Kimura Hironobu, Takamura Hiroyuki, Watanabe Kishichiro
Dept. of Surgery, NTT West Kanazawa Hospital.
Gan To Kagaku Ryoho. 2009 Nov;36(11):1919-22.
A 77-year-old woman was admitted to our hospital because of para-aortic lymph node swelling pointed out by abdominal CT scan. She had a previous history of colectomy with a diagnosis of ascending colonic cancer 8 years later. Pathological examination was a moderately-differentiated adenocarcinoma with lymph node metastasis (Stage IIIa). PET scan demonstrated hot spots of para-aortic and left supra-clavicular lesions. The serum CEA and CA19-9 levels regained the normal value. No malignancy was recognized by endoscopic examinations of upper and lower gastrointestinal tract. We supported that swelling of lymph nodes were due to lymphoma. Laparotomic biopsy of para-aortic lymph node was done after 6 months. Histologically metastatic adenocarcinoma was recognized. We performed systemic chemotherapy of UFT and LV on recurrent colonic cancer. After 9 courses, spots of para-aortic and left supra-clavicular lesions disappeared on the PET scan. Lymph node metastasis was not found by CT scan 20 months after beginning chemotherapy. Thus, we consider that this therapy was recommendable for the treatment of an older adult patient with recurrent colonic cancer.
一名77岁女性因腹部CT扫描发现腹主动脉旁淋巴结肿大而入住我院。她曾在8年前因升结肠癌接受过结肠切除术。病理检查为中度分化腺癌伴淋巴结转移(Ⅲa期)。PET扫描显示腹主动脉旁和左锁骨上病变有热点。血清CEA和CA19-9水平恢复正常。上下消化道内镜检查未发现恶性肿瘤。我们认为淋巴结肿大是由淋巴瘤引起的。6个月后对腹主动脉旁淋巴结进行了剖腹活检。组织学检查发现为转移性腺癌。我们对复发性结肠癌进行了UFT和LV全身化疗。9个疗程后,PET扫描显示腹主动脉旁和左锁骨上病变的热点消失。化疗开始20个月后,CT扫描未发现淋巴结转移。因此,我们认为这种治疗方法对老年复发性结肠癌患者是值得推荐的。