内容紹介
Summary
A 65-year-old man presented to our hospital with a chief complaint of abdominal pain during defecation. Abdominal contrast-enhanced CT showed circumferential wall thickening with contrast effects in the sigmoid colon, and multiple metastases in the liver. Colonoscopy revealed a type 2 colon tumor that was obstructing the passage. A diagnosis of sigmoid colon cancer and multiple liver metastases was made based on laparoscopic sigmoidectomy plus D3 dissection. Pathologically, the resected specimen was diagnosed as colorectal neuroendocrine cell carcinoma(NEC)that was positive for synaptophysin and CD56. Postoperatively, 8 courses of FOLFOX plus bevacizumab(BV)therapy were administered, but CT showed remarkable increase in liver metastasis, and he died 5 months after the operation. Colorectal NEC is a very rare disease, for which no chemotherapy has been shown to be effective. Since we encounterd a case of sigmoid colon NEC with multiple liver metastases that followed a rapid course, we have presented it along with a literature review.
要旨
症例は65歳,男性。排便時腹痛を主訴に当院を受診した。腹部造影CTでS状結腸に造影効果を伴う全周性壁肥厚を認め,肝臓内には多発転移を認めた。下部消化管内視鏡検査にてS状結腸に狭窄を伴う2型大腸腫瘍を認めた。S状結腸癌,多発肝転移の診断にて腹腔鏡下S状結腸切除術+D3リンパ節郭清を施行した。切除標本の病理組織学的所見ではsynaptophysin,CD56が陽性で大腸神経内分泌細胞癌(NEC)の診断であった。術後,FOLFOX+bevacizumab療法を8コース施行したがCTでは肝転移の著明な増大を認め,術後5か月で死亡した。大腸NECは非常にまれな疾患であり,確立された化学療法は示されていない。今回われわれは,急激な経過をたどった多発肝転移を伴うS状結腸神経内分泌細胞癌の症例を経験したので,若干の文献的考察を加えて報告する。
目次
A 65-year-old man presented to our hospital with a chief complaint of abdominal pain during defecation. Abdominal contrast-enhanced CT showed circumferential wall thickening with contrast effects in the sigmoid colon, and multiple metastases in the liver. Colonoscopy revealed a type 2 colon tumor that was obstructing the passage. A diagnosis of sigmoid colon cancer and multiple liver metastases was made based on laparoscopic sigmoidectomy plus D3 dissection. Pathologically, the resected specimen was diagnosed as colorectal neuroendocrine cell carcinoma(NEC)that was positive for synaptophysin and CD56. Postoperatively, 8 courses of FOLFOX plus bevacizumab(BV)therapy were administered, but CT showed remarkable increase in liver metastasis, and he died 5 months after the operation. Colorectal NEC is a very rare disease, for which no chemotherapy has been shown to be effective. Since we encounterd a case of sigmoid colon NEC with multiple liver metastases that followed a rapid course, we have presented it along with a literature review.
要旨
症例は65歳,男性。排便時腹痛を主訴に当院を受診した。腹部造影CTでS状結腸に造影効果を伴う全周性壁肥厚を認め,肝臓内には多発転移を認めた。下部消化管内視鏡検査にてS状結腸に狭窄を伴う2型大腸腫瘍を認めた。S状結腸癌,多発肝転移の診断にて腹腔鏡下S状結腸切除術+D3リンパ節郭清を施行した。切除標本の病理組織学的所見ではsynaptophysin,CD56が陽性で大腸神経内分泌細胞癌(NEC)の診断であった。術後,FOLFOX+bevacizumab療法を8コース施行したがCTでは肝転移の著明な増大を認め,術後5か月で死亡した。大腸NECは非常にまれな疾患であり,確立された化学療法は示されていない。今回われわれは,急激な経過をたどった多発肝転移を伴うS状結腸神経内分泌細胞癌の症例を経験したので,若干の文献的考察を加えて報告する。