DOI: 10.36347/sasjs.2020.v06i10.006

Pages: 344-347

Introduction: Multiple primary colon tumors are rare and pose significant problems in diagnosis and treatment. We report a case of synchronous transverse colon tumor discovered during management of an occlusion. Observation: A 56-year old patient was admitted to the emergency ward for the management of acute intestinal obstruction. During the surgery, we discovered a bifocal colon tumor: 01 stenosing 5 cm tumor located at the left colic angle and 01 non-stenosing 3 cm tumor located 5 cm from the right colonic angle. We realized enterotomy of the terminal ileum 15 cm from the ileo-cecal crossroads; an ileostomy on a rod in right iliac fossa. The postoperative extension assessment found absence of secondary hepatic, peritoneal, pulmonary and bone lesions. Via Colonoscopy, we found bifocal stenosing tumor of the transverse colon classified T4N0M0. A month and a half later, he underwent a segmental colectomy removing the transverse colon and the two colonic angles with colo-colonic anastomosis and additional appendectomy. The surgery management was simple. Conclusion: Synchronous and consecutive (metachronic) development of two or more primary adenocarcinomas accounts for 3–5% of colorectal cancer cases. It remains important to detect these synchronous tumors at the time of surgery although a third of lesions may be missed this way. The choice of the type of surgery remains controversial, especially for multiple colorectal tumors.