual to find a link between IM in adults and right colon cancer, as evidenced by a few documented cases in the existing literature [ 2 , 3 ].…”