Watanabe Yusaku, Iwamoto Ryo, Kitagawa Shuji, Kinoshita Seiya, Ueno Michi, Mineta Shumei, Okamoto Yuko, Uraoka Mio, Kubota Hisako, Higashida Masaharu, Okada Toshimasa, Tsuruta Atsushi, Fujiwara Yoshinori, Ueno Tomio
Dept. of Digestive Surgery, Kawasaki Medical School.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2378-2379.
An 82-year-oldwoman previously underwent total gastrectomy for gastric cancer at the age of 75 years. After 7 years of follow-up, a colonoscopy was performedto investigate the cause of constipation, which revealedan irregularity in the rectal submucosa. A colonoscopy-guidedbiopsy showedpoorly differentiatedad enocarcinoma, andthe immunohistochemical staining pattern showedMUC2(-), MUC5AC(+), CDX2(+), andCA1 25(-). FDG-PET showedintense uptake only at the rectum. Thus, laparoscopic high anterior resection was performed. Pathological findings showed that poorly differentiated adenocarcinoma and signet-ring cell carcinoma hadd evelopedmainly in the submucosa. In comparison with the immunohistological features of the previous gastric cancer, the rectal tumor hadsimilar morphological characteristics. The definitive diagnosis was rectal metastasis from gastric cancer. She has remained recurrence-free in the 20 months since this operation.
一名82岁女性曾在75岁时因胃癌接受了全胃切除术。经过7年的随访，为调查便秘原因进行了结肠镜检查，结果显示直肠黏膜下层有异常。结肠镜引导下活检显示为低分化腺癌，免疫组化染色模式显示MUC2（-）、MUC5AC（+）、CDX2（+）和CA125（-）。FDG-PET显示仅直肠有强烈摄取。因此，进行了腹腔镜高位前切除术。病理结果显示，低分化腺癌和印戒细胞癌主要在黏膜下层发展。与先前胃癌的免疫组织学特征相比，直肠肿瘤具有相似的形态学特征。最终诊断为胃癌直肠转移。自此次手术以来的20个月里，她一直没有复发。
