Benfatto G, Catania G, Buffone A, Benfatto S A, Licari V, Tenaglia L, Giovinetto R, Fancello R, Giovinetto A
Dipartimento di Chirurgia, Università degli Studi di Catania.
G Chir. 2003 Aug-Sep;24(8-9):285-8.
The Authors deal with a rare case of 'meta-metachronous' carcinoma of the colon. A seventy years old man was admitted to ward after being diagnosed an adenocarcinoma of the transverse colon. The anamnestic data pointed out that the patient had already been operated twice for the colon carcinoma, which had been diagnosed in the left colon and in the cecum respectively seven and two years before. A colonoscopy performed sixteen months before did not show any lesion of the residual colon. It is likely that tiny lesions, which were still in the adenoma phase, were not diagnosed by the endoscopy; it is also possible that the adenoma-carcinoma sequence was extremely fast. On the basis of this experience the Authors recommend that patients with metachronus carcinoma undergo either frequent controls or a preventive subtotal colectomy.
作者们讨论了一例罕见的结肠“异时性异时”癌病例。一名70岁男性在被诊断为横结肠癌后入院。既往史资料显示,该患者此前已因结肠癌接受过两次手术,分别于7年前和2年前在左半结肠和盲肠被诊断出患有结肠癌。16个月前进行的结肠镜检查未发现残留结肠有任何病变。很可能仍处于腺瘤阶段的微小病变未被内镜检查诊断出来;也有可能腺瘤-癌的转变过程极其迅速。基于这一经验,作者们建议异时性癌患者要么接受频繁的检查,要么进行预防性次全结肠切除术。