2度にわたり腸重積症をきたした異時性大腸癌の1例

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  • A CASE OF COLONIC CANCER WITH INTUSSUSCEPTION TWICE FOR SIX YEARS

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We experienced a rare case of colonic cancer causing intussusception twice for these 6 years. An 88-year-old man was seen at the hospital because of diarrhea. There was a previous history of undergoing sigmoidectomy for retrograde intussusception due to a cancer of the sigmoid coin in the hospital 6 years earlier. The resected specimen showed a cancer in villous adenoma measuring 4.5×3.5cm in size and the depth of invasion was mucosa, without lymph node metastasis. In this admission an ascending colon cancer with intussusception was suspected by physical findings, ultrasonography, computed tomography and colonoscopy. Lapalotomy was performed, and we found the terminal ileum invaginated into the ascending colon and two tumors in the ascending colon. Ileocecal lesion and the ascending colon were resected with regional lymph nodes. The resected specimen showed two Borrman's type 1 cancers, measuring 6.0×4.0cm (moderately differentiated adenocarcinoma, ss, ly2, v0) and 3.5×1.5cm in size (moderately differentiated adenocarcinoma, pm, ly1, v0). The postoperative course was uneventful.<br> Such a specific clinical feature as we experienced in this case developing intussusception twice has not been discribed in the literature so for. Adult intussusception of the large intestine can occur easier when the tumor of origin is protrudent and large, the mount of invasion is little in comparison with the size of the tumor, and the tumors arises in a portion of the colon where is more movable.

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