Poorly differentiated adenocarcinoma in the ascending colon with peritoneal dissemination : case report of a patient who survived more than eleven years

Poorly differentiated adenocarcinoma of the large bowel is a rare condition known as having a poor prognosis. We report here- in a case of a patient with a poorly differentiated adenocarcinoma in the ascending colon with peritoneal dissemination who survived more than eleven years thanks to adjuvant chemotherapy. A 53- year-old woman with continuous diarrhea was referred to our hos- pital. Physical examination revealed a fist-sized mass in the right lower quadrant. Barium enema study and colonoscopy showed an ascending colon tumor. Abdominal computed tomography showed extensive ascites and masses besides the ascending colon and in the upper abdomen. Laparotomy confirmed dissemination to the peri- toneum, the pouch of Douglas and the omentum. Right hemicolec- tomy was performed and two masses of the omentum were removed in a palliative intent. Twenty mg of mitomicin C were given intraperitoneally. The resected specimen revealed an ulcerat- ed hard mass 5??5cm in size with unclear margin. Histology showed a poorly differentiated adenocarcinoma with dissemination to the omentum. A continuous infusion of 3000 mg of 5-fluorouracil per 48 hours was given weekly for four weeks followed by 450 mg of oral UFT-E (Uracil:Tegafur) per day as post-operative chemotherapy. The postoperative course was uneventful. Although she underwent removal of a breast cancer eight years after the operation for colon cancer, no sign of tumor progression has been observed for 132 months since the initial operation, by taking UFT- E without any adverse events. (Acta gastroenterol. belg., 2008, 71, 321-324).