骨格筋転移を来した胃癌の1例 A CASE OF GASTRIC CANCER WITH METASTASIS TO THE SKELETAL MUSCLE

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症例は67歳,男性.胃進行癌手術施行約4カ月後に左前腕部の無痛性腫瘤を主訴に来院した.触診にて左前腕部に可動性のある弾性硬の腫瘤を触知し,同部の超音波検査にて,筋肉内に比較的境界明瞭な低エコー腫瘤を認めた.左前腕部腫瘍の診断にて摘出手術を施行した.腫瘍は橈側手根伸筋内に存在した.切除標本は, 2.9×1.7×1.5cm大で薄い被膜に覆われた割面乳白色の腫瘍であった.組織学的所見は筋組織内に低~中分化腺癌を認め,胃癌の筋層内転移と診断された.摘出術後,肺,肝,を含め全身的に転移の検索を行い,明らかな転移巣は認めなかったが,約2カ月後に左前腕部の筋層内転移再発を認め,さらに右側胸部(右前鋸筋内)にも同様の腫瘤を認めたため,再び腫瘍摘出手術を行い,病理組織より筋層内転移の再発と診断された.<br> 自験例を含めた胃癌の筋層内転移の本邦報告例17例の検討では筋転移は下肢に多くみられ,組織型は一定した傾向は持たなかった.

A 67-year-old man was seen at the hospital because of a painless tumor in the left antebrachial region about 4 months following an operation for advanced gastric cancer. On palpation, a movable elastic hard tumor was palpated in the left antebrachial region. Ultrasonographic study of the legion revealed a relatively well-demarcated and hypoechoic mass in the muscle. The mass was removed with a diagnosis of tumor of the left antebrachial region. The tumor was present in the carpal extensor muscle. The removed tumor was 2.9×1.7×1.5cm in size and was covered with thin capsule. The cut surface was milk white in color. Histopathologically, poorly to moderately differentiated adenocarcinoma in the muscular tissue was demonstrated. Metastasis of the gastric cancer to the muscular layer was diagnosed. After the removal, an exploration of the whole body including the lung and liver revealed no other recognizable metastatic foci. About 2 months later, however, recurrence in the musculature of the left forearm as well as a similar tumor in the right chest (in the right anterior serratus muscle) was confirmed. These tumors were removed again. Histopathologically, recurrence of muscular metastasis was diagnosed.<br> In a review of 17 cases of muscular metastasis of gastric cancer including this case in the Japanese literature, the muscular metastasis commonly occurs in the lower extremities and has no certain propensity for histologic type.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 60(12), 3167-3171, 1999-12-25

    Japan Surgical Association

参考文献:  23件中 1-23件 を表示

被引用文献:  8件中 1-8件 を表示

各種コード

  • NII論文ID(NAID)
    10008498953
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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