22197              RING CARCINOMA OF THE SIGMOID COLON

The patient was a man aged 60 who presented with progressive constipation, anorexia and abdominal swelling, terminating in a large bowel obstruction.  He was managed with gastric suction, intravenous therapy and serial enemas without satisfactory improvement.  Sigmoidoscopy was blocked at 24cms.

On the day after admission the left leg became cold and mottled and he died suddenly next day from massive pulmonary embolism.  At postmortem a tumour was found in the sigmoid colon 20 cms from the anus.  There were no obvious metastases in regional nodes or the liver.  The specimen shows the tumour which is 5 cms in length and completely encircles the bowel.  Its inner surface is irregular and nodular and there is a narrow straight lumen about 1 cm in diameter.  The tumour is obviously infiltrating in the mesocolon on the left side, and nodules of tumour are present beneath the peritoneum on the serosal surface.  A leash of tortuous congested vessels is present on the serosal aspect of the growth.  Histology shows tubular columnar-celled adenocarcinoma.