Nakatsu Hiroki, Hazama Shoichi, Tomochika Shinobu, Sakamoto Kazuhiko, Yoshino Shigefumi, Oka Masaaki
Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2009 Nov;36(12):2217-9.
We report a case of transverse colon cancer with gastric regional lymph node metastasis. A 50-year-old man was admitted to our hospital for abdominal distension and abnormal evacuation. He was diagnosed with advanced transverse colon cancer with regional lymph node metastasis by a barium enema examination and computed tomography. In operative findings, the main tumor at splenic flexure had invaded greater omentum. Therefore, left hemicolectomy with D3 lymph node dissection including gastroepiploic lymph node (classified to No. 204) was performed. Histopathological examination revealed the metastasis to gastroepiploic lymph node. Six months after initial surgery, mediastinal and hilar lymph node swelling was detected by follow-up CT scan, although mFOLFOX6 was administered as postoperative adjuvant chemotherapy. We therefore performed FOLFIRI as second-line chemotherapy. He had a stable disease during FOLFIRI. Extensive lymph node dissection of gastric region may be useful for advanced transverse cancer.
我们报告一例伴有胃区域淋巴结转移的横结肠癌病例。一名50岁男性因腹胀和排便异常入院。经钡剂灌肠检查和计算机断层扫描，他被诊断为伴有区域淋巴结转移的晚期横结肠癌。手术所见，脾曲处的主要肿瘤侵犯了大网膜。因此，实施了包括胃网膜淋巴结（分类为第204组）清扫的D3淋巴结清扫左半结肠切除术。组织病理学检查显示胃网膜淋巴结转移。尽管术后辅助化疗采用了mFOLFOX6方案，但初次手术后6个月，随访CT扫描发现纵隔和肺门淋巴结肿大。因此，我们实施了FOLFIRI作为二线化疗。他在接受FOLFIRI治疗期间病情稳定。广泛的胃区域淋巴结清扫术可能对晚期横结肠癌有用。
