Secondary involvement of the transverse colon by tumors of the pelvis: Spread of malignancies along the greater omentum

Abstract

Based on selected case studies the pathways of spread of malignancies arising from the pelvis are discussed. Secondary involvement of the transverse colon with characteristic lesions at the inferior border may be seen in these cases, caused by metastatic spread via the greater omentum. Ultrasonography and computed tomography may prove this diagnosis by showing peritoneal metastatic spread and tumorous infiltration of the greater omentum.

Direct invasion of the transverse colon by a cecal tumor

“…Peritoneal spread of tumor commonly involves the gastrocolic ligament, as well as the more inferior portion of the greater omentum. Direct extension of tumor from the greater omentum to the transverse colon produces a desmoplastic reaction which in one published series involved primarily the superior wall and in another series primarily the inferior wall [2,3]. The findings on barium enema are similar to those seen in invasive pancreatic or gastric carcinoma, and likewise usually appear eccentric, although concentric lesions may be noted in advanced cases [2,3].…”

“…Characteristic findings of tethered or spiculated folds, nodularity, and luminal distortion may result from extension of pancreatic or gastric carcinoma along tigamentous attachments or from direct extension of metastatic disease involving the greater omentum [1][2][3]. We present a patient in whom similar findings on barium enema resulted from direct invasion of the transverse colon by a large cecal tumor.…”