A Case of Pooly Differentiated Carcinoma of the Ascending Colon with Rapid Postoperative Progression Suggesting Disseminated Carcinomatosis of the Bone Marrow

Takayuki Tajima, Masaya Mukai, Tomoya Hinoki, Yasuo Ootani, Shinkichi Sato*, Hisao Nakasaki and Hiroyasu Makuuchi**

Department of Surgery and Department of Pathology, Tokai University Oiso Hospital*
Department of Surgery, Tokai University Hospital**

Poorly differentiated adenocarcinoma of the large bowel is rare, and many of its clinical characteristics remain unknown. We report a case of poorly differentiated adenocarcinoma of the ascending colon with rapid clinical deterioration after resection of the primary tumor resulting in death. The patient's was strongly suggested disseminated carcinomatosis of the bone marrow, clinical course. The 48-year-old man presented with right abdominal pain and was diagnosed as having ascending colon cancer and was hospitalized. Since preoperative investigations showed signet ring cell carcinoma of the ascending colon, the right half of the colon was resected. The tumor was macroscopically classified as type IV and cytology of ascites showed Class V. Metastasis to Group 4 lymph nodes was observed. Pathologically, the tumor was diagnosed as poorly differentiated adenocarcinoma of the ascending colon. Back pain present preoperatively increased with thrombocytopenia from postoperative day 8. Bone scintigraphy revealed abnormal accumulation of 99mTc in the entire skeleton. He rapidly developed disseminated intravascular coagulation syndrome, and died about 2 months postoperatively. From his clinical course, he was considered to have disseminated carcinomatosis of the bone marrow from large bowel cancer. We report the present case in detail and discusses findings from the literature.

Key words
disseminated carcinomatosis of the bone marrow, poorly differentiated carcinoma of the large bowel, DIC

Reprint requests
Takayuki Tajima Department of Surgery, Tokai University Oiso Hospital
21-1 Gakkyou, Oiso-cho, Naka-gun, 259-0198 JAPAN

Accepted
September 28, 2005

To read the PDF file you will need Abobe Reader installed on your computer.