右半結腸再建を伴う食道癌術後に病理で判明した虫垂好銀性カルチノイドの1例 A CASE OF ARGYROPHIL CARCINOID OF THE APPENDIX DIAGNOSED AFTER OPERATION FOR ESOPHAGEAL CANCER WITH AN ESOPHAGEAL RECONSTRUCTION USING THE RIGHT COLON

この論文にアクセスする

この論文をさがす

著者

抄録

症例は71歳, 男性. 下顎歯肉腫瘤を主訴に来院し, 諸検査にて胃癌術後に下顎歯肉癌と食道癌の同時性重複癌が発見された3重複癌と診断された. 左頸部および右鎖骨上窩には有意なリンパ節腫大を認めた. 下顎歯肉癌は生検時に取りきれていた. 右半結腸再建を伴う胸部食道亜全摘を施行後, 病理組織診断で, 食道は進達度smの扁平上皮癌であったが, 再建の際に切徐された虫垂の病理診断で好銀性カルチノイドが発見された. カルチノイドは粘膜固有層に限局しており, 断端陰性で, 予後良好な好銀性カルチノイドと診断されたことから, 追加切除は行わない方針とした. その後左頸部および右鎖骨上窩のリンパ節郭清を行い, 右鎖骨上窩のリンパ節残存部に放射線照射を施行した. 術後1年2カ月後の現在, 食道癌, 下顎歯肉癌, 虫垂カルチノイドそれぞれの再発や新たな転移巣の出現は認められていない. また, 残存した右鎖骨上窩リンパ節の増大傾向もなく経過している.

A 71-year-old man was seen at the hospital because of a gingival tumor of the lower jaw. Following various examinations, he was found having triple cancer in which synchronous double cancer involving gingival cancer of the lower jaw and esophageal cancer was detected after surgery for gastric cancer. Significant lymph node swellings were noted in the left neck and right supraclavicular fossa. The gingival cancer was completely removed at a biopsy. After subtotal excision of the thoracic esophagus with esophageal reconstruction using the right hemicolon, the histopathological diagnosis of the esophageal cancer was squamous cell carcinoma localized in the submucosal layer. However, the pathological study of the appendix which was removed at the reconstruction surgery disclosed argyrophil carcinoid of it. The carcinoid was localized in the lamina propria mucosae, and the surgical stump was negative, so that argyrophil carcinoid which has favorable prognosis was diagnosed. No additional resection was thus performed. Thereafter we performed dissection of lymph nodes of the left neck and right supraclavicular fossa, followed by irradiation to the remnant lymph nodes in the right supraclavicular fossa. As of 14 months after the operation, no recurrence or new metastasis of esophageal cancer, gingival cancer and argyrophil carcinoid of the appendix has occurred, and no increasing tendency in the remnant lymph node swelling of the right supraclavicular fossa has been observed.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association  

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 68(1), 111-115, 2007-01-25 

    Japan Surgical Association

参考文献:  12件

参考文献を見るにはログインが必要です。ユーザIDをお持ちでない方は新規登録してください。

各種コード

  • NII論文ID(NAID)
    10018716657
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
ページトップへ