大腸癌異時性副腎転移の１切除例

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  • A Case Report of Surgically Removed Metachronous Adrenal Metastasis from Sigmoid Colon Cancer.

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A 67-year-old male underwent sigmoidectomy for sigmoid colon cancer. Macroscopic examination of the resected specimen showed type 2, advanced colon cancer, 22×16mm in diameter, SE, P0, H0, M (-). Histological examination disclosed poorly differentiated adenocarcinoma, se, ly2, v1, n4 (+), Stage IV, Cur B. Sixteen months later, computed tomography disclosed an abnormal low density mass, 5cm in diameter, in the right adrenal gland, suggestive of adrenal metastasis. Since no other metastases in the lung, liver or bone could be identified, right adrenalectomy was performed. Resected specimen showed hard tumor, 65×45×30mm in diameter, with a yellowish-white and solid cut surface. Histological findings were the same as that of the sigmoid colon cancer. Thirteen months after adrenalectomy, the recurrances of paraaortic lymph nodes and bone metastases of the thoracic vertebras were revealed by abdominal computed tomography and bone scintigraphy. Although 7 months later descending colon cancer was detected and resected, he was died with postoperative pneumonia. Patients with adrenal metastasis from colon and rectal cancer often have multiple organ metastases. However, if the adrenal metastasis is solitary or the other metastatic lesions are well-controlled, the adrenal metastasis should be excised completely.

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