A Case of Mucinous Carcinoma of the Transverse Colon with Remarkable Extramural Invasion and the Fistula to the Ileum

Tadao Ito, Hiroo Konishi, Tatsuro Mugitani, Nobuki Yamaoka, Yukihiko Sagara, Yoshifumi Sasaki¹⁾ and Hisakazu Yamagishi²⁾

Department of Surgery, Horikawa Hospital Sasaki Clinic¹⁾ Department of Digestive Surgery, Kyoto Prefectural University of Medicine²⁾

We report a case of mucinous carcinoma of the transverse colon. A 69-year-old woman was admitted to our hospital because of a right lower abdominal mass. The mass was palpable and tender, and was the size of an infant's head. Barium enema showed the compression and the extramural outflow of barium at the transverse colon. Endoscopic examination showed the narrowing and the fistula at the transverse colon, although no intraluminal growth of the tumor was found. The mucous membrane around the opening of the fistula appeared normal. Endoscopic biopsy of the fistula led to a histological diagnosis of mucinous carcinoma. Right hemicolectomy with partial resection of the terminal ileum was performed, because the tumor had caused a fistula to the ileum as well. Postoperative pathological findings revealed the tumor the transverse colon cancer. Mucinous carcinoma of the colon with the direct invasion to the other organs is large and shows the remarkable intraluminal growth in most cases. In this case, the tumor showed an uncommon growth pattern of no intraluminal growth. In addition, since most of the fistulas are to the duodenum or the jejunum, the fistula to the ileum is even rarer.

Key words
mucinous carcinoma, colon cancer, extramural growth

Reprint requests
Tadao Ito Department of Digestive Surgery, Kyoto Pref. Univ. of Medicine 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841 JAPAN

Accepted
January 31, 2001

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