Synchronous Primary Carcinoma of the Colon – A case report and review of literature

Synchronous carcinoma of the colon is rare but not infrequent. The incidence ranges from 2-5% . Synchronous primary carcinoma of the colon is defined as two or more primary colonic cancers are identified at the same time and confirmed by histological evaluation. The significance of synchronous primaries is not to miss second lesion, patients needs complete screening of the colon and excision of all the lesions. Patient may go for extended colectomy. We came across one such case who presented with pain abdomen for one month and abdominal distension with vomiting for two days. On abdominal examination a hard lump was present in the right upper abdomen after upper gastro intestinal decompression was done by nasogastric tube aspiration.USG abdomen revealed thickening and narrowing of ascending colon and splenic flexure areas of the colon. Colonoscopy could not be negotiated beyond upper end of the descending colon. Exploratory laparotomy was done and two growths one at just above the caecum and another is just below the splenic flexure. Extended right hemicolectomy was done followed by end to end ileo-colostomy was done. Post operative period was uneventful. We are presenting this case because of its rarity which demands complete evaluation of the colon by colonoscopy. if colonoscopy does not yield any result exploratory laporotomy and meticulous palpation of the colon is advised. We also reviewed the literature to freshen our knowledge regarding synchronous primary of colon.