Ishikawa Takahisa, Homma Shigenori, Nishikawa Makoto, Nakamoto Hiroki, Yokoyama Ryoji, Taketomi Akinobu
Department of Surgery, Hokkaido Prefectural Welfare Federation of Agricultural Cooperatives Abashiri-Kosei General Hospital, Abashiri, Japan.
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Asian J Endosc Surg. 2019 Jan;12(1):118-121. doi: 10.1111/ases.12598. Epub 2018 May 10.
Here we report a case of advanced rectal and prostate cancer with synchronous lateral lymph node (LLN) metastases that was treated with laparoscopic surgery. A 71-year-old man presented with fecal occult blood and was diagnosed with rectal cancer. A metastatic right LLN was suspected after CT examination of a 19-mm lymph node (proximal internal iliac artery region) and a 13-mm lymph node (distal internal iliac artery region) in the right lateral region. We planned neoadjuvant chemotherapy to suppress local and distant recurrence. This treatment decreased the size of the primary rectal tumor. We performed laparoscopic abdominoperineal resection and right LLN dissection. The histopathological diagnosis was LLN metastases from the rectal and prostate cancers. It is rare for synchronous metastases from rectal and prostate cancers to be observed in the LLN. It may be difficult to determine an appropriate treatment strategy in cases like this.
在此,我们报告一例晚期直肠癌和前列腺癌伴同步侧方淋巴结(LLN)转移并接受腹腔镜手术治疗的病例。一名71岁男性因粪便潜血就诊,被诊断为直肠癌。CT检查发现右侧区域一个19毫米的淋巴结(髂内动脉近端区域)和一个13毫米的淋巴结(髂内动脉远端区域)后,怀疑右侧LLN有转移。我们计划进行新辅助化疗以抑制局部和远处复发。该治疗减小了直肠原发肿瘤的大小。我们进行了腹腔镜腹会阴联合切除术及右侧LLN清扫术。组织病理学诊断为直肠癌和前列腺癌的LLN转移。直肠癌和前列腺癌在LLN中出现同步转移的情况罕见。对于此类病例,可能难以确定合适的治疗策略。