大腸癌の腹膜播種を疑った魚骨による大網腫瘤の1例 A CASE OF AN OMENTAL TUMOR DUE TO A FISHBONE SUGGESTIVE OF PERITONEAL METASTASIS OF ADVANCED COLON CANCER

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大腸癌手術時に腹膜播種を疑った魚骨による大網腫瘤の1例を経験したので報告する.患者は83歳,男性.主訴は腹痛.上行結腸癌と診断され,右半結腸切除術を施行した.大網腫瘤が存在し腹膜播種と判断し小腸部分切除,大網切除を併施した,結腸癌はwell differentiated adenocarcinoma, ss, ly0, v0, n0であり大網腫瘤は魚骨による肉芽腫と診断された.魚骨穿孔は緊急手術症例が多く,慢性型では原因不明の腫瘤と診断されることが多い.本症例では術前には腹腔内腫瘤は診断できなかった. CTを再検討した結果,大網腫瘤に一致して線状石灰化像が確認可能であった.腹腔内腫瘤では過剰な治療を避けるため鑑別疾患を考慮し,画像検査の詳細な再検討が必要である.

A case of an omental tumor suggestive of peritoneal metastasis of advanced colon cancer is reported. An 83-year-old man was admitted to the hospital because of abdominal pain. Barium enema and colonoscopy showed ascending colon cancer. Right colectomy was performed for ascending colon cancer, when an omental tumor was found out. So partial resection of the small intestine with the omental tumor was performed because a possibility of peritoneal metastasis could not be ruled out. Histopathologically, the colon tumor was well differentiated adenocarcinoma, ss, ly0, v0, n (-), and the omental tumor was an inflammatory granuloma caused by a fish bone.<br>Perforation due to a fishbone is often identified in emergency cases accidentally and is often diagnosed as an omental tumor of unknown origin in chronic cases. In this case the intraabdominal tumor could not be diagnosed before surgery. A retrospective review of CT findings disclosed that we had to be able to recognize a linear calcified lesion which coincided with the omental tumor. In order to avoid excessive treatments for an intraabdominal tumor, minute exploration of imaging findings is required by keeping the possibility of the disease in mind.

収録刊行物

  • 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), 818-821, 2004-03-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10012865670
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
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