Korean J Radiol.  2008 Jul;9(Suppl):S56-S60. 10.3348/kjr.2008.9.s.s56.

The Association of Anisakiasis in the Ascending Colon with Sigmoid Colon Cancer: CT Colonography Findings

• Yoo HJ
• Kim SH
• Lee JM
• Kim MA
• Han JK
• Choi BI

• KMID: 1100106
• DOI: http://doi.org/10.3348/kjr.2008.9.s.s56

Abstract

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

Keyword

Anisakiasis; Parasites; Colon, neoplasms; Colon, inflammation; Colon, CT

MeSH Terms

Adenocarcinoma/*complications/*radiography/surgery
Anisakiasis/*complications/*radiography/surgery
Colectomy
Colonic Diseases/*complications/*radiography/surgery
*Colonography, Computed Tomographic
Female
Humans
Middle Aged
Sigmoid Neoplasms/*complications/*radiography/surgery

Figure

• 

  Fig. 1 Anisakiasis of ascending colon in association with sigmoid colon cancer. A, B. Coronal multiplanar reconstruction images of CT colonography demonstrated concentric and enhancing wall thickening with luminal narrowing in sigmoid colon (arrow in A) and low attenuating wall thickening with pericolic infiltration in ascending colon (arrows in B). C. Volume rendered surface-shaded image on CT colonography revealed apple-core shaped, concentric narrowing in sigmoid colon (arrow). In ascending colon, segmental fold thickening with thumb print-like appearance was seen (arrowheads). D. Virtual endoscopic image of sigmoid colon revealed concentric mass (arrows). E. Irregular fold thickening and mild luminal narrowing was identified in virtual endoscopic image of ascending colon. F. Gross pathologic specimen revealed ulceroinfiltrative mass (arrows) in sigmoid colon and another ulcerative mass (arrowheads) in ascending colon. The adjacent folds (*) around ascending colonic mass were edematous. G. Histological examination (original magnification ×5, Hematoxylin & Eosin staining) revealed heavy infiltration by eosinophils. Several parasite worms (arrows) were found within edematous submucosal layer. H. Microscopic photograph (original magnification, ×100) of cross-section through intestinal region of nematode. Note external cuticle (C) of overlying muscle layer (M), two Y-shaped lateral epidermal cords (EC), and digestive tract (DT) with single layer of columnar epithelial cells.

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