大動脈周囲リンパ節転移陽性にもかかわらず根治切除後5年以上生存した胆嚢腺扁平上皮癌の1例

  • 坂田 純
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野
  • 白井 良夫
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野
  • 若井 俊文
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野
  • 金子 和弘
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野
  • 永橋 昌幸
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野
  • 畠山 勝義
    新潟大学大学院医歯学総合研究科消化器・一般外科学分野

書誌事項

タイトル別名
  • Radical Resection for Adenosquamous Carcinoma of the Gallbladder with Paraaortic Lymph Node Metastasis: Report of a 5-Year Survivor

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Paraaortic lymph node metastasis has a dismal prognosis in patients with gallbladder carcinoma. We report a case of a gallbladder cancer patient with paraaortic nodal disease who survived over 5 years after resection. A 65-year-old man with locally advanced gallbladder cancer underwent radical resection involving cholecystectomy, wedge resection of the gallbladder bed, pancreaticoduodenectomy, and regional and paraaortic lymph node dissection. Histologic examination showed the primary tumor to be adenosquamous carcinoma with four positive lymph nodes, one of which was a dissected paraaortic node. The patient underwent repeat lymphadenectomy for paraaortic nodal recurrence detected by computed tomography 29 months after the initial resection. Some 36 months later, metastasis to soft tissue in the right knee was managed by amputating the right lower limb above the knee and that to the second lumbar vertebra by external-beam radiation. Left supraclavicular nodal disease found 60 months after the initial resection was resected. The man died of multiple pulmonary metastases 77 months after the initial resection. This case and a review of the literature suggest that paraaortic lymph node dissection may provide a survival benefit for selected patients with gallbladder carcinoma.

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