A CASE OF ADVANCED CECAL CANCER COMBINED WITH TUBERCULOUS MESENTERIC LYMPHADENITIS

We report a case of advanced cecal cancer combined with the tuberculous mesenteric lymphadenitis that was miss-diagnosed as distant lymph node metastases (N4+) of the cecal cancer during operation. A 68-year-old woman was admitted to the hospital in the hope of undergoning surgery for a cecal cancer which was detected with close examination. She and her family had no previous history of tuberculosis. At laparotomy, beaded swelling of lymph nodes sized as 1_??_3cm were observed along from the ileocolic to the supramesenteric artery, and at the 1st and 2nd jejunal arteries. We missdiagnosed these lymph nodes swelling as metastases (N4+) of the cecal cancer and a right hemicolectomy with possible lymph node dissection was performed. Histopathological study revealed that the lymph nodes were not metastases but tuberculous mesenteric lymphadenitis. There was no findings of coexisting colonic tuberculosis at the cecum. A possibility of coexisting tuberculous mesenteric lymphadenitis must be ruled out when we find the extraordinarily extended intraabdominal lymph node swelling without other distant metastases in patients with coloreectal cancer.