En bloc Pancreaticodudenectomy with Colectomy for Locally Advanced Right Sided Colon Cancer

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Cancer Research

Background:

• Colorectal cancer, particularly adenocarcinoma, presents with varied symptoms including melena, weight loss, and abdominal masses.
• Hepatic flexure tumors can be challenging due to their location and potential for adjacent organ involvement.
• Early diagnosis and appropriate surgical intervention are crucial for improving patient outcomes in adenocarcinoma cases.

Purpose of the Study:

• To report a case of a 57-year-old male with a hepatic flexure adenocarcinoma.
• To detail the diagnostic and surgical management of this specific case.
• To evaluate the short-term outcome following an extended right hemicolectomy with en bloc pancreaticoduodenectomy.

Main Methods:

• Clinical presentation of melena, weight loss, and an abdominal mass.
• Diagnostic workup including colonoscopy with biopsy confirming well-differentiated adenocarcinoma and contrast-enhanced computed tomography (CECT).
• Surgical intervention involving extended right hemicolectomy with en bloc pancreaticoduodenectomy for curative intent.

Main Results:

• Colonoscopy revealed an ulcero-proliferative growth in the hepatic flexure, with biopsy confirming well-differentiated adenocarcinoma.
• CECT showed a hepatic flexure mass with possible duodenal invasion but no advanced disease features.
• The patient underwent successful surgery and was discharged on the 10th postoperative day.

Conclusions:

• Extended right hemicolectomy with en bloc pancreaticoduodenectomy is a viable surgical option for selected cases of hepatic flexure adenocarcinoma with adjacent duodenal involvement.
• Curative intent surgery in this case led to a favorable outcome with no evidence of recurrence at 14 months.
• This case highlights the importance of comprehensive diagnostic evaluation and tailored surgical strategies for complex colorectal cancer presentations.