内容紹介
A Case of Anal Canal Squamous Cell Carcinoma Detected with Anal Stenosis Eight Years Following Resection for Rectal Adenocarcinoma
Summary
An 89-year-old woman underwent low anterior resection for rectal adenocarcinoma(Ra, pT3N0M0, pStageⅡ, Cur A)in 2008. In February 2016, she underwent an outpatient examination because of a defecation disturbance. Lower gastrointestinal endoscopy was performed and the stenotic region was biopsied. However, no malignancy was detected and the stenotic site expanded. However, the patient experienced recurrence of the same symptoms, developed severe anal stenosis, and underwent another examination in December 2016. Magnetic resonance imaging indicated a neoplastic lesion around the entire circumference of the anal canal. Transperineal needle biopsy results indicated squamous cell carcinoma. The patient was diagnosed with postoperative rectal cancer and metachronous anal canal squamous cell carcinoma(P, cT4bN2M0, cStage Ⅲb). Laparoscopic artificial anus construction was performed with the aim of unblocking the anal canal stenosis. Considering the patient's age and performance status, radiation therapy was administered. Two months after administering radiation therapy, the tumor decreased in size, and anal pain reduced.
要旨
症例は89歳,女性。2008年直腸腺癌に対して低位前方切除術を施行した(Ra,pT3N0M0,pStageⅡ,Cur A)。2016年2月に排便困難が出現し,外来を受診した。下部消化管内視鏡検査を施行し狭窄部位を生検したが悪性所見を認めず,狭窄部を拡張した。12月に高度肛門狭窄で再受診した。MRI検査では全周性の腫瘍性病変を肛門管内に認め,経会陰的針生検を施行し,扁平上皮癌の診断を得た。直腸癌術後の異時性肛門管扁平上皮癌P,cT4bN2M0,cStage Ⅲbと診断し,閉塞解除目的に腹腔鏡下人工肛門造設術を施行後,年齢,PSなどを考慮し,放射線療法を施行した。放射線療法終了後2か月で腫瘍は縮小し,肛門部痛は改善傾向である。
目次
Summary
An 89-year-old woman underwent low anterior resection for rectal adenocarcinoma(Ra, pT3N0M0, pStageⅡ, Cur A)in 2008. In February 2016, she underwent an outpatient examination because of a defecation disturbance. Lower gastrointestinal endoscopy was performed and the stenotic region was biopsied. However, no malignancy was detected and the stenotic site expanded. However, the patient experienced recurrence of the same symptoms, developed severe anal stenosis, and underwent another examination in December 2016. Magnetic resonance imaging indicated a neoplastic lesion around the entire circumference of the anal canal. Transperineal needle biopsy results indicated squamous cell carcinoma. The patient was diagnosed with postoperative rectal cancer and metachronous anal canal squamous cell carcinoma(P, cT4bN2M0, cStage Ⅲb). Laparoscopic artificial anus construction was performed with the aim of unblocking the anal canal stenosis. Considering the patient's age and performance status, radiation therapy was administered. Two months after administering radiation therapy, the tumor decreased in size, and anal pain reduced.
要旨
症例は89歳,女性。2008年直腸腺癌に対して低位前方切除術を施行した(Ra,pT3N0M0,pStageⅡ,Cur A)。2016年2月に排便困難が出現し,外来を受診した。下部消化管内視鏡検査を施行し狭窄部位を生検したが悪性所見を認めず,狭窄部を拡張した。12月に高度肛門狭窄で再受診した。MRI検査では全周性の腫瘍性病変を肛門管内に認め,経会陰的針生検を施行し,扁平上皮癌の診断を得た。直腸癌術後の異時性肛門管扁平上皮癌P,cT4bN2M0,cStage Ⅲbと診断し,閉塞解除目的に腹腔鏡下人工肛門造設術を施行後,年齢,PSなどを考慮し,放射線療法を施行した。放射線療法終了後2か月で腫瘍は縮小し,肛門部痛は改善傾向である。