Unusual sized cecal mass presenting without obstruction: a case report

Abstract

BackgroundColorectal cancer (CRC) is a common and lethal disease with thousands of new cases of large bowel cancer diagnosed in the United States each year. Colorectal cancer frequently causes obstruction of the large bowel. Cases of obstructions and perforations have been documented with masses well below 6 cm in diameter. Obstruction and/or perforation are important predictors of prognosis with respect to colorectal carcinomas.Case PresentationThe following is the presentation of an unusual case of a 13 × 12 × 16 cm colonic adenocarcinoma without any signs of obstruction or perforation.ConclusionPerioperative mortality rates for colorectal cancer with obstruction have been documented anywhere from 5% to 47.6%, making obstruction an important predictive factor in long-term patient survival. Although a correlation between obstruction and patient outcome has been determined, a correlation between colorectal tumor size/staging and obstruction has yet to be investigated.

Which tumor came first: Liver or the colon?

“…Interestingly, the patient in this case had a very large hepatic flexure neoplasm with hepatic invasion in the absence of obstruction, perforation and peritoneal metastases. Only one similar case has been previously reported [5].…”

“…Most colonic neoplasms associated with LBO are less than six centimetres, however there is no correlation between tumour size and obstruction [5]. Nevertheless, larger masses are more likely to be associated with obstruction due to luminal narrowing and have an increased peritoneal metastatic potential due to a more aggressive tumour biology [6].…”