Matsumoto Satoru, Takahashi Masahiro, Takahashi Shusaku, Yamagami Hideki, Ishizu Hiroyuki
Dept. of Surgery, Hokkaido P. W. F. A. C Sapporo-Kosei General Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1611-1613.
A 73-year-old man underwent a screening colonoscopy, and a depressed lesion in the sigmoid colon was detected. Biopsy revealed a Group V lesion, and he was diagnosed with sigmoid colon cancer. During surgery, there was dense adhesion of the appendix to the sigmoid colon, and sigmoidectomy combined with appendectomy was performed. However, pathological examination revealed goblet cell carcinoid of the appendix with direct invasion into the sigmoid colon. To the best of our knowledge, no similar cases have been reported in Japan. Additional surgery with lymph node dissection was recommended, but it was rejected by the patient. For adjuvant chemotherapy, a total of 8 courses of capecitabine plus oxaliplatin therapy were administered. To date, the patient is alive without recurrence 2 years postoperatively. Postoperative adjuvant chemotherapy for goblet cell carcinoid of the appendix is a useful option for cases in which additional surgery cannot be performed.
一名73岁男性接受了结肠镜筛查，发现乙状结肠有一个凹陷性病变。活检显示为V组病变，他被诊断为乙状结肠癌。手术过程中，阑尾与乙状结肠紧密粘连，遂行乙状结肠切除术联合阑尾切除术。然而，病理检查显示阑尾杯状细胞类癌并直接侵犯乙状结肠。据我们所知，日本尚未报道过类似病例。建议进行淋巴结清扫的额外手术，但患者拒绝了。辅助化疗方面，共给予8个疗程的卡培他滨加奥沙利铂治疗。迄今为止，患者术后2年仍存活且无复发。对于无法进行额外手术的阑尾杯状细胞类癌病例，术后辅助化疗是一种有用的选择。
