内容紹介
Two Cases of Fournier's Gangrene That Occurred during Chemotherapy for Rectal Cancer
Summary
Two cases of Fournier's gangrene occurred during chemotherapy for advanced rectal cancer. Patients were treated using surgical debridement and antibiotic therapy. Case 1: A 66-year-old man had advanced rectal cancer with para-aortic and inguinal lymph node metastases. He received a sigmoid colostomy and chemotherapy(capecitabine, oxaliplatin, bevacizumab). Due to progression of the rectal mass, we performed radiotherapy(30 Gy)and chemotherapy(irinotecan, S-1, bevacizumab). After 14 days, he was hospitalized with a diagnosis of Fournier's gangrene with anal pain and fever. Case 2: A 63-year-old man had mucinous rectal carcinoma with sacrum invasion. He received a sigmoid colostomy and chemotherapy. Sixteen days after regorafenib therapy, as a fifth-line of chemotherapy, he was hospitalized with a diagnosis of Fournier's gangrene with hip pain, swollen perineum, and fever. There have been no reports of Fournier's gangrene occurring during chemotherapy for rectal cancer. We report 2 cases with a review of literature.
要旨
直腸癌に対する化学療法施行中に発症した会陰部壊疽性筋膜炎を2例経験した。いずれの症例も切開排膿,デブリドマン,抗生剤投与,洗浄処置にて救命,軽快した。症例1: 66歳,男性。傍大動脈リンパ節,鼠径リンパ節に転移を伴う直腸癌に対し人工肛門造設術,XELOX+bevacizumab療法を施行した。病状が進行し,さらに放射線照射(30 Gy)後,IRIS+bevacizumabを投与し,14日目に肛門痛,発熱を主訴に来院,会陰部壊疽性筋膜炎と診断した。症例2: 63歳,男性。仙骨浸潤を伴う直腸粘液癌に対し,人工肛門造設術,化学療法を施行したが病状の進行を認め,五次治療のregorafenib投与後16日目に腰痛,臀部腫脹,発熱を来し来院,会陰部壊疽性筋膜炎と診断した。直腸癌に対する化学療法中の会陰部壊疽性筋膜炎の報告はまれであり,文献的考察も含めて報告する。
目次
Summary
Two cases of Fournier's gangrene occurred during chemotherapy for advanced rectal cancer. Patients were treated using surgical debridement and antibiotic therapy. Case 1: A 66-year-old man had advanced rectal cancer with para-aortic and inguinal lymph node metastases. He received a sigmoid colostomy and chemotherapy(capecitabine, oxaliplatin, bevacizumab). Due to progression of the rectal mass, we performed radiotherapy(30 Gy)and chemotherapy(irinotecan, S-1, bevacizumab). After 14 days, he was hospitalized with a diagnosis of Fournier's gangrene with anal pain and fever. Case 2: A 63-year-old man had mucinous rectal carcinoma with sacrum invasion. He received a sigmoid colostomy and chemotherapy. Sixteen days after regorafenib therapy, as a fifth-line of chemotherapy, he was hospitalized with a diagnosis of Fournier's gangrene with hip pain, swollen perineum, and fever. There have been no reports of Fournier's gangrene occurring during chemotherapy for rectal cancer. We report 2 cases with a review of literature.
要旨
直腸癌に対する化学療法施行中に発症した会陰部壊疽性筋膜炎を2例経験した。いずれの症例も切開排膿,デブリドマン,抗生剤投与,洗浄処置にて救命,軽快した。症例1: 66歳,男性。傍大動脈リンパ節,鼠径リンパ節に転移を伴う直腸癌に対し人工肛門造設術,XELOX+bevacizumab療法を施行した。病状が進行し,さらに放射線照射(30 Gy)後,IRIS+bevacizumabを投与し,14日目に肛門痛,発熱を主訴に来院,会陰部壊疽性筋膜炎と診断した。症例2: 63歳,男性。仙骨浸潤を伴う直腸粘液癌に対し,人工肛門造設術,化学療法を施行したが病状の進行を認め,五次治療のregorafenib投与後16日目に腰痛,臀部腫脹,発熱を来し来院,会陰部壊疽性筋膜炎と診断した。直腸癌に対する化学療法中の会陰部壊疽性筋膜炎の報告はまれであり,文献的考察も含めて報告する。