Psoas Abscess And Osteomyelitis Of Femoral Head Due To Ileocecal Adenocarcinoma: A Case Report

Retroperitoneal abscess or psoas abscess secondary to perforated colon cancer is unusual. The subtle symptoms of colon carcinoma associated with psoas abscess readily delay the diagnoses, potentially resulting in prolonged sepsis and higher mortality. We report a 64-year-old woman presented with swelling and pain in the right abdomen and inguinal region with painful motion of right hip. A computed tomography (CT) scan showed thick wall of the ileocecum and a huge right-sided retroperitoneal abscess with gas. MRI revealed a large right-sided psoas abscess and destruction of femoral head. Culture of the pus from the inguinal region showed the infection of Escherichia coli. A right hemicolectomy with drainage was performed. Pathology of resected specimen indicated a well-differentiated adenocarcinoma. Thus, the psoas abscess and destruction of femoral head were considered to be caused by retroperitoneal perforation of ileocecal adenocarcinoma.