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Case Reports
. 2008 May 24;2(2):181-6.
doi: 10.1159/000132359.

Recurrent Ascending Colon Cancer Manifesting as Inferior Vena cava Thrombus

Masayuki Tori  1 , Hiroki Akamatsu, Shigeyuki Ueshima, Masahiko Tsujimoto, Masaaki Nakahara
Affiliations
Case Reports

Recurrent Ascending Colon Cancer Manifesting as Inferior Vena cava Thrombus

Masayuki Tori et al. Case Rep Gastroenterol. .

Abstract

We report an extremely rare case of recurrent ascending colon cancer manifesting as inferior vena cava (IVC) thrombus. A 77-year-old woman previously diagnosed with ascending colon cancer underwent right hemicolectomy with lymph node dissection. Though the tumor invaded the retroperitoneum and involved the right ovarian artery and vein, curative operation was performed. The patient took 5-FU p.o. Two and a half years later, tumor thrombus in the IVC extending into the right atrium was incidentally found and diagnosed as recurrence of colon cancer by biopsy. RF-induced hyperthermia using 5-FU and CDDP i.v. was immediately performed, but she died after 6 months because of multiple liver and pulmonary metastases. In treating colon cancers invading the retroperitoneum, it should be recalled that some cases recur as tumor thrombus in the IVC and that close follow-up is therefore necessary.

Keywords: Inferior vena cava; Recurrent colon cancer; Tumor thrombus.

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Figures

Fig. 1
Fig. 1
Resected specimen reveals type 3 tumor in the cecum, 8.5 cm in diameter, with retroperitoneal invasion.
Fig. 2
Fig. 2
Microscopically, the tumor is a moderately differentiated adenocarcinoma (G2) (T4N1M0, stage IIIB, Dukes C) (a). Remarkable tumor thrombus was detected in microcapillary vessels around the tumor (V2) (b).
Fig. 3
Fig. 3
CT scan shows huge tumor thrombus in the IVC. a Tumor thrombus extends above the diaphragm. b Tumor thrombus is detected in the right hepatic vein. c Tumor thrombus extends below the right hepatic vein, involving it.
Fig. 4
Fig. 4
Venography from the right femoral vein shows obstruction of the IVC by tumor thrombus at the level of the left renal vein (arrow #1), with development of collateral veins including vertebral veins (arrows #2).
Fig. 5
Fig. 5
Biopsy by catheter from the femoral vein revealed adenocarcinoma consistent with the former histopathological findings of ascending colon cancer.
Fig. 6
Fig. 6
CT scan six months before the biopsy shows a small low-density area beside the IVC suggestive of tumor thrombus in the right ovarian vein (arrow).
See this image and copyright information in PMC

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