Locally Advanced Colon Cancer with Abdominal Wall Abscess: A Challenging Case Treated by an Innovative Approach

Abstract

Colon cancer rarely combines with abscess of the abdominal wall. We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy. A 58-year-old woman presented with a locally advanced right colon cancer with abdominal wall abscess and no evidence of distant metastasis. Extended right hemicolectomy was performed with en-bloc excision of the bladder dome, the right annex and full thickness removal of the anterior abdominal wall including the abscess. Abdominal wall repair was perfomed by a biological mesh (Permacol ™ Biologic Implant) and to facilitate healing the patient was then treated with Vacuum-Assisted Closure (V.A.C. ® ) Therapy. Histology showed a mucinous moderately differentiated adenocarcinoma without nodal metastases (n = 57). Surgical margins including the abdominal wall was tumor free. The postoperative clinical course was uneventful. V.A.C.® Therapy treatment reported excellent results in terms of active promotion of the granulation tissue, this allowing for a subsequent placement of a skin graft. Patient is alive and disease-free one year after surgery. The present case shows some peculiar characteristics such as the size of the initial lesion, the abdominal wall abscess and the use of innovative devices such as biological mesh and V.A.C.® Therapy. We demonstrate that extensive surgery for locally advanced colon cancer, in high-volume centers, provides favorable results in terms of survival and quality of life.

Unlucky patient combining two rarities: sigmoid colon cancer mimicking appendicular abscess and pseudomembranous colitis involving the small bowel

“…8 Although a few cases of colorectal carcinoma have been reported to present with or as an intra-abdominal or abdominal wall abscess, this case is the first case with colorectal cancer presenting as an appendicular to the best of our knowledge. 9,10,11 Our patient initially presented with symptoms of fever and fatigue that were not specific for any colon related diseases. Upon examination and investigations, the clinical suspicion was pointing more towards an appendix related problem, as the pain was most severe in right iliac fossa and the radiological findings were supportive of a diagnosis of appendicular abscess.…”