直腸癌の単発性尾状葉転移および膣転移の1例

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  • A CASE OF METASTASES TO THE CAUDATE LOBE AND VAGINA FROM A COLORECTAL CANCER

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A rare case of metastases to the caudate lobe and vagina from a rectal cancer is described. A 74-year-old woman was admitted to the hospital because of a vaginal tumor and a liver tumor in the S 1 segment. There was a history of undergoing a low anterior resection for a colorectal cancer (mod. diff. adenocarcinoma, ss, stage II) and a left nephrectomy for a renal carcinoma 4 years before admission. On admission CEA level in serum elevated to 41.5ng/ml. Abdominal plain CT demonstrated a 4.0×3.0cm tumor with extensive calcification in the S 1 segment of the liver. Contrast CT showed faint enhancement. The tumor was revealed as low intensity on T 1-weighted MRI and high intensity on T 2-weighted MRI. Ultrasonography guided needle biopsy for the liver tumor revealed adenocarcinoma. With the preoperative diagnosis of metastases to the caudate lobe and vagina from the rectal cancer, an operation was performed. The liver tumor was localized in the left caudate lobe, and the tumor did not infiltrate into the inferior vena cava and hepatic vein. A partial resection of the caudate lobe for the liver tumor and a local resection of the vaginal wall for the vaginal tumor were performed. Histologically metastases of the rectal cancer to the caudate lobe and vagina was confirmed.

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