Furukawa Haruna, Fukunaga Mutsumi, Munakata Satoshi, Kawabata Ryohei, Nakata Ken, Yamamoto Tameyoshi, Kawase Tomono, Kimura Yutaka, Ohzato Hiroki
Dept. of Surgery, Sakai City Hospital.
Gan To Kagaku Ryoho. 2013 Nov;40(12):2068-70.
We report the case of a 64-year-old man who had early submucosal invasive colorectal cancer with synchronous multiple liver metastases. The patient underwent endoscopic resection for a type Isp polyp of the sigmoid colon. The pathological diagnosis was well-differentiated adenocarcinoma with submucosal layer( sm3) invasion and lymphatic infiltration (ly2). A positive vertical margin was suspected. Abdominal computed tomography revealed multiple tumors at the S2/3, S5, and S8 segments of the liver and a small gastric submucosal tumor. The patient underwent sigmoid colon resection with D3 lymphadenectomy, left lateral hepatic segmentectomy, partial hepatectomy in the S5 and S8 segments, and partial gastrectomy. Histological examination showed lymph node metastasis but no residual cancer in the sigmoid colon. The histological findings from the liver were similar to those found in primary colorectal carcinoma. The gastric submucosal tumor was confirmed to be a gastrointestinal stromal tumor with a low risk grade. As the present case is considered rare, we herein review our previous report on a case of early colorectal cancer with synchronous multiple liver metastases.
我们报告了一例64岁男性患者,其患有早期黏膜下浸润性结直肠癌并伴有同步多发肝转移。该患者接受了乙状结肠Isp型息肉的内镜切除术。病理诊断为高分化腺癌,侵犯黏膜下层(sm3)且有淋巴浸润(ly2)。怀疑切缘阳性。腹部计算机断层扫描显示肝脏S2/3、S5和S8段有多个肿瘤以及一个小的胃黏膜下肿瘤。该患者接受了乙状结肠切除并D3淋巴结清扫、左外侧肝段切除、S5和S8段部分肝切除以及部分胃切除。组织学检查显示有淋巴结转移,但乙状结肠无残留癌。肝脏的组织学表现与原发性结直肠癌相似。胃黏膜下肿瘤经证实为低风险级别的胃肠道间质瘤。鉴于本病例被认为较为罕见,我们在此回顾我们之前关于一例早期结直肠癌并伴有同步多发肝转移病例的报告。