Chida Keigo, Nakanishi Kazuaki, Shomura Hiroki, Homma Shigenori, Hattori Atsuo, Kazui Keizo, Taketomi Akinobu
Department of Surgery, Japan Community Healthcare Organization Hokkaido Hospital, Kita-Ku, Kita 14, Nishi 7, Sapporo, 060-8638, Japan.
Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Surg Case Rep. 2017 Dec;3(1):65. doi: 10.1186/s40792-017-0341-z. Epub 2017 May 10.
Spontaneous regression (SR) of many malignant tumors has been well documented, with an approximate incidence of one per 60,000-100,000 cancer patients. However, SR of colorectal cancer (CRC) is very rare, accounting for less than 2% of such cases. We report a case of SR of transverse colon cancer in an 80-year-old man undergoing outpatient follow-up after surgical treatment of early gastric cancer. Colonoscopy (CS) revealed a Borrmann type II tumor in the transverse colon measuring 30 × 30 mm. Because the patient underwent anticoagulant therapy, we did not perform a biopsy at that time. A second CS was performed 1 week after the initial examination and revealed tumor shrinkage to a diameter of 20 mm and a shift to the Borrmann type III morphology. Biopsy revealed a poorly differentiated adenocarcinoma. One week after the second CS, we performed a partial resection of the transverse colon and D2 lymph node dissection. Histopathology revealed inflammatory cell infiltration and fibrosis from the submucosal to muscularis propria layers in the absence of cancer cells, leading to pathological staging of pStage 0 (T0N0). The patient had an uneventful recovery, and CS performed at 5 months postoperatively revealed the absence of a tumor in the colon and rectum. The patient continues to be followed up as an outpatient at 12 months postoperatively, and no recurrence has been observed.
许多恶性肿瘤的自发消退（SR）已有充分记录，在每60000 - 100000名癌症患者中，其发生率约为1例。然而，结直肠癌（CRC）的SR非常罕见，占此类病例的比例不到2%。我们报告1例80岁男性横结肠癌自发消退的病例，该患者因早期胃癌手术治疗后接受门诊随访。结肠镜检查（CS）发现横结肠有一个Borrmann II型肿瘤，大小为30×30 mm。由于患者正在接受抗凝治疗，当时我们未进行活检。在初次检查1周后进行了第二次CS，结果显示肿瘤缩小至直径20 mm，并转变为Borrmann III型形态。活检显示为低分化腺癌。第二次CS 1周后，我们对横结肠进行了部分切除及D2淋巴结清扫。组织病理学显示，从黏膜下层到固有肌层有炎性细胞浸润和纤维化，未见癌细胞，病理分期为pStage 0（T0N0）。患者恢复顺利，术后5个月进行的CS显示结肠和直肠无肿瘤。术后12个月，患者继续作为门诊患者接受随访，未观察到复发。
