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Introduction: Colorectal cancer is the third most commonly diagnosed cancer worldwide, and its incidence is rising in developing countries. Studies have shown an association between sarcopenia and various poor short-term outcomes in cancer patients who underwent surgery. In this case study, we sought to highlight the importance of a modern prognostic factor, the psoas muscle index (PMI), in colorectal cancer. Case Presentation: We present the case of a 59-year-old male patient with sigmoid cancer. We calculated the PMI as the sum of the areas of the left and right psoas muscle at the level of the L3 vertebra, divided by the square of the patient’s height, using computed tomography measurements. We also measured the density of the proas muscles. Prior to surgery, the left psoas muscle had an area of 14.52 cm2, and the right 14.54 cm2, with a PMI of 9.4967 cm2/m2. The mean density of the psoas muscles was 43.60 UH. The surgery consisted in a rectosigmoid resection with termino-terminal colorectal anastomosis. The histopathological examination confirmed moderately differentiated adenocarcinoma, stage IIIB (pT3N1M0). The patient left the hospital eight days after surgery in good general condition. Long-term follow-up was performed by phone and CT scans at 1, 6, and 12 months. Conclusions: CT-measured PMI may be a potential prognostic imaging marker in patients with colorectal cancer that can be easily and routinely assessed preoperatively.

Introduction: Colorectal cancer is one of the most common types of malignant tumors worldwide. In patients with situs abnormalities such as situs inversus totalis or situs ambiguus, the presence of this tumor could be a challenge for the surgeon, especially in cases in which the laparoscopic approach is considered. Case presentation: We report the case of a 69-year-old male patient with situs inversus totalis. This particular case of situs inversus totalis was not a classical type because the patient had bilateral bilobed lungs, polysplenia, preduodenal portal vein in association with midgut malrotation. The pathology report after surgery revealed moderately differentiated adenocarcinoma of the sigmoid colon, stage pT3 N1c M1a, liver metastases but without metastases in the eight resected lymph nodes. We compared this rare association of diseases of particular anatomic aspects with other reports in the specialty literature. Conclusion: The identification of situs abnormalities or other malformations in patients with resectable colorectal cancer is essential, thus preoperative imaging studies are imperative for a proper surgical management. Colorectal cancer metastasizing patterns in patients with intestinal malrotation need to be further investigated.