Vol 73, No 3 (2023)
Pictures in Oncology
Published online: 2023-02-23

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Malignant neoplasm of the sigmoid colon found accidentally during a routine gynecological examination

Kamila Stopińska1, Adrianna Marzec1, Anita Olejek1
Nowotwory. Journal of Oncology 2023;73(3):199.

Abstract

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Pictures in oncology

NOWOTWORY Journal of Oncology

2023, volume 73, number 3, 190

DOI: 10.5603/NJO.2021.0022

© Polskie Towarzystwo Onkologiczne

ISSN 0029540X, e-ISSN: 2300-2115

www.nowotwory.edu.pl

Malignant neoplasm of the sigmoid colon found accidentally during a routine gynecological examination

Kamila StopińskaAdrianna MarzecAnita Olejek
Department and Clinic of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, Bytom, Poland

How to cite:

Stopińska K, Marzec A, Olejek A. Malignant neoplasm of the sigmoid colon found accidentally during a routine gynecological examination. NOWOTWORY J Oncol 2023; 73: 199.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

The patient underwent a routine gynecological examination with cytology every year. During 1 appointment, the gynecologist noticed and described a well-defined structure with a positive echo behind the uterus, measuring 22x24 mm in the transvaginal ultrasound (fig. 1). This structure aroused the oncological vigilance of the gynecologist performing the examination. Further diagnostics were recommended, during which a colonoscopy was performed, which revealed a tumor clamping the lumen of the sigmoid colon. In the next stage, a CT scan of the abdominal cavity and pelvis, without any contrasting agent, was performed (fig. 2). The examination revealed a thickening of the colon wall at the level of the initial segment of the sigmoid colon. The patient was qualified for surgical resection of the sigmoid colon. Histopathological examination of the excised tumor confirmed the diagnosis of pT3N1aM0 sigmoid adenocarcinoma. The patient underwent a cycle of adjuvant chemotherapy. This case shows that regardless of the medical specialty, attention should be paid to changes in other organs, including those that are not directly examined. Most colorectal cancers are diagnosed in older patients, over 70 years of age [1]. This patient was in her 50s at diagnosis, so it can be concluded that one should be vigilant for cancer, even if the patient is not directly in the high-risk age group. In this patient, the tumor was asymptomatic and accidental detection enabled the implementation of treatment that led to remission. If the gynecologist had ignored the lesion revealed in the transvaginal ultrasound, most likely the tumor would have been detected at the inoperable stage and, subsequently, only palliative treatment would be possible. In the available literature, one can find information that the only early detection of the disease presents an opportunity for remission [2].

Figure 1. Transvaginal ultrasound, echopositive structure behind the uterus
Figure 2. CT of the abdominal cavity of the pelvis without contrast, segmental thickening of the sigmoid colon

References

  1. Kenig J. Colon cancer in the older population. Nowotwory. Journal of Oncology. 2021; 71(2): 119–121, doi: 10.5603/njo.2021.0025.
  2. Salibasic M, Pusina S, Bicakcic E, et al. Colorectal Cancer Surgical Treatment, our Experience. Med Arch. 2019; 73(6): 412–414, doi: 10.5455/medarh.2019.73.412-414, indexed in Pubmed: 32082011.



Nowotwory. Journal of Oncology