Synchronous colorectal carcinomas

Case contributed by Dr Bruno Di Muzio


Patient presents in the emergency department with signs of bowel obstruction.

Patient Data

Age: 65 years
Gender: Male

CT Abdomen and pelvis (selected images)

There is small and large bowel obstruction due to a segment of wall thickening causing colonic stricture at the splenic flexure; there are associated fat stranding and prominent regional lymph nodes. The upstream distension of the colon reveals a mass lesion in the right colonic flexure, also suspicious for malignancy. 


Diagram illustrative of the findings

Arrows pointing the colonic flexure abnormalities.

Case Discussion

The patient underwent surgery that confirmed both lesions to be malignant. Total colectomy was performed and the pathological diagnosis was adenocarcinoma.

Synchronous colorectal cancers are characterised by the presence of others distinct tumoural foci at diagnosis, intra-operatively, or within 6 months of the resection of the primary lesion. After the 6 months, a new distinct colorectal cancer is called metachronous 1.

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Case information

rID: 18658
Published: 17th Jul 2012
Last edited: 2nd Aug 2018
Inclusion in quiz mode: Included

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