A left-sided cystic pancreatic incidentaloma with sigmoid colon adenocarcinoma: a case report

Abstract

Background: The synchronous colorectal malignancy is well described in the literature but combination of pancreatic incidentaloma with sigmoid cancer has not been well described and the association has not been described in syndrome.

Case presentation: A 65-year-old man from the Indian subcontinent with a history of abdominal pain with loss of appetite, and with a history of bleeding per rectum and altered bowel habits presented to our hospital. An abdominal examination revealed a palpable mass in the region of his epigastrium and left hypochondrium, and a rectal examination was normal. A work-up included blood investigations, an abdominal contrast-enhanced computed tomography scan, a colonoscopy, and a positron emission tomography/computed tomography scan. He was managed by simultaneous distal pancreaticosplenectomy and radical sigmoidectomy. The final histopathology results were suggestive of moderately differentiated adenocarcinoma of the sigmoid colon with serous cystadenoma of the pancreas.

Conclusions: The synchronous sigmoid colon cancer and pancreatic cystic incidentaloma is a rare presentation, which, to the best of our knowledge, has not been reported in the literature. We report the surgical management of this case and present a review of the literature. Genetic studies may be conducted to find out whether there is common genetic mutation resulting in these two malignancies, and may be helpful in screening programs.

Keywords: Pancreatic incidentaloma; Serous cystadenoma pancreas; Sigmoid carcinoma.

Fig. 1

Cystic lesion in distal pancreas on computed tomography

Fig. 2

Circumferential thickening of sigmoid colon on contrast-enhanced computed tomography.

Fig. 3

Cystic lesion in distal pancreas

Fig. 4

Growth in distal sigmoid colon

Fig. 5

Circumferential growth in distal sigmoid