内容紹介
Summary
A 70's male was admitted to our hospital with complaints of anorexia and abdominal pain. CT showed thickening of the ascending colon. Colonoscopy revealed multiple diverticula of the ascending colon, but no tumor on the mucosa. The patient was diagnosed as a case of diverticulitis of the ascending colon and was advised laparoscopic ileocecal resection. The resected specimen showed wall thickening; however, no remarkable findings were observed, with the exception of multiple diverticula on the mucosal surface. Histological examination showed well-differentiated tubular adenocarcinoma extending into the serosa probably arising from the diverticulum. Chemotherapy was performed after surgery. The patient died due to peritoneal dissemination from the ascending colon cancer 14 months after surgery.
要旨
患者は70歳台前半,男性。主訴は食欲不振と腹痛。CTでは上行結腸の壁肥厚,大腸内視鏡検査では多発憩室を認めたが腫瘍性病変はなかった。上行結腸憩室炎の診断で腹腔鏡下回盲部切除術を施行した。切除標本では大腸壁は肥厚していたが粘膜面には腫瘍を認めなかった。病理組織学的検査で上行結腸には憩室が多発し漿膜下にかけて高分化管状腺癌を認めた。憩室由来の上行結腸癌と診断した。術後に化学療法を施行したが腹膜播種により術後14か月で死亡した。
目次
A 70's male was admitted to our hospital with complaints of anorexia and abdominal pain. CT showed thickening of the ascending colon. Colonoscopy revealed multiple diverticula of the ascending colon, but no tumor on the mucosa. The patient was diagnosed as a case of diverticulitis of the ascending colon and was advised laparoscopic ileocecal resection. The resected specimen showed wall thickening; however, no remarkable findings were observed, with the exception of multiple diverticula on the mucosal surface. Histological examination showed well-differentiated tubular adenocarcinoma extending into the serosa probably arising from the diverticulum. Chemotherapy was performed after surgery. The patient died due to peritoneal dissemination from the ascending colon cancer 14 months after surgery.
要旨
患者は70歳台前半,男性。主訴は食欲不振と腹痛。CTでは上行結腸の壁肥厚,大腸内視鏡検査では多発憩室を認めたが腫瘍性病変はなかった。上行結腸憩室炎の診断で腹腔鏡下回盲部切除術を施行した。切除標本では大腸壁は肥厚していたが粘膜面には腫瘍を認めなかった。病理組織学的検査で上行結腸には憩室が多発し漿膜下にかけて高分化管状腺癌を認めた。憩室由来の上行結腸癌と診断した。術後に化学療法を施行したが腹膜播種により術後14か月で死亡した。