Female patient 39yo, thin, pale, anemia with crises of epigastric and left flank pain without fever and lost weight for 2 weeks.
Ultrasound detected one mass in LUQ nearby gastric greater curvature that made thought about stomach tumor. But in swallowing water to examine, ultrasound revealed gas in the mass which adhered stomach so it may exist a fistula that connected gas in the mass and stomach.
Gastric endoscopy confirmed stool inside stomach and a fistula, d#10mm on gastric wall. Then a colonoscopy showed left colon tumor at splenic angle.
MSCT proved left colon tumor invaded stomach with fistula that adhered to gastric corpus. Lesion of thickening colon wall #25mm, degraded surrounding fatty tissue and captured mildly contrast.
Surgery was done to remove left colon tumor that seeding peritoneum, posterior uterus and lymph nodes. Tumor invaded stomach, tail of pancreas and lower pole of spleen.
Histopathological result post op is a colon adenocarcinoma grade 2 invasing serosa and metastasing nodes and peritoneum.
