A CASE OF DISSEMINATED CARCINOMATOSIS OF BONE MARROW DUE TO RECURRENCE OF SIGNET RING CELL CARCINOMA IN JUVENILE COLON CANCER

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  • 播種性骨髄癌症にて再発した若年者大腸印環細胞癌の１例

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Abstract

A 21-year-old woman was admitted with lower abdominal pain and diarrhea. There were normal findings on tumor markers. The colonoscopy revealed a circulated Type 3 tumor in the transverse colon. Signet-ring-cell carcinoma was diagnosed from the biopsy. The method of the operation was total colectomy with low anterior resection of the rectum, hysterosalpingo-oophorectomy, peritonectomy in the pelvic space, and chemohyperthermic peritoneal perfusion (42°C, 60 min) because of serosal exposure of the tumor and peritoneum disseminations (p2). Pathological diagnosis was signet ring cell carcinoma, se, ly3, v2, n (+), and metastasis to peritoneum and bilateral ovaries. Chemotherapy with leucovorin/5-FU was performed for a year after operation, and oral chemotherapy with TS-1 was then given for a year. However, she showed lumbago and bilateral femoral pains about 25 months after operation. The laboratory exam showed disseminated intravascular coagulation (DIC). There were multiple high intensity lesions from lumbar to sacral vertebrae and pelvic bones on MRI-T2. We diagnosed them as due to disseminated carcinomatosis of the bone marrow and treated her with systemic chemotherapy using MTX/5-FU, which did not prove effective. She died 27 months after operation.

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