24894  CARCINOMA OF THE COLON ADHERENT TO OVARY AND UTERUS

The patient was a woman aged 87 who was admitted with gangrene of the left tow and gross congestive cardiac failure.  The gangrene spread and she died 4 days later.  There was no history of alimentary symptoms.  At postmortem a large matted mass was found in the pelvis, which dissection showed to result from an encircling carcinoma of the colon some 5 cms in length with an ulcerated nodular surface.  This is shown in the specimen.  The lower border of the tumour is adherent to the left ovary and to the posterior surface of the left cornu of the uterus.  There is hypertrophy of the muscle coat of the colon proximal to the tumour and there is dilatation and thinning of the colon below it.  A separate malignant polyp 2 x 1.5 cms is present on the anterior wall of the colon just distal to the main tumour.  The uterus is atrophic and there is a small endocervical polyp protruding through the external os.  Histology shows a well-differentiated tubular columnar-celled adenocarcinoma.