放射線照射領域の双孔式ストーマに発生したＳ状結腸癌の１例

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  • A Case of Adenocarcinoma Occurred at Site of Radiated Double-barrel Sigmoid Colostomy.

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A 60-year-old female developed an adenocarcinoma at the site of double-barrel sigmoid colostomy. She underwent a total hysterectomy and the subsequent radiation therapy due to uteric carcinoma when she was 34 years old. She had rectal stenosis one year later and underwent sigmoid colostomy. She had been healthy thereafter, however, when she was 58 years old, she noticed an elevated lesion at the site of colostomy. Biopsy revealed well-differentiated adenocarcinoma, so surgery was recommended but she refused it. Two years later, the entire stoma became a carcinoma, which directly invaded the abdominal wall on MRI images.<BR>A bow-shaped skin incision was made and en bloc resection of the tumor, colostomy and the surrounding tissues was performed. Finally, descending colostomy in the left upper quadrant of the abdomen was reconstructed.<BR>Primary adenocarcinoma occurring at a double-barrel colostomy is very rare, and such a case may never have been reported, although there were some reports of carcinoma occurring at an end colostomy. Since the site of the present carcinoma was radiatded, the radiation may contribute to this carcinogenesis, suspecting its late effect. Our surgical procedure enabled simultaneously operation of combined resection and intraabdominal manipulation, and the reconstruction site of the stoma was easily selected.

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