内容紹介
Summary
A 72-year-old man with advanced dementia presented with a right lower abdominal painful mass, and on detailed examination and investigation, was diagnosed to have moderately differentiated circumferential tubular adenocarcinoma infiltrating the abdominal wall in the middle of the ascending colon. It was extremely painful, and there was also a risk of ileus if left untreated. Therefore, laparoscopic right hemicolectomy was performed. One year after surgery, examination revealed local recurrence. After consultation with family members, we started with chemotherapy, using capecitabine and bevacizumab. It is our policy to administer chemotherapy under adequate surveillance. Thus, outpatient chemotherapy was safely administered in a dementia patient with shrinkage of local recurrent lesions.
要旨
症例は高度認知症を有する72歳,男性。右下腹部有痛性腫瘤を主訴に近医より紹介受診された。精査の結果,上行結腸中位に腹壁に浸潤する全周性の腫瘍を認め,生検の結果,中分化型腺癌と診断された。癌部の疼痛が強く,放置しておくとイレウスの危険性もあると判断されたため,腹腔鏡下右半結腸切除術を施行した。術後1年目の検査で前回手術部周辺に局所再発を認めた。家族と相談し十分な監督管理下に化学療法を行う方針とし,capecitabine(Cape)+bevacizumab(Bmab)を用いた治療を開始した。現在も外来で治療継続中であるが,局所再発病変は縮小傾向である。
目次
A 72-year-old man with advanced dementia presented with a right lower abdominal painful mass, and on detailed examination and investigation, was diagnosed to have moderately differentiated circumferential tubular adenocarcinoma infiltrating the abdominal wall in the middle of the ascending colon. It was extremely painful, and there was also a risk of ileus if left untreated. Therefore, laparoscopic right hemicolectomy was performed. One year after surgery, examination revealed local recurrence. After consultation with family members, we started with chemotherapy, using capecitabine and bevacizumab. It is our policy to administer chemotherapy under adequate surveillance. Thus, outpatient chemotherapy was safely administered in a dementia patient with shrinkage of local recurrent lesions.
要旨
症例は高度認知症を有する72歳,男性。右下腹部有痛性腫瘤を主訴に近医より紹介受診された。精査の結果,上行結腸中位に腹壁に浸潤する全周性の腫瘍を認め,生検の結果,中分化型腺癌と診断された。癌部の疼痛が強く,放置しておくとイレウスの危険性もあると判断されたため,腹腔鏡下右半結腸切除術を施行した。術後1年目の検査で前回手術部周辺に局所再発を認めた。家族と相談し十分な監督管理下に化学療法を行う方針とし,capecitabine(Cape)+bevacizumab(Bmab)を用いた治療を開始した。現在も外来で治療継続中であるが,局所再発病変は縮小傾向である。