[The surgical case of a 34-year-old female patient with a metastatizing double colon tumor with different histological structure, causing mechanical obstruction].

We would like to present the case of a young woman (age 34) who was admitted to our department due to unbearable colicky pain, which started one week prior to her hospitalization. Examinations revealed mechanical obstruction, which is very unusual in her age without surgical history. During emergency surgery, we found descending colon tumour which was invading the abdominal wall with pelvic carcinomatosis at the border of the sigmoid colon. Due to extreme colonic dilation and impending rupture of the colonic serosa, we performed a subtotal colectomy with ileosigmoid anastomosis. In addition, pelvic peritonectomy was carried out, too. The histopathological examination of the resected part demonstrated adenocarcinoma of the descending-sigmoid colon, as well as another - histologically different - tumour (a well-differentiated neuroendocrine carcinoma [NEC]), which would not have been discovered, because it was invisible and impalpable. However, this latter tumour was responsible for the peritoneal metastases.