COEXISTENCE OF TUBERCULOSIS AND ADENOCARCINOMA OF THE COLON

ABSTRACTA 60-years-old, male patient presented with a-tender swelling in the right iliac fossa with right hip flexiondeformity suggesting of psoas abscess. Following emergency drainage of faeculant pus, the general conditionof the patient improved. The barium enema showed leaking ascending colonic ulcer and colonoscopicexamination revealed nonspecific ulcerative lesion in the ascending colon. Repeat investigations were alsonon-conclusive except there was a stricture at the ascending colon on colonoscopy. A second operationshowed that there was a huge mass of terminal ileum, cecum and ascending colon and perforation of ascendingcolonic ulcer most likely carcinoma. Right hemicolectomy was performed with uneventful postoperativeperiod. Histopathological examination revealed well differentiated adenocarcinoma limited to the musclelayer of the ascending colon and features suggestive of colonic tuberculosis at the same site. Antituberculartreatment was completed with regular follow-up and monitoring on CEA level. Patient has been doing well3 years postoperatively. Although rare, the coexistence of colonic tuberculosis with carcinoma may occur. Adefinitive diagnosis can be established only by histological examination.Key Words: Colonic tuberculosis, Adenocarcinoma, Histology.