A LONG-TERMSURVIVAL CASE OF HEPATIC METASTASIS OF RECTAL CARCINOID

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  • FURUKAWA Yusuke
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine
  • OTANI Gosei
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine
  • NISHIYAMA Yasuhiko
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine
  • IHARA Atsushi
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine
  • HIKI Yoshiki
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine
  • KAKITA Akira
    Department of Surgery, Medical Center for Gastrointestinal Diseases, Higashi Hospital, Kitasato University, School of Medicine

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Other Title
  • 直腸カルチノイド肝転移における長期生存の1例

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Abstract

A 71-year-old man was admitted to the hospital because of anal bleeding and a rectal polyp which was pointed out at another hospital. On digital examination of the rectum, a tumor with the size of tip of the small finger about 3 cm from the anal verge was palpated. Biopsy under rectoscopy offered a suspecion of carcinoid tumor, and the tumor was extirpated peranum for diagnostic treatment. Histopathologically it was carcinoid tumor with a high malignant potential and invasion into the proper muscle was confirmed. Abdominoperineal excision of the rectum and lateral lymph node dissection were added, when a metastatic lesion 1 cm in size in the left lobe of the liver was dissection were added, when a metastatic lesion 1 cm in size inthe left lobe of the liver was detected and it was also extirpated. On difinitive pathological diagnosis, a remnant carcinoid tumor in the rectum, pararectal lymph node matastasis, and hepatic metastasis were confirmed. About 3 years later recurrence of hepatic metastasis occurred and the first transarterial embolization (TAE) was performed. Though the metastatic foci temporalily diminished with the TAE, recurence was repeated and thereafter a total of five times of TAE were conducted. The patient is still aliver for 13 years afte the hepatic metastasis. It is thought that aggressive TAE therapy is useful for hepatic metastasis of rectal carcinoid tumor.

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