Takiyama Aki, Nozawa Hiroaki, Ishihara Soichiro, Takiyama Hirotoshi, Murono Koji, Yasuda Koji, Otani Kensuke, Nishikawa Takeshi, Tanaka Toshiaki, Kiyomatsu Tomomichi, Kawai Kazushige, Hata Keisuke, Watanabe Toshiaki
Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
World J Surg Oncol. 2016 Oct 26;14(1):273. doi: 10.1186/s12957-016-1026-y.
Secondary metastasis to regional lymph nodes for adjacent bowel invaded by colorectal cancers (CRCs) has not been extensively reviewed. We herein present three such cases.
The first case is a cancer involving the cecum and sigmoid colon, and its primary site could not be determined even by pathological evaluation. Nodal involvement was revealed both in the mesocolon of the cecum and sigmoid. The second and third cases are a sigmoid colon cancer invading the jejunum and an ascending colon cancer invading the jejunum, respectively. These patients harbored secondary metastases to lymph nodes draining from the invaded small bowel segments. In spite of complete resection, all three patients metachronously developed liver metastases or recurrent disseminated nodules in the pelvis and subsequently died.
In cases of CRC invading another bowel segment, bowel resection with regional lymphadenectomy for both involved segments should be considered to achieve complete resection. However, the radical surgery did not necessarily provide a long-term survival.
结直肠癌（CRC）侵犯临近肠段时区域淋巴结的继发性转移尚未得到广泛综述。我们在此呈现三例此类病例。
第一例是累及盲肠和乙状结肠的癌症，即便通过病理评估也无法确定其原发部位。在盲肠和乙状结肠的结肠系膜中均发现有淋巴结受累。第二例和第三例分别是侵犯空肠的乙状结肠癌和侵犯空肠的升结肠癌。这些患者在受侵小肠段引流区域的淋巴结出现继发性转移。尽管进行了根治性切除，所有三名患者均异时性发生肝转移或盆腔复发性播散性结节，随后死亡。
在CRC侵犯另一肠段的病例中，应考虑对两个受累肠段进行肠切除及区域淋巴结清扫以实现根治性切除。然而，根治性手术不一定能带来长期生存。
