管外発育型直腸癌の1例  [in Japanese] A CASE OF RECTAL CANCER WITH AN EXTRAMURAL GROWTH  [in Japanese]

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Abstract

管外発育を示す直腸癌の1例を報告する.症例は50歳女性で便秘にて発症した.肛門指診や注腸造影検査,腹部CT検査で直腸を圧排する直径10cmの骨盤内腫瘍を認め,血管造影にて主に上直腸動脈から栄養されるhypervascular tumorだったことから直腸平滑筋肉腫疑いとして開腹した.腫瘍は超手拳大で直腸,子宮,左卵巣,尿管,骨盤壁に浸潤していた.このため,浸潤臓器を含めて腫瘍を摘出し, S状結腸直腸吻合術と左尿管皮膚瘻造設術を施行した.腫瘍は組織学的に腺扁平上皮癌を一部に含む低分化腺癌であった.原発臓器として直腸とともに左卵巣の可能性も考えられたが,血管造影所見などから総合的に管外発育型直腸癌と診断された.直腸癌のまれな発育形式であるために報告した.

A case of rectal cancer with an extramural growth is presented. A 50-year-old woman complained of severe constipation. A pelvic tumor which was 10 cm in diameter and compressed the rectum, was pointed out by digital examination, Barium enema, and CT examination. The tumor was hypervascular and fed by the superior rectal artery. With a diagnosis of rectal leiomyosarcoma, a laparotomy was performed. The tumor invaded the rectum, uterus, left ovary, left ureter, and pelvic wall. The resection of the tumor including affected organs, sigmoido-proctostomy, and left uretero-cutaneostomy were performed. Microscopically, the tumor was poorly differentiated adenocarcinoma which partially contained adeno-squamous cell carcinoma. Though the origin of the tumor was thought to be either the rectum or ovary, the tumor was finally diagnosed as rectal cancer with an extramural growth based on imaging findings including angiography. The extramural growth is rare in rectal cancers.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 57(7), 1677-1680, 1996-07-25

    Japan Surgical Association

References:  11

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008522787
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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