子宮癌検診を契機に初期病変で発見され晩期再発した腹膜癌の1例  [in Japanese] A Case of Early Primary Peritoneal Carcinoma Revealed by Endometrial Cytology which Resulted in Late Recurrence  [in Japanese]

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Abstract

患者は55歳,女性,癌検診を希望し前医受診.子宮内膜細胞診Class Vにて当科に紹介された.内診および経腟超音波検査で異常所見なく,再施行した子宮内膜細胞診はClass Vであった.骨盤MRI,腹部CTに異常所見なく原発巣は不明で,腫瘍マーカーはCA125;12.3U/ml,CA19-9;0.1U/ml,CEA;1.4ng/mlと基準値内であった.子宮内膜全面掻爬検体に病理学的悪性所見は認めなかった.腹腔鏡下両側付属器摘出術を施行し,骨盤腔,腹腔内に肉眼的異常を認めなかった.両側付属器に病理学的悪性所見はなかったが,腹水細胞診はClass Vで腺癌と診断した.2カ月半後に開腹し,単純子宮全摘術+大網生検+腹膜生検を行い腹膜に腺癌組織を確認し,子宮内膜細胞診を契機に腹膜癌をきわめて早期に発見したことが判明した.術後化学療法を追加したが79カ月後に腹水貯留と腹腔内播種で晩期再発し,現在化学療法を断続的に施行しつつ担癌生存中である.

An asymptomatic 55-year-old woman had an endometrial cytology, which found it positive. Physical examination, ultrasound, and MRI of the pelvic cavity showed no marked abnormality. Serum tumor markers were within normal range. The total endometrial curettage showed no malignancy. Laparoscopic bilateral salpingo-oophorectomy revealed neither pathological nor macroscopic abnormal findings except ascitic cytology with Class V. Three months later, total abdominal hysterectomy and biopsy of greater omentum and peritoneum were conducted, and adenocarcinoma in the peritoneum was found. Despite adjuvant chemotherapy, the case resulted in late recurrence with peritoneal dissemination and ascites. The patient is alive with tumor receiving intermittent chemotherapies.

Journal

  • Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)

    Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 37(6), 1180-1184, 2012-12-30

    Japanese College of Surgeons

References:  12

Codes

  • NII Article ID (NAID)
    10031152875
  • NII NACSIS-CAT ID (NCID)
    AN00002502
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    03857883
  • Data Source
    CJP  J-STAGE 
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