Itabashi Michio, Tada Yusuke, Bamba Yoshiko, Takemoto Kaori, Yoshimura Yuka, Kimura Masato, Hirosawa Tomoichiro, Ogawa Shinpei, Kameoka Shingo
Department of Surgery II, Tokyo Women's Medical University, School of Medicine, 8-1 Kawadacho Sinjuku-ku, Tokyo 162-8666, Japan.
Int Surg. 2009 Jan-Feb;94(1):80-3.
The right half of the colon was resected in a 70-year-old woman in August 2002 for ascending colon cancer. The peritoneum was also resected because of metastasis (Stage IV). Since tumor markers gradually increased, positron emission tomography (PET)/ computed tomography (CT) revealed peritoneal dissemination. Abdominal pain appeared 40 months after surgery. Barium enema findings revealed an ileal constriction approximately 25 cm from the anastomosed site toward the anus. Repeat PET/CT revealed peritoneal dissemination coinciding with ileal constriction. CT did not reveal well-defined tumor shadows. The patient was diagnosed with constriction associated with peritoneal metastasis and underwent surgery. Surgical findings revealed a roughly 2-cm peritoneal metastatic focus and ileal constriction. The site was resected and anastomosed. Postoperative progress was favorable; the patient was discharged and enjoys a favorable quality of life through outpatient adjuvant chemotherapy. PET/CT is suggested to be useful in observing the progress of peritoneal dissemination and may be of assistance in determining the course of treatment.
2002年8月，一名70岁女性因升结肠癌接受了右半结肠切除术。由于发生转移（IV期），腹膜也被切除。由于肿瘤标志物逐渐升高，正电子发射断层扫描（PET）/计算机断层扫描（CT）显示有腹膜播散。术后40个月出现腹痛。钡灌肠检查结果显示，距吻合口向肛门方向约25 cm处有回肠狭窄。重复PET/CT检查显示腹膜播散与回肠狭窄相符。CT未显示明确的肿瘤阴影。该患者被诊断为与腹膜转移相关的狭窄，并接受了手术。手术所见为一个约2 cm的腹膜转移灶和回肠狭窄。该部位被切除并进行了吻合。术后恢复顺利；患者出院，通过门诊辅助化疗享有良好的生活质量。PET/CT被认为有助于观察腹膜播散的进展，可能有助于确定治疗方案。
