内容紹介
Summary
A 70-year-old woman underwent treatment for cecal cancer(pT4bN1M0, Stage Ⅲb)in 2010. Four years and 2 months after the first surgery, she underwent ileum resection for stenosis due to perineal dissemination(P3). Two years after this recurrence, during which time she had completed 26 courses of FOLFIRI plus bevacizumab(Bmab), 9 courses of capecitabine plus oxaliplatin(CapeOX)plus Bmab, and 3 courses of Cape, no peritoneal dissemination was detected by computed tomography(CT). Thereafter, an additional 19 courses of Cape plus Bmab were introduced, but CEA continued to increase. Right ovarian metastasis was suspected based on CT and FDG-PET/CT examination. Four years and 1 month after the initial recurrence of perineal dissemination, the patient underwent bilateral ovarian resection, during which the lack of peritoneal dissemination was confirmed. Pathologically, right ovarian metastasis was diagnosed. The patient is still alive 4 years and 6 months after the first operation.
要旨
症例は70歳台,女性。初回手術は盲腸癌に対して結腸右半切除術を施行した(pT4bN1bM0,Stage Ⅲb)。4年2か月後に腹膜播種再発(P3)によるイレウスを認め,小腸切除を施行した。術後FOLFIRI+bevacizumab(Bmab)を26コース,capecitabine+oxaliplatin(CapeOX)+Bmabを8コース,Cape+Bmabを3コース施行すると,腹膜播種再発から2年後のCT検査にて播種は不明瞭化し完全寛解と判定した。その後,Cape+Bmabを19コース追加するもCEAの上昇を認め,CT,FDG-PET/CT検査にて右卵巣転移が疑われた。播種再発から4年1か月後に腹腔鏡下両側付属器摘出術を施行し,病理組織学的検査にて右卵巣転移と診断した。術中腹腔内に腹膜播種結節は認めなかった。現在,腹膜播種再発から4年6か月が経過するも無再発生存中である。
目次
A 70-year-old woman underwent treatment for cecal cancer(pT4bN1M0, Stage Ⅲb)in 2010. Four years and 2 months after the first surgery, she underwent ileum resection for stenosis due to perineal dissemination(P3). Two years after this recurrence, during which time she had completed 26 courses of FOLFIRI plus bevacizumab(Bmab), 9 courses of capecitabine plus oxaliplatin(CapeOX)plus Bmab, and 3 courses of Cape, no peritoneal dissemination was detected by computed tomography(CT). Thereafter, an additional 19 courses of Cape plus Bmab were introduced, but CEA continued to increase. Right ovarian metastasis was suspected based on CT and FDG-PET/CT examination. Four years and 1 month after the initial recurrence of perineal dissemination, the patient underwent bilateral ovarian resection, during which the lack of peritoneal dissemination was confirmed. Pathologically, right ovarian metastasis was diagnosed. The patient is still alive 4 years and 6 months after the first operation.
要旨
症例は70歳台,女性。初回手術は盲腸癌に対して結腸右半切除術を施行した(pT4bN1bM0,Stage Ⅲb)。4年2か月後に腹膜播種再発(P3)によるイレウスを認め,小腸切除を施行した。術後FOLFIRI+bevacizumab(Bmab)を26コース,capecitabine+oxaliplatin(CapeOX)+Bmabを8コース,Cape+Bmabを3コース施行すると,腹膜播種再発から2年後のCT検査にて播種は不明瞭化し完全寛解と判定した。その後,Cape+Bmabを19コース追加するもCEAの上昇を認め,CT,FDG-PET/CT検査にて右卵巣転移が疑われた。播種再発から4年1か月後に腹腔鏡下両側付属器摘出術を施行し,病理組織学的検査にて右卵巣転移と診断した。術中腹腔内に腹膜播種結節は認めなかった。現在,腹膜播種再発から4年6か月が経過するも無再発生存中である。