Presentation
Abdominal pain and large mass feeling on physical exam. Elevated ESR and Positive CRP on lab data.
Patient Data
There is marked asymmetrical increased wall thickness due to the tumoral infiltration in the hepatic flexure of the colon, accompanied by pericolic fat stranding and several regional enlarged lymph nodes. A thick-walled fluid collection with internal air bubbles is also noted medial to the mentioned mass, highly suggestive of perforation.
A few non-enhanced simple cortical cysts are seen in both kidneys.
Case Discussion
Large colon mass, pathology proven moderately differentiated adenocarcinoma, with focal tumoral perforation and abscess formation.
Colon perforation is a rare complication in patients with colon cancer, and the perforation characteristics differ based on the perforation site, presenting as either perforation at the cancer site or perforation proximal to the cancer site.
Perforation occurred in the cancer site in this patient and walled off with the tumoral desmoplastic reaction.
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