Morita T, Meguro N, Tomooka Y, Maeda O, Saiki S, Kuroda M, Miki T, Usami M, Kotake T
Department of Urology, Center for Adult Diseases, Osaka.
Hinyokika Kiyo. 1991 Mar;37(3):295-8.
A 61-year-old man diagnosed with poorly differentiated adenocarcinoma of the prostate (T4 NxM0, stage C) underwent endocrine therapy. The reduction of the tumor was recognized but soon annular rectal stricture appeared. In spite of the subsequent chemotherapy, symptoms aggravated. Then total pelvic exenteration and colostomy were performed. Prostate was easily separated from the rectal wall and the tumor continuity was not proved. Immunohistochemical inspection indicated that the origin of the tumor cells of the rectum was the prostate. Histopathological examination of the rectum using the step section method showed no trace of cancer invasion but many cancer cells in the intramural lymphatic duct. We concluded that adenocarcinoma of the prostate metastasized to the rectum by way of lymphatic flow and caused the annular stricture of the rectum.
一名61岁男性被诊断为前列腺低分化腺癌(T4 NxM0,C期),接受了内分泌治疗。肿瘤体积缩小,但很快出现环状直肠狭窄。尽管随后进行了化疗,症状仍加重。随后进行了全盆腔脏器切除术和结肠造口术。前列腺很容易从直肠壁分离,未证实肿瘤连续性。免疫组织化学检查表明,直肠肿瘤细胞起源于前列腺。采用连续切片法对直肠进行组织病理学检查,未发现癌浸润痕迹,但在壁内淋巴管中有许多癌细胞。我们得出结论,前列腺腺癌通过淋巴引流转移至直肠,导致直肠环状狭窄。