Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1643-1651
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1643
Colon cancer arising from colonic diverticulum: A case report
Hajime Kayano, Yusuhiko Ueda, Takashi Machida, Shinichiro Hiraiwa, Hidenori Zakoji, Takuma Tajiri, Masaya Mukai, Eiji Nomura
Hajime Kayano, Yusuhiko Ueda, Takashi Machida, Masaya Mukai, Eiji Nomura, Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
Shinichiro Hiraiwa, Takuma Tajiri, Departments of Pathology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
Hidenori Zakoji, Departments of Urology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hajime Kayano, MD, PhD, Assistant Professor, Doctor, Surgeon, Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Tokyo, Hachioji 192-0032, Japan. h.kayano@tsc.u-tokai.ac.jp
Telephone: +81-42-6391111 Fax: +81-42-6391144
Received: February 26, 2019
Peer-review started: February 27, 2019
First decision: April 18, 2019
Revised: April 28, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: July 6, 2019
Abstract
BACKGROUND

Colonic diverticulosis is a common disease, and the coexistence of colonic diverticulosis and colorectal cancer is often seen clinically. It is very rare that colon cancer arises from the mucosa of a colonic diverticulum. When colon cancer arises in a diverticulum and then tends to develop outside the wall, without developing within the lumen, the differential diagnosis from complicating lesions due to colonic diverticulitis is difficult.

CASE SUMMARY

A 76-year-old man was admitted to a nearby clinic with a chief complaint of discomfort and urinary frequency. Since a vesicosigmoidal fistula was seen on abdominal computed tomography, he was referred to our hospital. Laparoscopic sigmoidectomy was performed because the various diagnostic findings were diagnosed as a vesicosigmoidal fistula with diverticulitis of the sigmoid colon. However, on histopathological examination, it was diagnosed as a vesicosigmoidal fistula due to colon cancer arising in the diverticulum. Laparoscopic partial resection of the bladder was performed because local recurrence was observed in the bladder wall one and a half years after surgery. It is currently one year after reoperation, but there has been no recurrence or metastasis.

CONCLUSION

Colon cancer arising in a diverticulum of the colon should be considered when diverticulitis with complications is observed.

Keywords: Colon cancer, Diverticulum, Colovesical fistula, Laparoscopic surgery, Diverticulitis, Case report

Core tip: Cancers arising from a diverticulum of the colon are extremely rare, and few cases have been reported. Cancer of a colonic diverticulum has difficulty progressing into the lumen, and it is often difficult to identify by imaging examinations. In addition, due to the anatomical characteristics of the diverticulum, it is easy for the cancer to progress outside the colon wall. Thus, it is often in an advanced stage at the time of discovery, and careful attention is needed.