Cáncer colorrectal de presentación atípica / Atypical presentation of a colorectal carcinoma

ABSTRACT

We report a 67 years old male with a history of pulmonary tuberculosis at the age of 15, that consults for malaise, weight loss and productive cough. Chest X ray examination showed a left pleural effusion. A pleural tap obtained a sterile exudate. A thorax CAT scan showed a proliferating mass in the splenic angle of the colon, with left lung and diaphragmatic invasion. Endoscopic biopsies confirmed the diagnosis of adenocarcinoma. The patient underwent a subtotal colectomy with partial excision of diaphragm and left lung. The pathological report showed a mucosecretory adenocarcinoma, infiltrating the pericolonic adipose tissue without adjacent organ infiltration and a chronic inflammatory process involving colonic serosa, diaphragm pleura, and lung. Adjuvant chemotherapy was indicated and the patient is asymptomatic and without evidences of tumor recurrence after a 24 months follow up (Rev Méd Chile 2004; 132 985-88).