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Open Access Highly Accessed Case report

Sigmoid colon cancer arising in a diverticulum of the colon with involvement of the urinary bladder: a case report and review of the literature

Yasumichi Yagi1*, Yasuhiro Shoji1, Shozo Sasaki1, Akemi Yoshikawa1, Yuji Tsukioka1, Wataru Fukushima1, Hisashi Hirosawa1, Ryohei Izumi1 and Katsuhiko Saito2

Author Affiliations

1 Department of Surgery, Toyama City Hospital, 2-1 Imaizumi Hokubu-machi, Toyama 939-8511, Japan

2 Department of Pathology, Toyama City Hospital, 2-1 Imaizumi Hokubu-machi, Toyama 939-8511, Japan

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BMC Gastroenterology 2014, 14:90  doi:10.1186/1471-230X-14-90

Published: 13 May 2014

Abstract

Background

Colon cancer can arise from the mucosa in a colonic diverticulum. Although colon diverticulum is a common disease, few cases have been previously reported on colon cancer associated with a diverticulum. We report a rare case of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder, which presented characteristic radiographic images.

Case presentation

A 73-year-old man was admitted to our hospital for macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a sigmoid colon tumor that protruded into the urinary bladder lumen. The radiographs showed a tumor with a characteristic dumbbell-shaped appearance. Colonoscopy showed a type 1 cancer and multiple diverticula in the sigmoid colon. A diagnosis of sigmoid colon cancer with involvement of the urinary bladder was made based on the pathological findings of the biopsied specimens. We performed sigmoidectomy and total resection of the urinary bladder with colostomy and urinary tract diversion. Histopathological findings showed the presence of a colovesical fistula due to extramurally growing colon cancer. Around the colon cancer, the normal colon mucosa was depressed sharply with lack of the muscular layer, suggesting that the colon cancer was arising from a colon diverticulum.

Conclusion

The present case is the first report of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. Due to an accurate preoperative radiological diagnosis, we were able to successfully perform a curative resection for sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder.

Keywords:
Colon cancer; Diverticulum; Urinary bladder invasion