直肠内镜黏膜下剥离术后局部复发：一例肿瘤细胞种植病例

Inoue Takashi, Fujii Hisao, Koyama Fumikazu, Nakagawa Tadashi, Uchimoto Kazuaki, Nakamura Shinji, Ueda Takeshi, Nishigori Naoto, Kawasaki Keijiro, Obara Shinsaku, Nakamoto Takayuki, Nakajima Yoshiyuki

Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.

Department of Endoscopy and Ultrasound, Nara Medical University Hospital, Kashihara, Japan.

Clin J Gastroenterol. 2014 Feb;7(1):36-40. doi: 10.1007/s12328-013-0445-3. Epub 2013 Dec 21.

We report a case of local recurrence of cancer after rectal endoscopic submucosal dissection (ESD). A 52-year-old male underwent a curative resection with ESD for rectal intramucosal cancer. Seventy-four months after ESD, surveillance colonoscopy showed an elevated lesion on the ESD scar, suspicious of a recurrence. The patient subsequently underwent a low anterior resection (intersphincteric) with lymph node dissection. Pathology revealed a well-differentiated adenocarcinoma, similar to the ESD specimen. We suspected that the local recurrence was caused by implantation of tumor cells during the ESD, due to surgical manipulation performed with the tumor in an exposed setting for a long period of time.

我们报告一例直肠内镜黏膜下剥离术（ESD）后癌症局部复发的病例。一名52岁男性因直肠黏膜内癌接受了ESD根治性切除术。ESD术后74个月，结肠镜检查发现ESD瘢痕处有一隆起病变，怀疑复发。该患者随后接受了低位前切除术（括约肌间）并进行了淋巴结清扫。病理显示为高分化腺癌，与ESD标本相似。我们怀疑局部复发是由于ESD期间肿瘤细胞种植所致，这是因为在长时间暴露肿瘤的情况下进行了手术操作。