Case Study: Coexistence of tuberculosis and adenocarcinoma in the colon

Summary

The occurrence of tuberculosis with adenocarcinoma is rare, but it has been observed by many. This association has been debated extensively in the literature [1-3]. Here I present a case with similar association, where extended right hemicolectomy was performed, and the diagnosis came only after histopathology. Colonoscopy, colonoscopic biopsy, imaging and other preliminary investigations failed to pick up the pathology because of the inherent complex pathogenesis. Therefore, the concurrent existence of tuberculosis and colon cancer should be kept in mind while dealing with certain clinical history!

Background

Tuberculosis has a predilection for the small intestine, especially the ileo-cecal junction, so patients presenting with features of stricture generally do undergo the appropriate investigations. In cases of severe fibrosis and narrowing of the lumen, it is difficult to get the exact diagnosis preoperatively. In the absence of regional lymphadenopathy and appropriate microbiological studies, tuberculosis might just remain a strong clinical suspicion. Further, the situation is very complicated if well-differentiated carcinoma develops in the narrowed lumen. It is impossible to diagnose if deeper stroma is absent in the biopsy, which is quite likely in cases of stricture. In such cases, we have to keep the possibility of the coexistence of tuberculosis and adenocarcinoma in the ascending colon.

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