同時性5多発進行大腸癌の1例

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  • SYNCHRONOUS QUINTUPLE ADVANCED CANCER OF THE COLON-A CASE REPORT-

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We report a rare case of synchronous quintuple advanced carcinoma of the colon. A 73-year-old man was admitted to the hospital because of discomfort of the anus. Gastrointestinal fiberscopy revealed five protruding lesions in the cecal, transverse, descending, sigmoid colon and upper rectum. During operation, five lesions were suspected to have serosal invasion. Cecal and sigmoid lesions were resected with D 2 lymphadenectomy and the other three lesions were extirpated with D 1 lymphadenectomy. Histologically sigmoid colon cancer invaded the mp layer and the other 4 lesions invaded subserosal layer. Regional lymph node metastases were found in the cecal carcinoma. p53 expression was positive in the tumors of the cecum and sigmoid colon, whereas p 21 expression was negative in the all tumors. These findings suggested that there that there were some differences in proliferation among these tumors. Six months after the operation, since multiple liver me-tastases were detected by CT examination, chemotherapy via hepatic artery has been performed. Synchronous quintuple advanced cancer of the colon is rare. Considering the total volume of all five tumors, some strategy for hematogenous metastasis which must occur in early stage would be needed.

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