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Revista Española de Enfermedades Digestivas
versión impresa ISSN 1130-0108
Rev. esp. enferm. dig. vol.110 no.3 Madrid mar. 2018
https://dx.doi.org/10.17235/reed.2017.5041/2017
PICTURES IN PATOLOGY DIGESTIVE
Right-colon mucinous adenocarcinoma mimicking a hydatid cyst
1Servicio de Cirugía General y Aparato Digestivo. Hospital Universitario Virgen de la Arrixaca. El Palmar, Murcia, España
INTRODUCTION
Hydatid disease is a fecal-oral transmission zoonosis which is endemically distributed among Mediterranean countries such as Morocco. It usually presents asymptomatically and a diagnosis is made due to cyst complications. It is most frequently located in the liver and lungs and forms large masses 1. The incidence of colon cancer has increased amongst population under 50 years of age during the last few decades 2. It has been proposed that young adult cases may have histological characteristics with a more aggressive clinical behavior. These patients are frequently diagnosed in advanced stages 3 and a mucinous histology is frequently detected. Diagnosis is usually delayed due to a low clinical suspicion and the attribution of symptoms to other diseases such as irritable bowel and parasitosis, among others 4.
CASE REPORT
We present the case of a 33-year-old Moroccan male who presented with abdominal pain. Blood tests revealed a hemoglobin level of 6.9 g/dl and an abdominal computed tomography (CT) identified a mass of 17 x 11 x 16 cm in the hepatic flexure of the colon that was suggestive of a hydatid cyst (Fig. 1). Hydatidosis serology was negative but the carcinoembryonic antigen level was 40 U/ml. Colonoscopy and biopsies confirmed the diagnosis of a stenosing signet ring cell adenocarcinoma. The patient underwent a laparotomy and a 20 cm mass that originated from hepatic flexure of the colon was identified that was attached to the omentum, right parietal peritoneum and hepatic edge (Fig. 2). An extended right colectomy and ileocolic anastomosis were performed. The postoperative period was uneventful. The pathological analysis identified a mucinous adenocarcinoma at the hepatic flexure of the colon with an adjacent cavitating lymph node metastasis of 16 mm.
BIBLIOGRAFÍA
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