Woman diagnosed with colorectal cancer after spotting ‘liver abscess’

Bowel cancer: Dr Philippa Kaye lists the symptoms

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Colon cancer affects men and women equally, occurring in two parts of the large intestine. The disease is often considered hidden because of its lack of symptoms in the early stages. When signs do eventually emerge they tend to be heavily involved with the intestinal tract. Some case reports, however, have described atypical symptoms like liver abscesses manifesting first.

The report, detailed in the Science Repository, explains: “Bowel cancer is the second most common non-cutaneous cancer diagnosed in Australia in both the sexes.

“Pyogenic liver abscess has been reported to be associated with malignancy, especially hepatobiliary and colorectal cancer.”

The report is that of a healthy 70-year-old woman, who presented with non-specific symptoms which were initially thought to be secondary to haematological malignancy.

Further examinations revealed a cluster of large cystic masses which were suggestive of metastatic cancer.

However, her liver lesions responded significantly to antibiotics, which was suggestive of a liver abscess instead.

The patient was admitted to the emergency with one week’s history of malaise and diarrhoea but denied having fever, abdominal pain, weight loss or rectal bleeding.

“She was subsequently confirmed to have caecal adenocarcinoma with no distant metastasis,” states the report.

It continues: “Although uncommon, pyogenic liver abscess can be the first presentation for colorectal malignancy.

“Colonoscopy is essential especially if no clear cause of a liver abscess is identified.”

The clinical presentations of colorectal cancer will likely vary depending on the site and disease stage of the tumour.

In the early stages, symptoms are uncommon but further down the line a patient may experience altered bowel habits, tenesmus and anaemia.

Advanced disease, on the other hand, may manifest as perforation and obstruction of the intestines.

Atypical presentations for colorectal cancer have often been reported, however, and it is therefore important for clinicians to recognise them.

According to the Science Repository, the risk of colon cancer in patients with liver abscesses is significantly higher in patients aged under 60.

It’s been hypothesised that biological processes interfering with the mucous and bacteria in colon cancer are responsible for liver abscesses.

According to Mount Sina, a liver abscess is described as a pus-filled pocket of fluid inside the liver, which is often triggered by uncommon bacteria.

Symptoms of a liver abscess may include:

  • Chest pain (lower right)
  • Pain in the right upper abdomen
  • Clay-coloured stools
  • Dark urine
  • Fever, chill and night sweats
  • Loss of appetite
  • Nausea, vomiting
  • Weight loss
  • Weakness
  • Yellow skin
  • Right shoulder pain.

Spotting the disease early means treatment is more likely to be successful, so anything abnormal in the body should be reported to a GP.

Because bacteria can spread to other body parts and cause infection, swift treatment is important.

Delaying treatment could also allow colon cancer to invade neighbouring tissue, making it harder to survive.

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