Colorectal cancer and intestinal tuberculosis.

Intestinal tuberculosis occurring together with colorectal cancer is an uncommon event and presents an interesting patho-aetiological relationship. Four cases of abdominal tuberculosis occurring together with colorectal cancer are presented. There were three males and a female. The median age was 71 years with a range from 68 to 75 years. All cancers were moderately differentiated adenocarcinomas. Two of the carcinomas were Dukes B, one had a metastatic liver nodule whilst one was locally advanced. One of the tumours occurred in the sigmoid colon, two were in the rectum and one was in the right colon. Acid-fast bacilli were identified in tissues from all patients. Of the four patients, tuberculosis was only found within the regional lymph nodes in one patient; in one patient tuberculosis was found immediately adjacent to the tumour plaque; in one patient tuberculosis was disseminated within the abdominal cavity; whilst in one patient the two diseases coexisted with the same tumour mass. All the patients had had a complete course of anti-tubercular chemotherapy but no patient had had radiotherapy or chemotherapy for cancer. All the patients are well and no patient has detectable recurrence of tuberculosis or cancer at a median follow-up of 34 months (range: 21-36). The exact relationship of abdominal tuberculosis with colonic cancer is speculative but the possibility of a cause and effect relationship exists.