多発性肝転移に対してラジオ波焼灼療法が奏功した直腸カルチノイドの１例

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  • Radiofrequency Ablation Therapy for Multiple Liver Metastases of Rectal Carcinoid-Report of A Case-

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We report a 53-year-old woman found in October 2001 to have occult blood. A tumor, 2cm in diameter, having a lower border 5cm from the anal verge was palpated in digital examination. Biopsy results indicated a carcinoid tumor. We conducted anterior resection with lateral node dissection and partial hepatectomy of a 5mm metastatic nodule in the S7 segment of the liver observed during surgery. Penetration of the rectal wall by the primary tumor was histopathologically classified as muscularis propria, and metastasis to the perirectal and left lateral lymph nodes was observed. After surgery, she was treated by adjuvant hepatic arterial infusion with 5-fluorouracil and mitomycin-C. Since metastasis to the S2 and S7 hepatic segments was observed 5 months later, the patient underwent percutaneous radiofrequency ablation (RFA). RFA was sequentially conducted on 20 metastatic foci through September 2005. As of 4 years since surgery, liver metastasis control is favorable, and no local recurrence or other distal metastasis has been observed. RFA is believed to be locally effective in multiple liver metastases in bilateral lobes of carcinoid tumors.

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