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An Unusual Presentation of Carcinoma of the Cecum

Arch Surg. 1977;112(4):538-539. doi:10.1001/archsurg.1977.01370040190034.
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To the Editor.—The presentation of large bowel pathology as an abscess remote from the primary lesion has been described,1 but the diagnosis is obscure and often delayed. Recently, we encountered a case of a 62-year-old man who had an abscess in the lateral compartment of the right thigh. There was no history of preceding bowel complaint. The differential diagnosis included an abscess due to penetrating injury or an infected hematoma; the possibility of underlying osteomyelitis or septic arthritis, or of pyomyositis, was also entertained. Plain roentgenograms demonstrated air in the tissues of the thigh (Figure). On draining the abscess, 1.5 litres of pus was obtained. The abscess cavity occupied the full length of the thigh; it extended proximally behind the origin of sartorius muscle, beneath the inguinal ligament, and into the right iliac fossa. The pus yielded a heavy growth of Proteus. The precise cause of the abscess


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