Takemoto Hiroyoshi, Uemura Yoshio, Aoki Taro, Tsujimura Naoto, Nakao Eiichiro, Otsuru Toru, Watanabe Risa, Matsumoto Takashi, Nishioka Kiyonori, Takachi Ko, Iijima Shohei, Kobayashi Kenji
Dept. of Surgery, Kinki Central Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):1832-4.
An 80-year-old woman was treated with low anterior resection and D3 lymph node dissection for rectal carcinoid in August 2007. Pathological diagnosis was a tumor 23 × 22 mm in size with muscularis propria invasion, ly1, v0, n1 (No. 251[1/12]). Partial hepatectomy was performed for liver metastasis in March 2010 and September 2011. In June 2013, an isolated tumor of 17 mm in diameter was detected between the inferior vena cava and the stomach using abdominal ultrasonography. The tumor was diagnosed as pancreatic head lymph node metastasis using abdominal enhanced computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET); fluorodeoxyglucose (FDG) uptake was noted at the site of the tumor, but not at other parts of the body. Curative resection was the chosen treatment option. Open surgery was performed in September 2013, and a tumor 30 mm in diameter located at the ventral side of the inferior vena cava, lateral side of the portal vein, and cranial side of duodenum was resected. No surrounding tissue infiltration was found. Pathological analysis of the resected specimen indicated lymph node metastasis of the rectal carcinoid. The patient has been disease free for 9 months after surgery.
一名80岁女性于2007年8月接受了低位前切除术及D3淋巴结清扫术治疗直肠类癌。病理诊断为肿瘤大小23×22 mm，侵犯固有肌层，ly1，v0，n1（第251组[1/12]）。2010年3月和2011年9月因肝转移行部分肝切除术。2013年6月，腹部超声检查发现下腔静脉与胃之间有一个直径17 mm的孤立肿瘤。通过腹部增强计算机断层扫描（CT）、磁共振胰胆管造影（MRCP）和正电子发射断层扫描（PET）诊断该肿瘤为胰头淋巴结转移；肿瘤部位有氟脱氧葡萄糖（FDG）摄取，但身体其他部位未见摄取。选择根治性切除作为治疗方案。2013年9月进行了开放手术，切除了位于下腔静脉腹侧、门静脉外侧和十二指肠颅侧的一个直径30 mm的肿瘤。未发现周围组织浸润。切除标本的病理分析表明为直肠类癌淋巴结转移。患者术后已无病生存9个月。
