肛門よりの腫瘤脱出で発見された直腸巨大 villous tumor の1例 A CASE OF HUGE VILLOUS TUMOR OF THE RECTUM PRESENTED WITH A PROLAPSED TUMOR FROM THE ANUS
症例は65歳,男性,主訴は肛門よりの腫瘤脱出. 1997年夏頃より血便,体重減少あるも放置していた. 1998年1月より粘血便持続のためオムツ使用.排便時に腫瘤が脱出するようになり近医受診し1998年2月18日当科紹介入院となる.排便時の脱出腫瘤は12cm大でカリフラワー様,軟らかく腫瘤の表面より粘液の排出を認めた.しかし電解質異常,脱水などdepletion syndromeは認めなかった.また腫瘤の還納は可能であった.精査後癌合併の可能性のあるvillous tumorの診断で経肛門的切除術を施行した.術後病理組織診断はcarcinoma in tubulovillous adenoma,深達度mであった.術後5年経過しているが狭窄所見,再発所見なく健在である.
A 65-year-old man was seen at the hospital because of a tumor prolapsed from the anus. He had noticed stools containing blood and a decrease in the body weight since around the summer of 1997, but had not consulted with any physician. Since January 1998, he started to use diapers because stools with mucus and blood persisted. Thereafter a tumor became prolapsed from the anus at defecations, and he was admitted to the hospital with the referral from a physician on February 18, 1998. The prolapsed tumor at defecation was 12cm in size, like cauliflower in shape and soft, from the surface of which exudation of mucus being identified. However, no depletion syndrome including abnormalities in electrodes and dehydration was revealed. And the prolapsed tumor was able to be reduced. With close exploration, villous tumor with possible association of malignancy was diagnosed, and transanal resection was carried out. Histopathological diagnosis was carcinoma in tubulovillous adenoma, with the invasion depth of tumor of m. As of 5 years after operation, no findings of stricture or recurrence have been seen, and the patient is doing well.
- 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association
日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 65(3), 735-738, 2004-03-25
Japan Surgical Association