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A Journal on Surgery

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Chirurgia 2016 April;29(2):46-9

language: Italian

Right colon cancer with infiltration of VI hepatic segment. Role of CT-colonography in differential diagnosis between abscess and cancer-infiltrating carcinoma

Damiano BISOGNI, Lorenzo DIOSCORIDI, Federica TOFANI, Alessandro FRANCIA, Carlo PAPAROZZI

SOD Chirurgia Generale ad indirizzo oncologico e funzionale, Dipartimento di Chirurgia e Medicina Traslazionale, AOUC, Firenze, Italia


Right colon cancers make up about 30% of colorectal cancers. A quite rare complication of these neoplasms is subphrenic abscess, with subsequent hepatic hepatic fistulas. Authors report the case of a 87 years old patient presenting our attention beacause of an oppressive abdominal pain and hematochezia for about a year. Colonoscopy documented a vegetating and stenosing tumor at the level of the distal half of the transverse colon and CT-colonography showed a lesion extending from the ileocecal valve till the hepatic flexure, with a possible fistulas with VI hepatic segment. The symptoms of the patient, together with the radiological images, seemed to lay an abscess-cancer. During the surgical operation the Authors observed an extensive infiltration of the sixth hepatic segment with no abscess or fistulas. The differential diagnosis between abscess-carcinoma and cancer invading neighboring structures is therefore very complex, and only partially solved by colon-TC.

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