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[一例乙状结肠癌转移至子宫的病例]

[A Case of Sigmoid Colon Cancer with Metastasis to the Uterus].

作者信息

Tokoro Yukinari, Tonooka Toru, Souda Hiroaki, Takiguchi Nobuhiro, Chibana Tomofumi, Kobayashi Ryosuke, Arimitsu Hidehito, Yanagibashi Hiroo, Chou Akihiro, Ikeda Atsushi, Nabeya Nobuhiro, Kainuma Osamu, Yamamoto Hiroshi, Nagata Matsuo

机构信息

Dept. of Gastroenterological Surgery, Chiba Cancer Center.

出版信息

Gan To Kagaku Ryoho. 2015 Nov;42(12):1662-4.

Abstract

A 65-year-old woman complaining of fetor ex vagina was diagnosed with endometrial adenocarcinoma of the uterus based on the pathological findings of an endometrial biopsy. Sigmoid colon cancer was found on a pre-operative CT scan. Diagnosis of double cancer was made and we performed sigmoidectomy and panhysterectomy with associated resection of both adnexa. Histopathological examination found that the tumor accounted for almost all of the uterine mucosa and over half of the muscular layer. Immunostaining showed CK7 (-), CK20 (+), CDX2 (+), ER (-), and PgR (-), and we diagnosed it as a metastasis to the uterus of the sigmoid colon cancer. The pathological diagnosis was a moderately differentiated adenocarcinoma, pT4b (SI: urinary bladder), pN0 (0/12), H0, P1,M1a (uterus), pStage Ⅳ. As adjuvant chemotherapy, she was administered XELOX for 6 months. Although colorectal cancer rarely metastasizes to the uterus, due to the increase in the prevalence of colorectal cancer, it may be also increase. To choose the best treatment course, it is necessary to diagnose whether it is a primary uterine cancer or a metastatic uterine cancer.

摘要

一名65岁女性因阴道异味前来就诊,根据子宫内膜活检的病理结果被诊断为子宫体部子宫内膜腺癌。术前CT扫描发现乙状结肠癌。诊断为双癌后,我们实施了乙状结肠切除术和全子宫切除术,并同时切除双侧附件。组织病理学检查发现肿瘤几乎占据了整个子宫黏膜和超过一半的肌层。免疫组化显示CK7(-)、CK20(+)、CDX2(+)、ER(-)、PgR(-),我们诊断为乙状结肠癌转移至子宫。病理诊断为中分化腺癌,pT4b(SI:膀胱),pN0(0/12),H0,P1,M1a(子宫),p分期Ⅳ期。作为辅助化疗,她接受了6个月的XELOX方案治疗。虽然结直肠癌很少转移至子宫,但由于结直肠癌患病率的增加,其转移至子宫的情况可能也会增多。为选择最佳治疗方案,有必要诊断是原发性子宫癌还是转移性子宫癌。

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