Aoyagi Haruhiko, Kaneko Jun, Kamiya Ayako, Isogai Jun, Iwata Noriko, Katsuta Eriko, Takahata Taro, Hasegawa Kumi, Teduka Kenji, Higuchi Tetsuro, Maejima Shizuaki
Dept. of Surgery, Hasuda Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2277-9.
In August 2008, a 52-year-old woman presented to our hospital with a complaint of bleeding upon defecation. The patient underwent lower gastrointestinal endoscopy with biopsy. PRb indicated a type 2 lesion in one-third of the circumference. The patient was diagnosed with squamous cell carcinoma by biopsy. Imaging did not reveal any metastasis to other organs. In September, she underwent an abdominoperineal resection of the rectum. Postoperative histopathological findings were PRb, type 2, A, N3, H0, P0, M0, and Stage III b. Adjuvant chemotherapy of oral S-1 was started. In January 2009, contrast-enhanced abdominal CT revealed a pelvic recurrence, and the patient underwent chemoradiotherapy. In October, chest CT showed a 5-mm solitary pulmonary metastasis in the right apex of the lung. In March 2010, chest CT showed a slight enlargement of the tumor in the right apex, but no other metastatic lesion was observed. In April, the patient underwent a thoracoscopic partial pneumonectomy. It has been 16 months postoperatively, and no recurrence has been observed. In the present report, we describe a case of squamous cell carcinoma of the anal canal that underwent multidisciplinary treatment including pneumonectomy. We also include a brief literature review.
2008年8月,一名52岁女性因排便时出血前来我院就诊。患者接受了下消化道内镜检查及活检。病理报告显示肿瘤环绕肠壁三分之一,为2型病变。活检诊断为鳞状细胞癌。影像学检查未发现其他器官转移。9月,她接受了腹会阴联合直肠癌切除术。术后组织病理学检查结果为PRb,2型,A,N3,H0,P0,M0,Ⅲb期。开始口服S-1辅助化疗。2009年1月,腹部增强CT显示盆腔复发,患者接受了放化疗。10月,胸部CT显示右肺尖有一个5毫米的孤立性肺转移灶。2010年3月,胸部CT显示右肺尖肿瘤略有增大,但未观察到其他转移灶。4月,患者接受了电视胸腔镜下部分肺切除术。术后已过去16个月,未观察到复发。在本报告中,我们描述了一例接受包括肺切除术在内的多学科治疗的肛管鳞状细胞癌病例。我们还包括一篇简短的文献综述。