Ueda Nobuhiko, Fujii Yoritaka, Miura Seiko, Fujita Jun, Tomita Yasuto, Fujita Hideto, Kinami Shinichi, Kosaka Takeo, Usuda Katsuo, Uramoto Hidetaka
Dept. of General and Digestive Surgery, Kanazawa Medical University.
Gan To Kagaku Ryoho. 2018 Dec;45(13):2081-2083.
A 49-year-old man underwent sigmoidectomy for the diagnosis of type 2 sigmoid cancer. Pathological findings showed a tumor 3.5×4.0cm in size, type 2, pSS, ly2, v1, pN0, cH0, cP0, cM0, pStageⅡ, R0. Asynchronistic metastases to the liver and lungs were subsequently found. Left hepatectomy was performed for 1 liver metastasis, and 4lung metastases were resected through 3 surgeries. A subcutaneous tumor in an abdominal wall scar was also resected in the 4th surgery for metastasis resection. All pathological diagnoses were metastases from sigmoid cancer, and complete curative resection was possible. The final surgery was performed 1 year and 1 month prior, and the patient has now survived without recurrence for 10 years and 2 months after sigmoidectomy. Chemotherapy was not administered during the whole course. This case shows that longterm survival is possible with repeated resection of recurrent metastasis of sigmoid cancer.
一名49岁男性因乙状结肠2型癌诊断接受了乙状结肠切除术。病理结果显示肿瘤大小为3.5×4.0cm,2型,pSS,ly2,v1,pN0,cH0,cP0,cM0,pⅡ期,R0。随后发现肝脏和肺部出现异时性转移。对1处肝转移灶进行了左肝切除术,并通过3次手术切除了4处肺转移灶。在第4次转移灶切除手术中,还切除了腹壁瘢痕处的皮下肿瘤。所有病理诊断均为乙状结肠癌转移,且有可能进行根治性切除。最后一次手术是在1年零1个月前进行的,患者在乙状结肠切除术后已存活10年零2个月,无复发。整个过程未进行化疗。该病例表明,通过反复切除乙状结肠癌复发转移灶可实现长期生存。