A Case of Diffusely Infiltrating Carcinoma of the Transverse Colon Presented Itself with the Direct Invasion to the Skin

Yoshiya Mishina, Kohjiroh Ohtsuka, Jin Hachiya, Masayuki Kawai, Yoshio Koyama, Shuhei Torii*

The Department of Surgery, Fukuroi Municipal Hospital
*The Department of Plastic Surgery, Nagoya University School of Medicine

We experienced a case of diffusely infiltrating transverse colon carcinoma with direct invasion to the skin as an initial symptom. A 79-year-old woman was admitted complaining of left lower abdominal tumor. A cauliflower-like tumor developed from the skin after admission. The patient was diagnosed as having diffusely infiltrating transverse colon cancer with direct invasion to the skin and the sigmoid colon. Left hemicolectomy with radical excision of the abdominal wall was performed as a curative operation. The wide defect in the abdominal wall was reconstructed using an extended musculo-cutaneous flap formed by the dominant pedicle of the inferior epigastric and superficial epigastric vessels. Diffusely infiltrating colon carcinoma was far advanced generally, and metastases sometimes manifested initial symptoms. This is the first case in Japan of diffusely infiltrating colon cancer with direct invasion to the skin as an initial symptom. Pathologically this case was classified as lymphangiosis type. The tumor was well or moderately differentiated adenocarcinoma originally, and it was considered to grow relatively expansively. Reconstruction by musculo-cutaneous flap was useful for the wide defect of the abdominal wall.

Key words
primary diffusely infiltrating carcinoma of the colon, skin metastasis of colon carcinoma, musculo-cutaneous flap

Reprint requests
Yoshiya Mishina The Department of Surgery, Kameda General Hospital
929 Higashi-cho, Kamogawa City, 296 JAPAN

Accepted
June 17, 1992

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