Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report

Abstract Background There are few reports of metastases from colon cancer to an inguinal hernia sac, and few reports of colon cancer originating in diverticula. We report a patient with carcinoma of the sigmoid colon arising in two diverticula, who presented with peritoneal seeding to an inguinal he...

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Main Authors: Jiro Kimura, Alan Kawarai Lefor, Shota Fukai, Kentaro Yoshikawa, Shingo Sasamatsu, Takashi Sakamoto, Ken Mizokami, Masaki Kanzaki, Tadao Kubota, Akira Saito, Hiroshi Izumi, Kunpei Honjo, Kunihiko Nagakari, Masaki Fukunaga
Format: Article
Language:English
Published: Japan Surgical Society 2018-05-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0455-y
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author Jiro Kimura
Alan Kawarai Lefor
Shota Fukai
Kentaro Yoshikawa
Shingo Sasamatsu
Takashi Sakamoto
Ken Mizokami
Masaki Kanzaki
Tadao Kubota
Akira Saito
Hiroshi Izumi
Kunpei Honjo
Kunihiko Nagakari
Masaki Fukunaga
author_facet Jiro Kimura
Alan Kawarai Lefor
Shota Fukai
Kentaro Yoshikawa
Shingo Sasamatsu
Takashi Sakamoto
Ken Mizokami
Masaki Kanzaki
Tadao Kubota
Akira Saito
Hiroshi Izumi
Kunpei Honjo
Kunihiko Nagakari
Masaki Fukunaga
author_sort Jiro Kimura
collection DOAJ
description Abstract Background There are few reports of metastases from colon cancer to an inguinal hernia sac, and few reports of colon cancer originating in diverticula. We report a patient with carcinoma of the sigmoid colon arising in two diverticula, who presented with peritoneal seeding to an inguinal hernia sac, and a review of the literature. Case presentation A 55-year-old male underwent open herniorrhaphy for a left inguinal hernia. At operation, a nodule in the inguinal hernia sac was resected and histologic examination revealed adenocarcinoma, which was suspected to be a metastasis from a distant primary lesion. Postoperative evaluation included colonoscopy and positron emission tomography which showed two suspected lesions in sigmoid diverticula. Laparoscopic subtotal colectomy was performed, and pathology revealed adenocarcinoma in two sigmoid diverticula. Conclusions If a nodule is found in an inguinal hernia sac, especially in older patients, peritoneal metastases should be considered. Resection of the nodule with histopathologic evaluation is essential. Colon cancer arising in a diverticulum should be considered as a possible site of the primary lesion.
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spelling doaj-art-d264c8ddcaa845e0a755207bcbedfe0e2025-08-20T02:51:38ZengJapan Surgical SocietySurgical Case Reports2198-77932018-05-01411510.1186/s40792-018-0455-yMetastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case reportJiro Kimura0Alan Kawarai Lefor1Shota Fukai2Kentaro Yoshikawa3Shingo Sasamatsu4Takashi Sakamoto5Ken Mizokami6Masaki Kanzaki7Tadao Kubota8Akira Saito9Hiroshi Izumi10Kunpei Honjo11Kunihiko Nagakari12Masaki Fukunaga13Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Jichi Medical UniversityDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Pathology, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Pathology, Tokyo Bay Urayasu Ichikawa Medical CenterDepartment of Surgery, Juntendo Urayasu Hospital, Juntendo UniversityDepartment of Surgery, Juntendo Urayasu Hospital, Juntendo UniversityDepartment of Surgery, Juntendo Urayasu Hospital, Juntendo UniversityAbstract Background There are few reports of metastases from colon cancer to an inguinal hernia sac, and few reports of colon cancer originating in diverticula. We report a patient with carcinoma of the sigmoid colon arising in two diverticula, who presented with peritoneal seeding to an inguinal hernia sac, and a review of the literature. Case presentation A 55-year-old male underwent open herniorrhaphy for a left inguinal hernia. At operation, a nodule in the inguinal hernia sac was resected and histologic examination revealed adenocarcinoma, which was suspected to be a metastasis from a distant primary lesion. Postoperative evaluation included colonoscopy and positron emission tomography which showed two suspected lesions in sigmoid diverticula. Laparoscopic subtotal colectomy was performed, and pathology revealed adenocarcinoma in two sigmoid diverticula. Conclusions If a nodule is found in an inguinal hernia sac, especially in older patients, peritoneal metastases should be considered. Resection of the nodule with histopathologic evaluation is essential. Colon cancer arising in a diverticulum should be considered as a possible site of the primary lesion.http://link.springer.com/article/10.1186/s40792-018-0455-yColon cancerDiverticulumHernia sac
spellingShingle Jiro Kimura
Alan Kawarai Lefor
Shota Fukai
Kentaro Yoshikawa
Shingo Sasamatsu
Takashi Sakamoto
Ken Mizokami
Masaki Kanzaki
Tadao Kubota
Akira Saito
Hiroshi Izumi
Kunpei Honjo
Kunihiko Nagakari
Masaki Fukunaga
Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
Surgical Case Reports
Colon cancer
Diverticulum
Hernia sac
title Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
title_full Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
title_fullStr Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
title_full_unstemmed Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
title_short Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report
title_sort metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy a case report
topic Colon cancer
Diverticulum
Hernia sac
url http://link.springer.com/article/10.1186/s40792-018-0455-y
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