Aoki Makoto, Hayashi Tetsuji, Fukunari Hiroyuki, Yamamoto Yudai, Nakao Keisuke, Shitara Kenji, Ajioka Yoichi
Dept. of Surgery, Niigata Prefectural Tokamachi Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1827-1829.
A 67-year old woman underwent laparoscopy-assisted high anterior resection for sigmoid colon cancer. A histopathological examination revealed no lymph node metastasis, but extramural cancer deposits were present. Four years later, enhanced computed tomography revealed recurrence in the retroperitoneum and metastasis to the left kidney. A left nephrectomy and left hemicolectomy were performed. A year after the second operation, computed tomography revealed metastasis to the lung. Histopathological reexamination for extra-lymph nodal spread after the first operation revealed venous involvement. Generally, colon cancer with extra-lymph nodal spread has a higher risk of retroperitoneal recurrence, and venous involvement leads to a poor prognosis. We describe our case with the known report.
一名67岁女性因乙状结肠癌接受了腹腔镜辅助下高位前切除术。组织病理学检查显示无淋巴结转移，但存在壁外癌灶。四年后，增强计算机断层扫描显示腹膜后复发并转移至左肾。遂进行了左肾切除术和左半结肠切除术。第二次手术后一年，计算机断层扫描显示肺部转移。对首次手术后淋巴结外扩散进行的组织病理学复查显示有静脉受累。一般来说，伴有淋巴结外扩散的结肠癌腹膜后复发风险较高，且静脉受累会导致预后不良。我们结合已知报道描述了我们的病例。
