Retroperitoneal abscess as an initial presentation of cecal carcinoma

We report an unusual case of cecal carcinoma presenting first time as retroperitoneal abscess. As the patient was septic on presentation and the underlying cancer was not clear, she was treated initially by extraperitoneal drainage of the abscess. She later underwent a palliative right hemicolectomy. She presented a month later with recurrence at the drainage site. This case highlights this unusual initial presentation of right colonic cancer, the diagnostic dilemma and the poor prognosis associated with it.