An Unusual Cause of Upper Gastrointestinal Bleeding in Clinical Practice; A Case Report of Locally Invasive Colon Cancer with Superimposed Actinomycosis
Y. A. Awuku *
Department of Medicine and Therapeutics, University of Cape Coast, Ghana
Y. A. Nartey
Department of Medicine and Therapeutics, University of Cape Coast, Ghana
J. I. Lovi
Department of Medicine and Therapeutics, University of Cape Coast, Ghana
M. Nortey
Department of Surgery, University of Cape Coast, Ghana
T. M. Morna
Department of Surgery, University of Cape Coast, Ghana
P. K. Akakpo
Department of Pathology, University of Cape Coast, Ghana
*Author to whom correspondence should be addressed.
Abstract
Background: Colon cancer commonly presents with lower gastrointestinal bleeding in symptomatic patients. Upper gastrointestinal bleeding as a symptom of colon cancer is unusual. This case highlights the diagnostic and management challenges of colon cancer masquerading as gastric ulcer with a bleeding complication.
Case Presentation: We report the case of a 45-year-old man who presented with passage of melaena stools with associated epigastric pain. Endoscopy revealed gastric ulcer in the greater curvature. Histopathology identified a diffuse adenocarcinoma with superimposed actinomycosis. Intra-operatively the patient was found to have a carcinoma of the transverse colon diffusely infiltrating and ulcerating the stomach in its greater curvature. Patient died from bilateral pulmonary thromboembolism 10 weeks after the surgery.
Conclusion: Although rare, colon cancer can present with upper gastrointestinal bleeding. It must be considered as a differential in the work up for a patient passing melaena stool.
Keywords: Colon cancer, upper gastrointestinal bleeding, gastric actinomycosis