levoleucovorin and Intussusception

Intussusception is a common in pediatric age group. But it is rare in adults. And intussusception caused by tumor account for 1% of bowel obstructions in adult. Intussusception is an extremely rare cause of abdominal pain in pregnancy. In particular, cases of Intussusception due to colorectal cancer during pregnancy have never been reported in Korea. Our patient is a 34 years old woman who presented at 14 weeks of her second pregnancy. She presented with right lower abdominal discomfort and intermittent palpable mass which was usually spontaneously resolved. In the MRI study, pathologic asymmetric wall thickening was still noted and ileocolic intussusception was noted, and in colonoscopy, there was ulcerofungating mass around ileocecal valve which may be a leading point of intussusception. Biopsy was done. Pathologic finding was poorly differentiated adenocarcinoma. Under the patient agreement, we performed dilatation and curettage and laparoscopic right hemicolectomy and lymph node dissection. Now she is receiving a FOLFOX chemotherapy.

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Colonic Neoplasms; Colonoscopy; Female; Fluorouracil; Humans; Intussusception; Laparoscopy; Leucovorin; Lymph Nodes; Magnetic Resonance Imaging; Organoplatinum Compounds; Pregnancy; Ultrasonography

We experienced a rare case of intussusception due to sigmoid colon cancer during chemotherapy. A-62-year-old female was started on mFOLFOX6 due to sigmoid colon cancer and hepatic metastases(stage IV). After 2 courses, she had abdominal pain and bloody stool. Abdominal ultrasonography showed a target sign, and abdominal CT showed edema of the mucosa of the sigmoid colon and invagination. She was diagnosed with intussusception due to sigmoid colon cancer, and underwent a bloodless reduction. However, because it was unavailable, we performed an emergency operation. The sigmoid colon invaginated 10 cm to the anal side. We then performed sigmoidectomy and lymphadenectomy(D2). The histopathological diagnosis was mucinous carcinoma, stage I. There was no report of intussusception with the chemotherapy. It is important to consider the intussusception of colon cancer even during chemotherapy.

Topics: Antineoplastic Combined Chemotherapy Protocols; Female; Fluorouracil; Humans; Intussusception; Leucovorin; Liver Neoplasms; Middle Aged; Organoplatinum Compounds; Sigmoid Diseases; Sigmoid Neoplasms