Okubo T, Takahashi H, Kaneko Y, Kurokawa T, Kanai M
Department of Surgery, Hakodate Medical Hospital, Hakodate, Japan.
Kyobu Geka. 2011 Jul;64(7):566-9.
A 63-year-old female was admitted to our hospital for investigation of serum elevation of carcinoembryonic antigen (CEA). She underwent high anterior resection for a rectal cancer 5-years ago. Chest computed tomography (CT) obtained 5-years ago showed a nodule in the right S10, measuring 1.3 x 0.8 cm in size. The nodule was assessed as benign. Chest CT on admission showed the enlarged nodule with a pleural indentation, measuring 2.2 x 1.6 cm in size. Definitive diagnosis could not be established. Since it was difficult to exclude the possibility of malignancy, video-assisted partial resection was performed. Histological examination of the nodule revealed primary adenocarcinoma in frozen sections. Lobectomy with lymph node dissection was performed. The ultimate diagnosis was adenocarcinoma with mixed subtypes. The tumor was classified as stage IA with T1bN0M0. We reported this case because it was a rare slow-growing adenocarcinoma that had a 5-years clinical history before operation.
一名63岁女性因癌胚抗原（CEA）血清升高入院接受检查。她5年前因直肠癌接受了高位前切除术。5年前的胸部计算机断层扫描（CT）显示右S10有一个结节，大小为1.3×0.8厘米。该结节被评估为良性。入院时的胸部CT显示结节增大，有胸膜凹陷，大小为2.2×1.6厘米。无法做出明确诊断。由于难以排除恶性可能性，遂进行了电视辅助部分切除术。结节的组织学检查在冰冻切片中显示为原发性腺癌。进行了肺叶切除加淋巴结清扫术。最终诊断为混合型腺癌。肿瘤被分类为T1bN0M0的IA期。我们报告这个病例是因为它是一种罕见的生长缓慢的腺癌，术前有5年的临床病史。
