A Case of Synchronous Laparoscopic Surgery for Sigmoid Colon Cancer Inaccessible by Colonoscopy and Left Adrenal...

We report the case of a 65-year-old man with sigmoid colon cancer who presented with left lower abdominal pain. Preoperative computed tomography (CT) revealed a tumor in the left adrenal gland. As the patient had no clinical symptoms suggestive of catecholamine excess, the lesion was initially suspected to be a left adrenal metastasis; however, endocrinological evaluation was performed to establish the differential diagnosis. According to the Endocrine Society Clinical Practice Guidelines, the patient was diagnosed with a left adrenal pheochromocytoma. To reduce overall surgical invasiveness and shorten the hospital stay, synchronous laparoscopic resection of the sigmoid colon cancer and the adrenal tumor was planned. The procedure was performed using five ports commonly utilized for left-sided colectomy, with an additional epigastric port, resulting in a total of six ports. Postoperatively, the patient developed adhesive small bowel obstruction, which resolved with conservative management, and he was discharged on postoperative day 19. Simultaneous laparoscopic resection of sigmoid colon cancer and left adrenal pheochromocytoma is extremely rare. The present case provides valuable insight suggesting that safe one-stage surgery may be feasible through meticulous perioperative planning and the use of a transperitoneal approach with a shared operative field. Further accumulation of similar cases is warranted to establish optimal treatment strategies.