胆管内進展および胆管内腫瘍栓を認めた大腸癌肝転移の1例  [in Japanese] A CASE OF METASTASTIC LIVER TUMOR FROM COLON CANcER INFILTRATING AND EMBOLIZING THE BILIALY TRACT  [in Japanese]

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Abstract

転移性肝癌では,肝内胆管進展および肝内胆管内腫瘍栓の報告はまれである.今回われわれは肝転移主病巣が小さいにも関わらず,胆管内進展および胆管内腫瘍栓を認めた大腸癌肝転移の1手術例を経験したので報告する.<br> 症例は61歳男性で2年前に, S状結腸癌で高位前方切除術施行.超音波検査・CT検査で肝S5とS6境界に転移性肝腫瘍を認め,肝右葉切除術施行.切除標本で,主腫瘍は1.5×1.5cm・白色で,肝内胆管B5aとB5bに直接浸潤し腫瘍径を形成していた.文献上,記載の詳細な2例と検討した. 3症例とも,顕微鏡的には胆管粘膜上皮を置換性に進展し,腫瘍栓を形成していた.<br> 大腸癌からの転移性肝癌はグリソン鞘に親和性が高いことから,腫瘍の位置がグリソン鞘近傍にある場合,術前のERPまたは術中胆管造影が切除範囲を決定する上で,重要であると考えられた.

A 61-year-old man was admitted to the hospital because of a hepatic tumor. He had a previous history of high anterior resection for sigmoid colon cancer 2 years earlier US and CT of the abdomen detected an irregular tumor between S5 and S6 segments of the liver. Intra-operative cholangiography revealed absence of the intrahepatic biliary tracts B5a and B5b. From the specimen, the tumor, 1.5 × 1.5 cm in size, infiltrated and embolized B5a and B5b. Histologically the tumor was determined to be a metastasis from Scolon cancer and had infiltrated the biliary tract in an exchange with mucous membrane. It has been reported that a metastatic tumor from colorectal cancer easily infiltrates Glisson's capsule. In cases in which a liver tumor is found near Glisson7s capsule, information about the biliary tract, such as pre-operative ERP or intra-operative cholangiography, is important.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 58(10), 2408-2414, 1997-10-25

    Japan Surgical Association

References:  8

Cited by:  7

Codes

  • NII Article ID (NAID)
    10008531209
  • 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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