Case report: Clinical findings of Synchronous Adenocarcinoma Lesions in the Transverse and Ascending Colon in a Remote Area of Kaimana, West Papua

Background: Synchronous colon cancer is a rare case; the prognosis tends to be poor, making diagnosis and management a challenge, especially in remote areas such as Kaimana, West Papua, with limited resources. Case Report: A 58-year-old man came with complaints of constipation and vomiting accompanied by unexplained weight loss. The patient had a history of digestive disorders for 5 years and was accustomed to consuming energy drinks with high frequency. During exploratory laparotomy, a tumor was found in the transverse colon, and a stoma was installed. The results of the colonoscopy biopsy showed adenocarcinoma with moderate differentiation in the ascending and transverse colon. The patient was managed with right hemicolectomy and, extended and end-to-end ileocolic anastomosis. After treatment, the patient showed improvement, and complaints improved. Discussion: A Highlight from this case is that this case is a rare case where the surgical management of synchronous colorectal cancer cases must be careful because there is a possibility of missing other small tumors. Extended hemicolectomy is the right choice considering the number of tumors, location, and limited resources in the hospital, with a high probability of success, so that it can improve the patient’s prognosis. Conclusion: Early screening of gastrointestinal complaints and assessment of risk factors in patients will greatly help in establishing the diagnosis of colon cancer. Extended hemicolectomy is a good management option, especially in cases of low-grade synchronous tumors, especially in areas with limited resources.