CASE 631: LEFT COLON TUMOR INVADING STOMACH and CREATED a FISTULA, Dr LÂM CẨM TÚ, Dr VÕ NGUYỄN THÀNH NHÂN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Female patient born in 1980,  from Bentre province went to Medic with a result of local ultrasound which described an uncertain diagnosis about an unknown mass between spleen and left kidney.

Ultrasound of Medic revealed a mass of digestive tube with pseudokidney sign and  pathologic cocard signd with its  26-33mm thick of wall that  invaded around the peritoneum on left side of abdomen. A suspection of the invaded left colon tumor was made.

MSCT confirmed the left colon tumor and revealed a connecting canal between the invaded stomach and the colon tumor.

For biopsy a gastric endoscopy was done but could not find out the gastrocolonic fistula.

Then colonic endoscopy was done in two times with results of high dysplasia of tubular adenoma.

 

Surgery was done to remove the left colon tumor from stomach, tail of pancreas and spleen and planned chemotherapy.

Discharge diagnosis: Adenocarcinoma of left colon grade 2  invading stomach stage 4.

CONCLUSIONS:

Young patient should have check-up whenever they can to avoid the difficult problems like that, big tumor invaded stomach, tail of pancreas and spleen that may lead to a critical operation with high risk.