The specimen is a convoluted portion of large bowel containing a fungating tumour mass on the upper portion. Immediately adjacent to this there is a portion of omentum with adherent skeletal muscle soft tissue and overlying skin. The tumour mass is adherent to the soft tissue and there is a large abscess cavity in the immediate vicinity of the subcutis. There is a loop of small bowel entrapped between the soft tissue and adherent tumour mass, microscopically this was also shown to be infiltrated by tumour.
This 58-year-old man presented with a short history of localised abdominal pain and weight loss. At operation a huge cavity was found deep to the external oblique muscle and this was drained. Further investigations revealed the presence of a carcinoma in the proximal ascending colon. The patient underwent laparotomy and the carcinoma was found to be firmly adherent to the overlying anterior abdominal wall. The intervening tissue was purulent and there was a distal abscess extending into the subcutaneous fibro-fatty tissue. The tumour abscess cavity and overlying skin were resected en masse. He made an uneventful recovery, but presented with cerebral metastases twelve months after the initial operation.