Kosugi Chihiro, Ono Masato, Saito Norio, Sugito Masanori, Ito Masaaki, Murakami Kouji, Sato Kazunori, Kotaka Masahito, Nomura Satoru, Arai Manabu, Kobatake Takaya
The Department of Colorectal (Pelvic) Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Hepatogastroenterology. 2005 Sep-Oct;52(65):1440-3.
Port site recurrence after laparoscopic surgery for colorectal cancer patients is a rare complication. We report a case of port site recurrence in a 46-year-old woman that was detected by positron emission tomography (PET) using 18[F]-fluoro-deoxyglucose (FDG). Surgical treatment consisted of laparoscopic ileo-cecal resection and lymph node dissection. At her nine months postoperative follow-up examination, her serum carcinoembryonic antigen (CEA) levels had raised to 15.8ng/mL. Although computed tomography and colonoscopic examination were performed, lung, liver and local recurrence in the colon were not detected. FDG-PET was then performed and detected a higher concentration of FDG at the port site in the abdominal wall. Port site recurrence was diagnosed clinically and surgical resection of tumor at the port site was performed. Pathology revealed a moderately differentiated adenocarcinoma diagnosed as port site recurrence. This case suggests that FDG-PET is an important examination for the detection of port site recurrence when serum CEA levels are rising and routinely radiographic examinations are unable to detect the site of recurrence.
结直肠癌患者腹腔镜手术后的切口部位复发是一种罕见的并发症。我们报告一例46岁女性患者的切口部位复发,通过使用18[F]-氟脱氧葡萄糖(FDG)的正电子发射断层扫描(PET)检测到。手术治疗包括腹腔镜回盲部切除术和淋巴结清扫术。术后9个月的随访检查中,她的血清癌胚抗原(CEA)水平升至15.8ng/mL。尽管进行了计算机断层扫描和结肠镜检查,但未检测到肺部、肝脏及结肠局部复发。随后进行了FDG-PET检查,发现腹壁切口部位有较高浓度的FDG。临床诊断为切口部位复发,并对切口部位的肿瘤进行了手术切除。病理显示为中度分化腺癌,诊断为切口部位复发。该病例表明,当血清CEA水平升高且常规影像学检查无法检测到复发部位时,FDG-PET是检测切口部位复发的重要检查手段。