[A Case of Sigmoid Colon Cancer Derived from Diverticula]

Area of Science:

• Gastroenterology
• Gynecologic Oncology
• Urologic Oncology

Background:

• Pelvic masses can present with complex symptoms, including urinary issues and abdominal distension.
• Differentiating between primary bladder tumors and those originating from adjacent organs like the colon can be challenging.
• Large pelvic tumors may obstruct adjacent structures, necessitating advanced diagnostic and surgical approaches.

Purpose of the Study:

• To report a rare case of mucous carcinoma originating from a sigmoid colon diverticulum that perforated into the bladder.
• To highlight the diagnostic and surgical challenges posed by a large, invasive pelvic mass.
• To demonstrate the feasibility of en bloc resection and favorable outcomes in selected elderly patients.

Main Methods:

• A contrast-enhanced CT and MRI were utilized for detailed imaging of the pelvic mass and its relationship with surrounding organs.
• Colonoscopy was attempted but was unsuccessful due to the tumor's size.
• Surgical management involved en bloc resection of the tumor with sigmoidectomy, hysterectomy, and partial cystectomy.

Main Results:

• Imaging revealed an 8 cm pelvic mass in contact with the sigmoid colon and perforated into the bladder.
• Histopathology confirmed the tumor as mucous carcinoma arising from a sigmoid colon diverticulum, despite appearing to originate from the bladder lumen.
• The patient underwent successful en bloc resection and remained recurrence-free at 18 months post-surgery.

Conclusions:

• Mucous carcinoma of the sigmoid colon can present as a pelvic mass with bladder involvement, mimicking a primary bladder tumor.
• En bloc resection is a viable surgical strategy for such complex pelvic tumors in elderly patients.
• Early diagnosis and aggressive surgical management can lead to favorable outcomes even in advanced cases.