下行結腸癌に合併した肝硬化性血管腫の1例  [in Japanese] A CASE OF SCLEROSING HEMANGIOMA WITH CANCER OF THE DESENDING COLON  [in Japanese]

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Abstract

症例は77歳,男性,熱発を主訴に受診.超音波検査にて肝S8に腫瘤を指摘,腹部単純CT検査では直径2.3cmのlow density massであり,内部に石灰化を伴っていた.造影CTでは腫瘤内部に造影効果は認めなかった.血液検査にてCEAが高値を示し,注腸検査,大腸内視鏡検査を施行したところ,下行結腸脾彎曲部に長径3cmの2型腫瘍を認めた.<br> 画像診断上,肝腫瘍は大腸癌肝転移と考えられ,左半結腸切除,肝S8部分切除を施行した.開腹時にS5にも小結節を認めたため同部の核出術も行った.<br> 組織学的に肝腫瘍は石灰化を伴った広汎に硝子化した線維組織で占められていたが,散在性に血管腔を認め硬化性血管腫と診断した.<br> 肝硬化性血管腫はまれな疾患であるが,下行結腸癌に合併したため転移性肝癌との鑑別が困難であった1例を報告した.

A 77-year-old man was admitted to the hospital because of fever. Abdominal echogram revealed a high echoic mass 2.3cm in diameter in S8 of the liver. The tumor was visualized as low density mass without ring enhancement and peripheral enhancement on a contrast enhanced CT scan of the abdomen. Barium enema study and a total colonic fiberscopy revealed the existence of type 2 cancer 3cm in longer diameter on the desending colon. Colonic cancer with liver metasis was strongly suspected. <br> Left hemicolectomy and a partial resection of the S8 liver tumor were performed, when a small nodule was detected of the liver surface of S5 which was also enucleated.<br> Histologically, the both liver tumors were composed of collagenous tissue with marked hyalinization and calcification, but some vascular spaces were seen within the nodules. Cavernous hemangioma was consequently considered as the origin of these tumors.<br> This paper describes a rare case of sclerosing hemangioma of the liver mimicking metastatic liver tumor, because it was associated with cancer of the desending colon.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 62(3), 757-760, 2001-03-25

    Japan Surgical Association

References:  7

Cited by:  8

Codes

  • NII Article ID (NAID)
    10008389019
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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