A Case of sigmoid Colonic Cancer Perforation Diagnosed 9 Years after Renal Transplantation

We report a case of perforated sigmoid colon cancer with a 9-year clinical history of renal transplantation. A 40-year-old man who had lower abdominal pain and a high fever, and who had been diagnosed as panperitonitis at another hospital, was referred to our hospital for operation. Abdominal CT examination revealed panperitonitis due to sigmoid colonic cancer perforation. A sigmoidectomy and descending colonostomy were performed. An immunosuppressive therapy was continued by intravenous injection of adequate Cicrosporine and Methylpredonisolon. The postoperative course was uneventful, and renal function was preserved well. A search of Japanese literature showed no colonic cancerous perforation after renal transplantation. An early surgical treatment and adequate immunosuppressive therapy led to good postoperative course. While renal transplant recipients survive longer, a careful examination for risk of malignancy is recommended.