Furumoto Katsuyoshi, Kojima Hidenobu, Takaya Haruo, Okuno Masayuki, Fuji Hiroaki, Mizuno Rei, Mori Tomohiko, Ito Daisuke, Kogire Masafumi
Dept. of Surgery, Kishiwada City Hospital.
Gan To Kagaku Ryoho. 2010 Feb;37(2):323-6.
We report a resected case of ascending colon cancer with left supraclavicular and paraaortic lymph nodes and liver metastases which completely responded in terms of metastases but not the primary tumor to FOLFOX4 therapy. A 62-year-old woman with epigastric discomfort was initially diagnosed as malignant lymphoma by FDG-PET with abnormal accumulation at left supraclavicular and paraaortic lesions. Pathological examination of the supraclavicular lymph nodes showed undifferentiated adenocarcinoma, and ascending colon cancer was detected by colonoscopy which was a mixture of various types of differentiation. FOLFOX4 therapy was effective for metastatic lesions but colon tumor did not regress and was accompanied by abdominal pain. Macroscopically, a curative right hemicolectomy was performed, and microscopic examination revealed that the tumor had become a mass of undifferentiated cancer cells. Thus, the present case demonstrates the dedifferentiation of colon cancer during chemotherapy.
我们报告1例升结肠癌伴左锁骨上和腹主动脉旁淋巴结及肝转移患者，该患者接受FOLFOX4治疗后转移灶完全缓解，但原发肿瘤未缓解。一名62岁女性因上腹部不适就诊，最初FDG-PET检查诊断为恶性淋巴瘤，左锁骨上和腹主动脉旁病变有异常放射性浓聚。锁骨上淋巴结病理检查显示为未分化腺癌，结肠镜检查发现升结肠癌，为不同分化类型的混合。FOLFOX4治疗对转移灶有效，但结肠肿瘤未消退且伴有腹痛。肉眼下，行根治性右半结肠切除术，显微镜检查显示肿瘤已变为未分化癌细胞团块。因此，本例显示了结肠癌在化疗过程中的去分化。
