胃,結腸,直腸,腎臓における同時性4重複癌の1例

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  • AN OPERATED CASE OF SYNCHRONOUS MULTIPLE CANCER OF THE STOMACH, COLON, KIDNEY AND RECTUM

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We have experienced a case of synchronous multiple cancers of the stomach, colon, kidney and rectum, which were successfully resected. A 65-year-old man was admitted to the hospital because of vomitting after drinking. Barium enema revealed a cancer of the rectum and polyps in the colon. Two papillary polyps in the ascending and descendingcolons, and a polyp in the transverse colon were polypected beforeoperation. Endoscopy disclosed a gastric cancer which was in the middle third. An abdominal ultrasonography and computed tomographyrevealed a right renal tumor. Operation was proceeded with abdominal median incision to resect the right kidney and distal stomach, followed by a resection of the rectum above the peritoneal reflection. Histologicsally, the gastric tumor was moderately differentiated adenocarcinoma, colonic polyps were well differentiated adenocarcinoma; the rectal tumor was well differentiated adenocarcinoma; and right renal tumor was granular cell type of renal carcinoma. There was a possibility that the rectal cancer might be a metastatic lesion, however, we considered it was a solitary carcinoma because of no communications intra and etramurally and its location. So all lesions were not metastatic each other and the definitive diagnosis of synchronous quadruple cancer was made. The etiology of these multiple cancers is still obscure.

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