Carcinoma colon recurrence in anterior abdominal wall of pregnant patient - case report

A 22 years old pregnant female of G2A1 presented as 38 weeks pregnancy with lower abdominal lump since 3 months. Initially painless, later had dull aching intermittent pain. Past history of exploratory Laparotomy for carcinoma of colon 1 year back. History of taken incomplete cycles of adjuvant chemotherapy was postoperatively. Per Abdominal examination showed 38 weeks uterus with a single globular mass of 6cms x 4cms situated just beneath the laparotomy scar in midline in suprapubic region. Firm in consistency, freely mobile but becomes less prominent on leg raising test. Ultasound abdomen showed thick walled 6cms x 3.7cms hypoechoic space occupying mass with septations and internal degeneration suggestive of Abscess or Haematoma in anterior parietes of abdomen. Liver and other abdominal viscerae appeared normal. Fine Needle Aspiration Cytology revealed only blood elements. Emergency Lower Segment Caesarean Section done for fetal distress, abdominal mass of 12cms x 10cms x 8cms adherent to rectus sheath was excised. Patient delivered a live healthy female baby. Postoperative recovery was uneventful. Histopathology of excised mass revealed well encapsulated moderately differentiated adenocarcinoma (non mucous secreting).