同時性肝転移と異時性卵巣転移を来たした直腸癌の1症例  [in Japanese] A Case of Rectal Cancer with Simultaneous Liver Metastasis and Heterochronous Ovarian Metastasis  [in Japanese]

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Abstract

症例は49歳女性,2005年6月に転移性肝腫瘍を有する直腸癌に対して低位前方直腸切除術と経皮的肝ラジオ波焼灼術(以下,RFA)を施行した.同年8月よりCEAの上昇を認めたがCTでは再発所見は認めなかった.同年12月のCT-PET検査でRFA施行部の肝局所再発を認め,2006年2月肝部分切除施行した.術後FOLFOX療法を施行し,2006年5月よりUFT,ロイコボリン内服へ変更し,2007年1月よりUFT内服のみとした.同年8月よりCEAの再上昇を認め,9月のCT-PETで骨盤腔内の腫瘤が疑われ,TS-1内服再開した.2008年1月CT-PETで同腫瘤の増大を認め,両側卵巣摘出した.病理では直腸癌の卵巣転移と診断された.術後現在まで再発を認めず経過観察中である.直腸癌卵巣転移では完全切除できれば積極的に切除し化学療法を追加することで長期生存が得られる可能性があり,予後の延長が期待出来ると考える.

We describe a 49-year-old woman who underwent low anterior rectal resection for rectal cancer and radiofrequency ablation (RFA) for liver metastasis in June 2005, followed by oral administration of TS-1. In August 2005, although the patient's CEA level was elevated, abdominal CT revealed no recurrence. In December 2005, CT and PET revealed local recurrence in the liver, for which RFA was performed, followed by partial hepatic resection in May 2006. Adjuvant chemotherapy with FOLFOX was administered, followed by UFT/leucovorin starting in May 2006, followed by UFT alone from January 2007. In August 2007, elevation of the CEA level was again observed, and CT and PET revealed a tumor in the pelvic cavity. TS-1 was therefore administered again. In January 2008, as CT and PET revealed enlargement of the tumor, bilateral oophorectomy was performed. The postoperative pathologic diagnosis indicated that the tumor was a metastasis of the rectal cancer to the ovary. At the time of writing in May 2008, the patient remains disease-free after the ovarian surgery. If an ovarian metastasis of rectal cancer can be removed completely, surgical resection combined with chemotherapy is recommended to improve the prognosis.

Journal

  • Yamaguchi medical journal

    Yamaguchi medical journal 57(6), 209-215, 2008-12-31

    Yamaguchi University Medical Association

References:  16

Codes

  • NII Article ID (NAID)
    110007056035
  • NII NACSIS-CAT ID (NCID)
    AN00243156
  • Text Lang
    JPN
  • Article Type
    NOT
  • Journal Type
    大学紀要
  • ISSN
    05131731
  • NDL Article ID
    10315227
  • NDL Source Classification
    ZS7(科学技術--医学)
  • NDL Call No.
    Z19-417
  • Data Source
    CJP  NDL  NII-ELS  IR 
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