上行結腸癌術後ｆｏｌｌｏｗ中に発見された原発不明癌の１例

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  • A CARCINOMA OF UNKNOWN PRIMARY ORIGIN, DETECTED BY FDG-PET AFTER RESECTION OF ASCENDING COLON CANCER, IS WELL CONTROLLED BY SURGICAL MANAGEMENT-A CASE REPORT-

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A 36-year-old woman, on whom a right hemicolectomy for an ascending colon cancer had been performed when she was 31 years old, was treated with fluorouracil as adjuvant therapy. In September 2003, fluorodeoxyglucose-positron emission tomography (FDG-PET) detected uptake sites in the pelvis. Since the tumor was solitary, the patient underwent surgical resection of the tumor. Pathologically, it was a metastatic lymph node tumor from an adenocarcinoma that differed from the ascending colon cancer. Whole body examination revealed no primary site ; therefore, the tumor was diagnosed to be a lymph node metastasis from a carcinoma of unknown primary origin. The patient was treated with paclitaxel and carboplatin as adjuvant therapy. In November 2004, FDG-PET detected uptake sites in the lymph node of the hepatic artery. The lymph node was also solitary, and a CT scan also revealed a cystic lesion in the left ovary ; therefore, we resected the lymph node and performed a total hysterectomy and bilateral oophorectomy. Pathologically, the tumor was diagnosed to be a lymph node metastasis from a carcinoma of unknown primary origin and there was no evidence of malignancy in the uterus or the ovary. In November 2005, FDG-PET detected no abnormal uptake. We therefore consider that the carcinoma of unknown primary origin has been well controlled.

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