Introduction
Enterocutaneous Fistula is an abnormal connection between the intestinal
tract and the skin that arises iatrogenically, often due to surgical
complications such as intestinal anastomotic dehiscence and enterotomies
(1)Abdominal trauma accounts for the etiology in 25-50% of ECF cases,
while other origins encompass cancer, radiation, inflammatory bowel
disease (IBD), ischemia, and infectious diseases. Therefore, the origins
of ECF can be postoperative, traumatic, or spontaneous.(2)
Colorectal carcinoma (CRC), in contrast, is the third most prevalent
cancer globally, with 1.8 million new diagnoses and stands as the second
leading cause of cancer-related deaths, contributing to approximately
881,000 fatalities in 2018(3). The cecum, the initial segment of the
colon, can harbor a specific form of cancer termed as carcinoma of the
cecum. Despite its often subtle clinical presentation, historical data
reveals that nearly 20% of colorectal tumors originate in the cecum.
Notably, gastrointestinal tuberculosis is often referred to as the
”great mimic” because it exhibits symptoms similar to those of cecal
malignancy, complicating its accurate diagnosis(4). Not only this, the
convergence of enterocutaneous fistula (ECF) with colorectal cancer
(CRC) too is a rare occurrence, typically indicative of an advanced
stage of the disease. This case report aims to elucidate the exceptional
conjunction of carcinoma of the cecum with enterocutaneous fistula, an
association rarely documented in the medical literature, thereby aiming
to underscore the possibilities of misdiagnosis, the importance of early
detection, intervention and management in advanced cases of colon cancer
that carry poor prognosis.