Poorly differentiated mesenteric carcinoma of unknown primary site detected by abscess formation: case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Poorly differentiated mesenteric carcinoma of unknown primary site detected by abscess formation: case report Yukinori Yamagata1*, Yukari Ando1, Keisuke Matsusaka2, Hisako Karube1, Haruna Onoyama1, Susumu Aikou1, Hiroharu Yamashita1, Kazuhiko Mori1, Sachiyo Nomura1, Masashi Fukayama2 and Yasuyuki Seto1
Abstract Background: Carcinoma of unknown primary site (CUP) is said to account for approximately 3 to 5% of all carcinomas. However, an isolated lesion in the abdominal cavity is rare, and there are no reports describing associated abscess formation. Case presentation: A 76-year-old woman had consulted a previous physician complaining of fever and right lower quadrant abdominal pain. Enhanced computed tomography (CT) showed an abscess formation around the cecum. She was treated conservatively with antibiotics, but the symptoms relapsed and she consulted our hospital. Enhanced CT showed a persistent abscess, a tumorous lesion in the mesentery and right hydronephrosis. Because malignancy could not be ruled out, surgical treatment was selected. At laparotomy, encapsulated abscesses were found on the mesenteric side and outside of the ileocecal region. When we raised the ileocecal region, a tumor was found to be fixed to the right ureter, and there was leakage of white, solid tumor content. This tumor content was submitted to intraoperative frozen section diagnosis which revealed a carcinoma. Ileocecal resection with D3 lymph node dissection and retroperitoneal tumor resection was thus performed. There were no abnormal findings in the uterus and adnexa, nor any evidence of peritoneal dissemination. We regarded this case as an incomplete resection and chemotherapy with paclitaxel and carboplatin was administered. The patient has remained alive and disease-free for almost one year since the primary operation. Conclusion: We described a case with mesenteric CUP discovered during surgery for an intra-abdominal abscess. It is necessary to pay attention to treatment-resistant intraperitoneal abscesses as they may accompany a tumor. Keywords: Carcinoma of unknown primary site, Abscess, Mesentery
Background Carcinoma of unknown primary site (CUP) is defined as the presence of metastatic cancer in the absence of an identifiable primary tumor site, even after thorough clinical examination and diagnostic studies. CUP accounts for approximately 3 to 5% of all malignancies, and is thus not particularly rare [1,2]. However, CUPs are a heterogeneous group of malignant neoplasms with different biological characteristics. In CUP cases, finding an isolated lesion in the abdominal cavity is rare, and * Correspondence: [email protected] 1 Department of Gastrointestinal Surgery, the University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan Full list of author information is available at the end of the article
associated abscess formation is extremely rare. Herein, we report a CUP case in which a tumor was discovered during surgery for a treatment-resista
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