術後1年2カ月目に発生した直腸癌孤立性副腎転移の1例

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  • A CASE OF RECTAL CANCER WITH A SOLITARY ADRENAL METASTASIS THAT OCCURRED 14 MONTHS AFTER THE OPERATION

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Adrenal metastasis of rectal cacer is often encountered, but it is rare that a case of solitary adrenal metastasis which was resectable is very rare. In this paper, we present our experience with such a case together with a review of previous seven cases in the Japanese literature.<br> The case involved a 63-year-old woman, who underwent an abdominoperineal excision of the rectum and associated resection of the uterus and vagina with a diagnosis of rectal cancer with vagina invasion in February, 1996. Histopathologically it was moderately differentiated adenocarcinoma in Stage IIIa. Thereafter, she was followed on an ambulant basis when a gradual increase in CEA was noted. On CT a left adrenal tumor was found in April, 1997. Endocrine examination revealed no abnormalities, and an extirpation of the tumor was conducted with a suspicion of metastatic adrenal tumor in May. Histological exploration resulted in that the tumor was adrenal metastasis of the rectal cancer. There have been no signs of recurrence, as of 7 months after the operation.<br> In a review of the seven cases seen in the Japanese literature, long survivors were observed among patients after extirpation of the tumor. So it is desirable to conduct operation aggressively as soon as possible after adrenal metastasis is detected.

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