Ikeda Kosuke, Sato Tsutomu, Maezawa Yukio, Kano Kazuki, Satoyoshi Tetsuta, Segami Kenki, Nakajima Tetsushi, Ogata Takashi, Cho Haruhiko, Yoshikawa Takaki
Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center.
Gan To Kagaku Ryoho. 2016 Nov;43(12):2208-2210.
A 69-year-old woman who underwent laparoscopic assisted distal gastrectomy for early gastric cancer(pathological T1bN1M0)in June 2011was admitted to the hospital because of abdominal pain in May 2015.A n abdominal CT scan showed ileus caused by a transverse colon tumor and ascending colon perforation.We performed emergency right hemicolectomy and diverting ileostomy.The postoperative pathological findings revealed poorly differentiated adenocarcinoma and signetring cell carcinoma similar to the gastric cancer resected 4 years ago.Immunohistochemical findings showed that the colon tumor was positive for CK7, but negative for CK20 and expressed a gastric mucin phenotype.From these findings, the colon tumor was diagnosed as a metastasis from early gastric cancer.Colon metastasis from early gastric cancer is rare and the diagnosis is difficult in some cases.We herein report this case and discuss the clinical and pathologic features of colon metastasis from gastric cancer.
一名69岁女性，于2011年6月因早期胃癌（病理T1bN1M0）接受了腹腔镜辅助远端胃切除术，2015年5月因腹痛入院。腹部CT扫描显示由横结肠肿瘤和升结肠穿孔引起的肠梗阻。我们进行了急诊右半结肠切除术和转流性回肠造口术。术后病理结果显示为低分化腺癌和印戒细胞癌，与4年前切除的胃癌相似。免疫组化结果显示结肠肿瘤CK7阳性，但CK20阴性，表达胃黏液表型。根据这些结果，结肠肿瘤被诊断为早期胃癌转移。早期胃癌的结肠转移罕见，某些情况下诊断困难。我们在此报告该病例并讨论胃癌结肠转移的临床和病理特征。
