内容紹介
Summary
A 64-year-old man presented with the chief complaint of weakness in the left half of his body. He fell down on the road while riding a bicycle and was transported to the emergency room. A contrast-enhanced brain MRI revealed a 28 mm ring-shaped mass in the right frontal lobe. A craniotomy was performed 14 days later. The histopathological diagnosis showed the tumor as a well-differentiated tubular adenocarcinoma. Postoperative examination revealed a rectal cancer and a left lung mass. A low-anterior resection was performed 1 month after the craniotomy, and a partial lung resection was performed 2 months after the rectal excision. Metachronous solitary metastasis of the left adrenal gland was noticed 10 months after the removal of the lung metastasis and we subsequently performed a left adrenalectomy. The patient is not undergoing any active treatment 13 months after the adrenalectomy, but has no signs of recurrence. The loco-regional surgery was enabled for local control of multi-relapsed lesions from rectal cancer.
要旨
症例は64歳,男性。主訴は左半身の脱力。自転車走行中に転倒し,救急搬送された。造影脳MRIで右前頭葉に径28mm大のリング状異常濃染を示す腫瘤を認めたため,開頭腫瘍摘出術を行った。病理組織学的診断は高分化管状腺癌であった。術後全身精査で下部直腸癌(高分化管状腺癌)と左肺腫瘤を認めた。脳腫瘍術後1か月で低位前方切除術を行い,直腸切除後2か月で肺部分切除を行った。肺転移切除術後10か月後に左副腎の異時性孤立性転移を認め,左副腎摘除術を行った。現在,副腎切除術後13か月を経過したが後治療はせず再発徴候はない。集学的治療により多発再発した直腸癌の局所コントロールが可能であった。
目次
A 64-year-old man presented with the chief complaint of weakness in the left half of his body. He fell down on the road while riding a bicycle and was transported to the emergency room. A contrast-enhanced brain MRI revealed a 28 mm ring-shaped mass in the right frontal lobe. A craniotomy was performed 14 days later. The histopathological diagnosis showed the tumor as a well-differentiated tubular adenocarcinoma. Postoperative examination revealed a rectal cancer and a left lung mass. A low-anterior resection was performed 1 month after the craniotomy, and a partial lung resection was performed 2 months after the rectal excision. Metachronous solitary metastasis of the left adrenal gland was noticed 10 months after the removal of the lung metastasis and we subsequently performed a left adrenalectomy. The patient is not undergoing any active treatment 13 months after the adrenalectomy, but has no signs of recurrence. The loco-regional surgery was enabled for local control of multi-relapsed lesions from rectal cancer.
要旨
症例は64歳,男性。主訴は左半身の脱力。自転車走行中に転倒し,救急搬送された。造影脳MRIで右前頭葉に径28mm大のリング状異常濃染を示す腫瘤を認めたため,開頭腫瘍摘出術を行った。病理組織学的診断は高分化管状腺癌であった。術後全身精査で下部直腸癌(高分化管状腺癌)と左肺腫瘤を認めた。脳腫瘍術後1か月で低位前方切除術を行い,直腸切除後2か月で肺部分切除を行った。肺転移切除術後10か月後に左副腎の異時性孤立性転移を認め,左副腎摘除術を行った。現在,副腎切除術後13か月を経過したが後治療はせず再発徴候はない。集学的治療により多発再発した直腸癌の局所コントロールが可能であった。