内容紹介
Summary
In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/μL, CRP levels of 5.69 mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30 mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0(0/27)StageⅡa tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.
要旨
症例は90歳,女性。2015年9月に腹痛,嘔吐を主訴に当院を受診した。WBC 10,420/μL,CRP 5.69 mg/dL,ALP 359 IU/L以外異常値は認めず,腫瘍マーカーはCEA 3.9 ng/mL,CA19-9 5.7 U/mLと正常であった。腹部CT検査では右側結腸に腸重積を認め,先進部に充実性腫瘍を認めた。結腸癌による腸重積の疑いで手術を施行した。手術所見では上行結腸の隆起性病変が横行結腸まで先進し,回腸の末端まで上行結腸内に嵌入した腸重積を認め,結腸右半切除術およびリンパ節郭清を施行した。切除標本では上行結腸に1型腫瘍を認め,腫瘍径は65×50×30 mm大であった。病理組織学的検査所見ではtub1>tub2,SS,ly0,v0,PM0,DM0,N0(0/27),StageⅡaであった。経過は良好で術後第12病日に退院となった。上行結腸癌による腸重積を来したまれな症例を経験した。
目次
In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/μL, CRP levels of 5.69 mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30 mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0(0/27)StageⅡa tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.
要旨
症例は90歳,女性。2015年9月に腹痛,嘔吐を主訴に当院を受診した。WBC 10,420/μL,CRP 5.69 mg/dL,ALP 359 IU/L以外異常値は認めず,腫瘍マーカーはCEA 3.9 ng/mL,CA19-9 5.7 U/mLと正常であった。腹部CT検査では右側結腸に腸重積を認め,先進部に充実性腫瘍を認めた。結腸癌による腸重積の疑いで手術を施行した。手術所見では上行結腸の隆起性病変が横行結腸まで先進し,回腸の末端まで上行結腸内に嵌入した腸重積を認め,結腸右半切除術およびリンパ節郭清を施行した。切除標本では上行結腸に1型腫瘍を認め,腫瘍径は65×50×30 mm大であった。病理組織学的検査所見ではtub1>tub2,SS,ly0,v0,PM0,DM0,N0(0/27),StageⅡaであった。経過は良好で術後第12病日に退院となった。上行結腸癌による腸重積を来したまれな症例を経験した。