Miyazaki Yasuaki, Yamabe Kazuo, Hayashi Nobuyasu, Michiura Toshiya, Nakagawa Tomo, Hyuga Satoshi, Murotani Tomotaka, Nagaoka Makio
Dept. of Surgery, Rinku General Medical Center.
Gan To Kagaku Ryoho. 2019 Feb;46(2):285-287.
A 72-year-old man with ascending colon cancer was admitted to our hospital. Right hemicolectomy and lymph node dissection(D3)were performed. The pathological diagnosis was signet-ring cell carcinoma, T4a(SE), N2b, M1a(LYM), Stage Ⅳ, R0, Cur B. Capecitabine was administered after surgery. Subcutaneous bleeding, thrombocytopenia, and a rapid increase in tumor marker levels occurred 9 months after surgery. He had already developed disseminated intravascular coagulation and was admitted to our hospital immediately. CT scan revealed metastasis in the thoracic vertebrae. Bone scintigraphy demonstrated multiple abnormal areas of uptake in the costal bones and the thoracic and lumber vertebrae. We made a final diagnosis of disseminated carcinomatosis of the bone marrow by histopathological examination. Unfortunately, before starting chemotherapy, his general condition deteriorated, and he died 14 days after hospitalization. We present here a case of colon cancer with disseminated carcinomatosis of the bone marrow.
一名72岁升结肠癌男性患者入院。行右半结肠切除术及淋巴结清扫术（D3）。病理诊断为印戒细胞癌，T4a（SE），N2b，M1a（LYM），Ⅳ期，R0，Cur B。术后给予卡培他滨治疗。术后9个月出现皮下出血、血小板减少及肿瘤标志物水平快速升高。患者已发生弥散性血管内凝血，立即入院。CT扫描显示胸椎转移。骨闪烁显像显示肋骨及胸腰椎多个异常摄取区域。经组织病理学检查，最终诊断为骨髓播散性癌病。不幸的是，在开始化疗前，患者一般状况恶化，住院14天后死亡。我们在此报告一例伴有骨髓播散性癌病的结肠癌病例。
