PMC3573778_01
Findings of contrast-enhanced CT. a CT image of the descending colon cancer (arrow). b The other tumor adjacent to the cecum (arrowhead) and abnormal dilatation of the ascending and transverse colon are depicted.
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F1
Abdominal contrast-enhanced computed tomography (CT) revealed a descending colon tumor accompanied by minimal perforation and abscess formation (fig. 1a) and dilatation of the oral side of the intestine (fig. 1b). Of importance, another tumor was detected in the cecum (fig. 1b).
Pathological examination of the resected specimens of the descending colon tumor and cecum tumor. a, b Macroscopic finding (a) and H&E staining (b, x200) of the descending colon tumor. c, d Macroscopic finding (c) and H&E staining (d, x200) of the cecum tumor.
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F2
Macroscopic examination of the resected specimen showed an advanced colon cancer, which was 45 x 35 mm in diameter (fig. 2a). Pathological examination revealed that the descending colon tumor was moderately-differentiated tubular adenocarcinoma lacking lymphovascular invasion (fig. 2b). Meanwhile, the cecum tumor, which was approximately 40 mm in diameter, had developed near the scar from the appendectomy (fig. 2c). Unexpectedly, it was diagnosed as poorly-differentiated HCC (fig. 2d).
Time series presentation of CT images. The cecum tumor (arrows) was detected by contrast-enhanced CT performed 2 years earlier (a), 1 year earlier (b) and on admission (c).
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F3
Retrospective re-reading of CT images revealed that a disseminated HCC had emerged in the cecum 2 years earlier and gradually enlarged (fig. 3).