An unusual presentation of a colon cancer patient

Abstract

We report a 53-year-old man who presented with anaemic symptoms, left upper quadrant discomfort and weight loss. Physical examination showed marked pallor and splenomegaly. Blood tests showed anaemia, thrombocytosis and presence of atypical lymphocytes. Initially, he was erroneously investigated for underlying haematological disorder and was suspected to have developed splenic infarct as he complained of sudden increase in left upper quadrant pain. Urgent computed tomography of the abdomen revealed a colonic tumour at the splenic flexure with abscess formation. Emergency laparotomy with left colectomy was performed. Pathology showed Dukes’ C moderately differentiated adenocarcinoma infiltrated to the subserosal surface with microabscesses formation in the serosa. The patient was treated as locally advanced colon carcinoma with chemo-irradiation to the anterior abdominal wall followed by adjuvant systemic chemotherapy. This case report illustrates a unique presentation of a patient with carcinoma of colon in the splenic flexure. Symptoms of colon cancer can be non-specific; the physician needs to be alert about the increasing prevalence of colorectal cancer and readily refer patients for further evaluation.