結腸癌に合併した皮膚筋炎の1例 [in Japanese] A CASE OF COLONIC CANCER WITH DERMATOMYOSITIS [in Japanese]
Access this Article
Search this Article
皮膚筋炎発症後結腸癌を認めた症例に対し外科的切除を施行し皮膚筋炎が改善した1例を報告する.患者は63歳の女性.平成7年2月特有の皮膚症状,筋力低下にて皮膚筋炎と診断されるとともに結腸癌を認め3月14日S状結腸切除術, D<sub>3</sub>郭清を施行した. P<sub>0</sub>, H<sub>0</sub>, N<sub>2</sub>(+), SS, M(-) Stage IIIbの2型S状結腸癌と診断され根治度は絶対治癒切除であった.術後は皮膚症状,筋力低下いずれも著明に改善した. 1990年～1994年に報告された悪性腫瘍合併皮膚筋炎症例26例について検討したところ,相対的非治癒切除,絶対治癒切除ともに一時的にも症状の改善が認められた.このことから皮膚筋炎症状と腫瘍との相関が示唆された.また根治度との関係については明らかでなく術後の皮膚筋炎の再燃と癌の再発に関し今後の検討を要すると思われた.
A case of colonic cancer associated with dermatomyositis in which dermatomyositis was improved after operation for the colonic cancer is reported.<br>A 63-year-old woman was diagnosed as having dermatomyositis based on peculiar dermal symptoms and decreased myodynamia, and simultaneously was found having a type 2 cancer of the sigmoid colon. Sigmoidectomy with D3 lymph node dissection was carried out. Macroscopically, the cancer was diagnosed as P<sub>0</sub>, H<sub>0</sub>, N<sub>2</sub>(+), SS, M(-), Stage IIIb. The operation was considered absolute curative.<br>After the surgery, dermatomyositis was improved completely. Twenty-six cases of dermatomyositis associated with malignancy seen in the Japanese literature from 1990 to 1994 were reviewed. Symptomatic remission in dermatomyositis, at least a temporal remission, was attained after both relatively non-curative and absolutely curative operations. It indicates that there is some relation between symptoms of dermatomyositis and the volume of the residual tumor. But the mechanism is still unknown, in that furthe studies on the relation between postoperative recurrence of dermatomyositis and recurrence of malignancy should be performed.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 58(6), 1324-1328, 1997-06-25
Japan Surgical Association