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直肠癌异时性孤立性掌骨转移

Metachronous solitary metacarpal bone metastasis from rectal cancer.

作者信息

Ito Homare, Horie Hisanaga, Sadatomo Ai, Naoi Daishi, Tahara Makiko, Kono Yoshihiko, Inoue Yoshiyuki, Koinuma Koji, Lefor Alan Kawarai, Sata Naohiro

机构信息

Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.

出版信息

J Surg Case Rep. 2017 Dec 15;2017(12):rjx247. doi: 10.1093/jscr/rjx247. eCollection 2017 Dec.

Abstract

Metachronous solitary metacarpal bone metastasis from rectal cancer has not been reported previously. Here, we describe a 54-year-old woman who underwent abdominoperineal resection for rectal cancer following neoadjuvant chemoradiotherapy. The resected specimen contained adenocarcinoma with no lymph node metastases (Stage II, T3N0M0); no adjuvant chemotherapy was administered. Fifteen months after surgery, the patient presented with pain and swelling of the right thumb. Radiography revealed metacarpal bone destruction, and fluorine-18 fluorodeoxyglucose positron emission tomography showed uptake only in the metacarpal bone. Open biopsy revealed an adenocarcinoma, and a right thumb resection was performed. Histological examination indicated features of adenocarcinoma similar to the findings of a rectal lesion, leading to a diagnosis of metachronous solitary metacarpal bone metastasis from rectal cancer. The patient remains free of disease after 6 years of follow-up. Our findings suggest that surgical resection may lead to favorable outcomes in patients with resectable solitary bone metastases.

摘要

此前尚未有关于直肠癌异时性孤立性掌骨转移的报道。在此,我们描述了一名54岁女性,她在接受新辅助放化疗后因直肠癌接受了腹会阴联合切除术。切除标本为腺癌,无淋巴结转移(II期,T3N0M0);未进行辅助化疗。术后15个月,患者出现右手拇指疼痛和肿胀。影像学检查显示掌骨破坏,氟-18氟脱氧葡萄糖正电子发射断层扫描显示仅掌骨有摄取。切开活检显示为腺癌,遂行右手拇指切除术。组织学检查显示腺癌特征与直肠病变结果相似,从而诊断为直肠癌异时性孤立性掌骨转移。随访6年后,患者无疾病复发。我们的研究结果表明,手术切除对于可切除的孤立性骨转移患者可能会带来良好的预后。

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