Absceso de Psoas Secundario a un Adenocarcinoma Mucinoso de Colon Perforado: Semiología.

Abstract

Abscess of Psoas Secondary to a Mucinous Adenocarcinoma of Perforated Colon: Semiology. Case Report. Psoas abscess secondary to perforated colon mucinous adenocarcinoma is a rare entity that occurs in 1.8% of the population, which makes it difficult to diagnose and increases morbidity and mortality (9). A patient with a diagnosis of psoas abscess of unknown pale etiology in regular general conditions, a history of recurrent drainage, a physical examination, presence of a catheter on the right iliac crest with leakage of scarce purulent serous fluid, paraclinics with evidence of anemia. normocytic heterogeneity, thrombocytosis and eosinophilia. As a possible diagnosis, spondylodiscitis was considered, a chest xray was performed to rule out pulmonary tuberculosis and MRI (Nuclear Magnetic Resonance) revealed a continuity solution in the posterior wall of the caecum with a collection that extended into the lateral wall of the pelvis. Affecting the iliac component of the right iliac psoas muscle, finding suggestive of a tumoral lesion, probably mucinous adenocarcinoma of the perforated caecum. Patient undergoes right hemicolectomy with histopathological report of blind tumor with macroscopic perforation present of type adenocarcinoma of high grade mucinous pattern with poor lymphoid response, extension to the serosa with perforation, metastasis to 2 lymph nodes and tumor implants to mesogastrium, classification pT4N1M1. Management was initiated with drainage, antibiotic therapy, iron, and the process of referral to the oncology clinic began. The case allowed us to recognize the operational performance of the diagnostic tests and the importance of their integration with the semiology of the patient, elements that were fundamental to reach an accurate diagnosis