超高齢者の蛋白漏出症をきたした大腸癌の1例

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  • A CASE OF PROTEIN-LOSING COLON CANCER

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An 85-year-old woman was admitted with chief complaints of diarrhea and pretibial edema. The laboratory data showed the presence of extreme anemia, hypoproteinemia and hypoalubuminemia (Hb 7.7g/dl, Ht 23.6%, total protein 4.6g/dl, albumin 1.2g/dl). A barim enema and a colonofiberscopy demonstrated a 10cm sized advanced cancer in ascending colon. Total parenteral nutrition could not improve the hyponutrition state and the hypoproteinemia progressively got worse. As fecal clearance of alpha 1 antitrypsin was high and 99mTc-HSA scintigraphy showed high uptake in the tumor of the ascending colon, protein-losing colon cancer was diagnosed. A right hemicolectomy was perfomed. Histological study revealed poorly differentiated adenocarcinoma with marked involvement of lymphatics. The clinical symptoms improved following the operation.

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