Concurrent ascending colon adenocarcinoma and colonic tuberculosis: a case report from Syria

Abstract

Tuberculosis was one of the most devastating diseases to humanity in recent decades, although pulmonary infection is the most common, Infection of any other organ is familiar as well. Colon cancer is another disease affecting the GI system and mostly targets people over 50. Only few studies mentioned the co-existence of cancer and tuberculosis occurring at the same place and time. Hence, we report a rare case of concurrent ascending colon adenocarcinoma and colonic tuberculosis. A 49 -year-old man presented to our clinic with constipation and abdominal pain. Two colonoscopies were performed and two biopsies were taken, the first one showed granulomatous inflammation consistent with TB, the second one showed low grade adenocarcinoma. Computed tomography showed annular thickening of the ascending colon with infiltrates around the lesions. A right hemicolectomy was performed the final pathology confirmed adenocarcinoma grade II and extensive tuberculosis granulomas involving colon into the serosa and the lymph nodes. Anti-TB medications were administered after surgery. Due to appropriate diagnostic methods, TB and cancer were detected at an early stage. In our treatment protocol, no adjuvant chemotherapy was applied after surgery due to the possibility of drug interaction with Anti-TB medications. the two diseases may co-exist thus diagnosing them may not be the easiest, not to mention the lack of a clear treatment protocol in case of their accompany.