A Case of Cecal Mucinous Crcinoma Forming a Colovesical Fistula

Yoshihide Furukawa, Rei Yashima and Kohjiro Urazumi

Department of Surgery, Ohta Atami Hospital

A 86-year-old woman had fever and urinary occult blood with a hard mass palpable in the lower right abdomen. Abdominal computed tomography and magnetic resonance imaging detected a tumor 13 cm in diameter extending from the ileocecum to the inside of the pelvis, excluding the bladder. Colonofiberscopy showed an elevated tumor in the cecum. Biopsy from the tumor showed well differentiated adenocarcinoma. The tumor had deeply invaded the bladder, necessitating right hemicolectomy with partial resection of the bladder. The 12.0×11.5 cm tumor was type 2 and developed in the cecum, forming a fistula from the cecal ulcer floor into the bladder. Histopathologically, the lesion was identified as mucinous carcinoma, infiltrating into the muscular tunic of the bladder, while the fistula wall was found to be composed of inflammatory granulation tissue without tumor cell infiltration. Colon cancers with fistulization into the bladder are commonly either sigmoid colon cancer or rectal cancer, with rare cases of cecal cancer as identified in the present diagnosis. In our case, the expanding mucinous mass of the tumor oppressively excluded the bladder wall to necrosis, eventually forming the colovesical fistula.

Key words
cecal cancer, mucinous carcinoma, colovesical fistula

Reprint requests
Yoshihide Furukawa Department of Surgery, Ohta Atami Hospital 5-240 Atami, Atamimachi, Koriyama-city, 963-1309 JAPAN

Accepted
September 25, 2002

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