印環細胞癌と低分化腺癌の異時性大腸多発癌の１例

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  • Signet ring cell carcinoma and poorly differentiated adenocarcinoma of colon in metachronous multiple cancer. A case report.

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A 33-year-old man was seen at the hospital because of melena and abdominal pain. Interstinal radiography with the use of an enema detected sigmoid cancer. In June, 1999, the patient underwent a sigmoidectomy. An examination of the excised specimen revealed the tumor to be poorly differentiated adenocarcinoma, se, ly2, v0, n2, ow(-) and aw(-). Intestinal radiography with use of an enema conducted at a periodic examination 20 months after the surgery disclosed a constriction in the descending colon. An anastomotic stenosis was suspected and a colonoscopy was conducted. Consequently, a lesion affecting the entire periphery was found in the descending colon 10cm orally from the anastomotic site. A biopsy revealed the lesion to be signet ring cell carcinoma, and the patient underwent a left hemicolectomy in March, 2001. Histopathologically, the tumor was signet ring cell carcinoma, ss, ly1, v0, n1, ow(-) and aw(-). Most histological types of colonic tumors are adenocarcinoma of high or intermediate level differentiation, and signet ring cell carcinomas account for only 1% of all colonic cancers. A case of signet ring cell carcinoma of the colon developed 20 months after the treatment of poorly differentiated colonic cancer is presented in metachronous multiple cancer, together with a review of the literature.

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