由于结肠皮肤瘘伴腹壁脓肿，结肠癌很少见。如果老年患者出现疼痛性腹壁肿块，应怀疑该病。本病例介绍感染的乙状结肠腺癌，旨在强调这种不常见的表现，并带来一些治疗问题。一名 90 岁的女性，既往有高血压和重度抑郁症病史，因左下腹疼痛到急诊科就诊。体检显示有轻微发烧；左下腹象限守卫，腹部肿块 10 厘米，有炎症症状。腹部CT扫描显示乙状结肠呈同心圆状，并伴有腹壁脓肿。她接受了紧急剖腹手术。术中，我们发现感染的乙状结肠肿瘤侵犯腹壁并伴有瘤周脓肿。该肿瘤位于腹壁瘘管的起源处。她接受了脓肿引流手术、乙状结肠切除术和结肠造口术。术后随访一切顺利。手术标本的病理检查得出结肠腺癌伴淋巴结侵犯，分类为 pT4N2M0。尽管进行了初步的医疗和放射干预，但仍需要紧急手术来解决侵入腹壁的感染乙状结肠肿瘤。病理检查发现癌症晚期，但及时干预和辅助治疗，结果积极，两年后未复发。该病例强调了识别结肠癌异常表现的重要性以及迅速诊断和干预的必要性。结肠癌并发结肠皮肤瘘的诊断仍然基于手术治疗后的病理检查。这些肿瘤已处于晚期并与不良预后相关。这凸显了在老年患者出现任何消​​化系统症状之前进行结肠镜检查的兴趣。版权所有 © 2023。由 Elsevier Ltd 出版。

As revealed as a colocutaneous fistula with an abscess in the abdominal wall, colon cancer is rare. It should be suspected in case of a painful abdominal wall mass in elderly patients. This case presentation of an infected sigmoid adenocarcinoma aims to highlight this uncommon presentation presenting some therapeutic issues.A 90-year-old woman with a past medical history of hypertension and major depressive disorder consulted the Emergency Department for lower left quadrant abdominal pain. The physical examination objectified a mild fever; lower left abdominal quadrant guarding, and abdominal mass of 10 cm with inflammatory signs. The abdominal CT scan showed a concentric thickness of the sigmoid colon with an abdominal wall abscess. She underwent an emergent laparotomy. Intraoperatively, we found an infected sigmoid tumour that invades the abdominal wall and is associated with a peritumoral abscess. This tumour was at the origin of the abdominal wall fistula. She underwent surgical drainage of the abscess, sigmoid colectomy, and colostomy. The postoperative follow-up was uneventful. The pathological examination of the operative specimen concluded with a colonic adenocarcinoma with lymph node invasion classified as pT4N2M0.Despite initial medical and radiological interventions, emergent surgery became necessary to address the infected sigmoid tumour invading the abdominal wall. Pathological examination revealed advanced cancer, but timely intervention and adjuvant therapy resulted in a positive outcome with no recurrence after two years. This case emphasizes the importance of recognizing unusual colon cancer presentations and the need for swift diagnosis and intervention.The diagnosis of colon cancer complicated with a colocutaneous fistula remains based on pathological examination after surgical management. These tumours presented an advanced stage and correlated to a poor prognosis. This highlights the interest in screening colonoscopy in front of any digestive symptoms in elderly patients.Copyright © 2023. Published by Elsevier Ltd.