{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:23:15Z","timestamp":1787656995706,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,13]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Mucinous adenocarcinoma (MAC) is a distinct subtype of colorectal cancer that is more often diagnosed at an advanced stage and has been associated with greater local invasiveness and a less favourable response to chemotherapy. We report a man in his 80s who presented with progressive weight loss, abdominal pain and altered bowel habits. Diagnostic evaluation revealed a large ascending colon mass extending to the hepatic flexure, with direct duodenal invasion causing high-grade obstruction. The patient underwent an en bloc extended right hemicolectomy with duodenal resection and reconstruction. Histopathological examination confirmed a moderately differentiated MAC, pathological stage pT4bN0. He subsequently received adjuvant capecitabine and remained under follow-up for approximately 3 years. This case highlights the aggressive nature of MAC and its uncommon but recognised extension into the duodenum.<\/jats:p>","DOI":"10.1136\/bcr-2026-273239","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:05:19Z","timestamp":1787655919000},"page":"e273239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced mucinous adenocarcinoma of the ascending colon with duodenal invasion: a surgical and diagnostic challenge"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9728-6310","authenticated-orcid":false,"given":"Mohammad","family":"Abuassi","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8479-5503","authenticated-orcid":false,"given":"Toufic","family":"Dabit","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bellal","family":"Alfar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jordan Hospital, Amman, Jordan"},{"name":"Ibn Sina University for Medical Sciences, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Jarrad","sequence":"additional","affiliation":[{"name":"Hepatology, Gastroenterology and Hepatobiliary\/Transplant Unit, Jordan Hospital, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiman","family":"Obed","sequence":"additional","affiliation":[{"name":"Ibn Sina University for Medical Sciences, Amman, Jordan"},{"name":"Jordan Hospital, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"2026082504050953000_19.8.e273239.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"2026082504050953000_19.8.e273239.2","doi-asserted-by":"crossref","DOI":"10.1186\/s40880-019-0361-0","article-title":"Mucinous colorectal adenocarcinoma: clinical pathology and treatment options","volume":"39","author":"Luo","year":"2019","journal-title":"Cancer Commun (Lond)"},{"key":"2026082504050953000_19.8.e273239.3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1159\/000487710","article-title":"Advanced mucinous colorectal cancer: epidemiology, prognosis and efficacy of chemotherapeutic treatment","volume":"98","author":"Ott","year":"2018","journal-title":"Digestion"},{"key":"2026082504050953000_19.8.e273239.4","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2321-7"},{"key":"2026082504050953000_19.8.e273239.5","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt591"},{"key":"2026082504050953000_19.8.e273239.6","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1038\/bjc.2016.57","article-title":"Predictive value of mucinous histology in colon cancer: a population-based, propensity score matched analysis","volume":"114","author":"Warschkow","year":"2016","journal-title":"Br J Cancer"},{"key":"2026082504050953000_19.8.e273239.7","doi-asserted-by":"crossref","DOI":"10.3892\/etm.2021.10813","article-title":"Right-sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience","volume":"22","author":"Cojocari","year":"2021","journal-title":"Exp Ther Med"},{"key":"2026082504050953000_19.8.e273239.8","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6462-1"},{"key":"2026082504050953000_19.8.e273239.9","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2011-200340"},{"key":"2026082504050953000_19.8.e273239.10","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s00384-018-2997-7","article-title":"A pooled analysis of en bloc right hemicolectomy with pancreaticoduodenectomy for locally advanced right-sided colon cancer","volume":"33","author":"Li","year":"2018","journal-title":"Int J Colorectal Dis"},{"key":"2026082504050953000_19.8.e273239.11","first-page":"5","article-title":"T4 colon cancer\u2014current management","volume":"44","author":"Diaconescu","year":"2018","journal-title":"Curr Health Sci J"},{"key":"2026082504050953000_19.8.e273239.12","first-page":"3","article-title":"Clinical practice guidelines for the surgical management of colon cancer: a consensus statement of the Hellenic and Cypriot Colorectal Cancer Study Group by the HeSMO","volume":"29","author":"Xynos","year":"2016","journal-title":"Ann Gastroenterol"},{"key":"2026082504050953000_19.8.e273239.13","first-page":"872","article-title":"Multivisceral resection for locally advanced right-sided colon cancer involving the duodenum and\/or pancreas: a narrative review","volume":"15","author":"Costa","year":"2023","journal-title":"World J Gastrointest Surg"},{"key":"2026082504050953000_19.8.e273239.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.06.022"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:05:21Z","timestamp":1787655921000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":14,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,25]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-273239"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273239","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}