早期胃癌を伴った横行結腸癌術後孤立性脾臓転移の1例 A Case of Metachronous Solitary Splenic Metastasis from Cancer of the Transverse Colon Associated with Early Gastric Cancer

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今回我々は早期胃癌を伴った横行結腸癌術後孤立性脾臓転移の1例を経験したので若干の文献的考察を加え報告する.症例は59歳女性,横行結腸癌イレウスにて平成10年12月手術を施行した.術後9カ月目に腫瘍マーカーの上昇を認め腹部CT検査にて脾腫瘍を指摘された.スクリーニングで行った胃内視鏡検査では幽門部にIIa+IIc病変を指摘された.横行結腸癌術後孤立性脾臓転移と早期胃癌の合併症例と診断,脾臓摘出術,胃全摘術を施行した.術後病理組織学的検査では脾腫瘍は中分化腺癌の組織像で,横行結腸癌からの転移と診断した.患者は術後18カ月経過した時点で無再発生存中である.大腸癌異時性孤立性脾臓転移は稀で,本邦報告例は自験例を含め26例にすぎなかった.文献的考察も含め,大腸癌孤立性脾臓転移には外科的切除を含めた積極的な集学的治療が長期生存に重要であると考えられた.

A case of metachronous solitary splenic metastasis from cancer of the transverse colon associated with early gastric cancer is reported, with a review of the literature. A 59-year-old woman underwent a transverse colectomy for ileus due to cancer of the transverse colon, in December 1998. Nine months later, serum tumor marker levels were elevated, and a splenic tumor was detected by an abdominal CT scan. Early gastric cancer was also detected by a gastrofiberscopic examination. A splenectomy and a total gastrectomy were per-formed, with a diagnosis of metachronous solitary splenic metastasis from cancer of the transverse colon and early gastric cancer. On a postoperative histologic study, the resected splenic tumor was moderately differentiated adenocarcinoma, consistent with transverse colon cancer. There have been no signs of recurrence at 18 months after the operation. Metachronous solitary splenic metastasis from colorectal cancer is so rare that only 26 cases, including our case, have been reported in the Japanese literature. In a review of those reported cases surgical resection and intensive therapy might contribute to long survival.

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  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 56(4), 156-160, 2003-04-01

    The Japan Society of Coloproctology

参考文献:  21件中 1-21件 を表示

被引用文献:  1件中 1-1件 を表示

各種コード

  • NII論文ID(NAID)
    10010767622
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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