COEXISTENCE OF TUBERCULOSIS AND ADENOCARCINOMA OF THE COLON

Abstract

ABSTRACT
A 60-years-old, male patient presented with a-tender swelling in the right iliac fossa with right hip flexion
deformity suggesting of psoas abscess. Following emergency drainage of faeculant pus, the general condition
of the patient improved. The barium enema showed leaking ascending colonic ulcer and colonoscopic
examination revealed nonspecific ulcerative lesion in the ascending colon. Repeat investigations were also
non-conclusive except there was a stricture at the ascending colon on colonoscopy. A second operation
showed that there was a huge mass of terminal ileum, cecum and ascending colon and perforation of ascending
colonic ulcer most likely carcinoma. Right hemicolectomy was performed with uneventful postoperative
period. Histopathological examination revealed well differentiated adenocarcinoma limited to the muscle
layer of the ascending colon and features suggestive of colonic tuberculosis at the same site. Antitubercular
treatment was completed with regular follow-up and monitoring on CEA level. Patient has been doing well
3 years postoperatively. Although rare, the coexistence of colonic tuberculosis with carcinoma may occur. A
definitive diagnosis can be established only by histological examination.

Key Words: Colonic tuberculosis, Adenocarcinoma, Histology.