S状結腸癌術後骨髄癌症によるDICに対し, MTX-5FU交代療法が有効であった1例

• 倉田 昌直

  筑波大学附属病院消化器外科

• 高田 泰次

  筑波大学臨床医学系外科

• 川本 徹

  筑波大学臨床医学系外科

• 吉田 貞夫

  筑波大学附属病院消化器外科

• 谷口 英樹

  筑波大学臨床医学系外科

• 轟 健

  筑波大学臨床医学系外科

• 深尾 立

  筑波大学臨床医学系外科

書誌事項

タイトル別名

• SUCCESSFUL MTX-5FU SEQUENTIAL THERAPY FOR DISSEMINATED INTRAVASCULAR COAGULATION DUE TO SYSTEMIC BONE MARROW METASTASIS AFTER OPERATION FOR CANCER OF THE SIGMOID COLON-A CASE REPORT-

抄録

A 53-year-old man was admitted to the hospital because of anal bleeding and lumbago. Barium enema and colonoscopic examinations revealed sigmoid colon cancer, and computed tomography revealed metastasis to the caudate lobe of the liver. A low anterior resection and a resection of the caudate lobe of the liver were performed. Pathological diagnosis was poorly differentiated adenocarcinoma. (se, ly₁, v₂, ow(-), aw(-), ew(+)) After the operation that resulted in curability B, bleeding through the abdominal drains was observed, and severe thrombocytopenia and elevated fibrin/fibrinogen degradative products (FDP) were indicative of disseminated intravascular coagulation (DIC). Despite the treatment with gabexate mesilate, the bleeding tendency was not improved. Since a bone scintigraphy demonstrated diffuse abnormal uptake of isotope, a bone marrow biopsy was performed. As a results, DIC associated with systemic bone marrow metastasis was diagnosed. Sequential methotrexate and 5FU (MTX-5FU) therapy (MTX 30mg/m², 5FU 600mg/m²) was introduced. After 7 courses of the chemotherapy, he recovered from DIC accompanied by an increase in platelet count and decreases in FDP and CEA (carcinoembryonic antigen) levels. It is suggested that the suquential MTX-5FU therapy was effective for DIC due to systemic bone marrow metastasis in the present case of sigmoid colon cancer.

収録刊行物

• 日本臨床外科学会雑誌

  日本臨床外科学会雑誌 61 (5), 1256-1260, 2000

  日本臨床外科学会

キーワード

• 大腸癌骨髄癌症
• 汎発性血管内血液凝固症候群(DIC)
• MTX-5FU交代療法

詳細情報

• CRID: 1390282679825905536
• NII論文ID: 130003601913
• NII論文ID: 10009379818
• NII書誌ID: AA11189709
• DOI: 10.3919/jjsa.61.1256
• ISSN: 18825133
• ISSN: 13452843
• ISSN: http://id.crossref.org/issn/13452843
• Web Site: http://www.jstage.jst.go.jp/article/ringe1998/61/5/61_5_1256/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2000234198
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
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