Sasaki Yusuke, Natsuizaka Mitsuteru, Takano Masatoshi, Suzuki Mio, Tsuyuguchi Masako, Nagasako Tomokazu, Kawamura Naoyuki, Kudo Mineo, Tsuda Ichirou, Meguro Jyunichi
Dept. of Gastroenterology, Sapporo Hokuyu Hospital.
Gan To Kagaku Ryoho. 2009 Nov;36(11):1927-9.
A 60-year-old man was referred to our hospital since his stool examination was positive for occult blood. Colonoscopy showed a tumor of Bauhin's valve and terminal ileum. Biopsy of the tumor was performed and pathological examination revealed adenocarcinoma. No other lesions were detected by gastroduodenoscopy and double-balloon enteroscopy. CT also showed multiple liver metastases. Ileocecal resection was performed because of severe stenosis of the terminal ileum. Histopathological examination revealed moderately-differentiated adenocarcinoma of Bauhin's valve and the terminal ileum, and no adenocarcinoma was found in the cecum and ascending colon. He was diagnosed with primary adenocarcinoma of the ileum with multiple liver metastases. Chemotherapy with mFOLFOX6 was performed after surgical resection. After 5 courses of chemotherapy, abdominal CT showed marked regression of the liver metastases, and tumor marker (CA19-9) was normalized from 1,100 U/mL to 36 U/mL. Effectiveness of mFOLFOX6 for primary adenocarcinoma of small intestine is suggested.
一名60岁男性因粪便潜血检查呈阳性而被转诊至我院。结肠镜检查显示回盲瓣和回肠末端有肿瘤。对肿瘤进行了活检,病理检查显示为腺癌。胃镜和双气囊小肠镜检查未发现其他病变。CT检查还显示有多处肝转移。由于回肠末端严重狭窄,进行了回盲部切除术。组织病理学检查显示回盲瓣和回肠末端为中分化腺癌,盲肠和升结肠未发现腺癌。他被诊断为原发性回肠腺癌伴多处肝转移。手术切除后进行了mFOLFOX6化疗。化疗5个疗程后,腹部CT显示肝转移灶明显缩小,肿瘤标志物(CA19-9)从1100 U/mL降至36 U/mL。提示mFOLFOX6对小肠原发性腺癌有效。