Uejima Chihiro, Yamamoto Manabu, Hara Kazushi, Sugezawa Ken, Tada Yoichiro, Tanio Akimitsu, Kihara Kyoichi, Fukumoto Yoji, Tokuyasu Naruo, Takano Shuichi, Sakamoto Teruhisa, Honjo Soichiro, Fujiwara Yoshiyuki
Dept. of Surgery, Faculty of Medicine, Tottori University.
Gan To Kagaku Ryoho. 2020 Mar;47(3):463-465.
The patient was a 63-year-old man. He underwent laparoscopic anterior resection of a rectal cancer when he was 60 years. The tumor was diagnosed as T3N0M0, Stage Ⅱ, and he was followed up without adjuvant chemotherapy. Two years and 9 months after surgery, anemia and increased levels of tumor markers were observed. CT scan revealed a mass in the mesentery. We suspected rectal cancer recurrence and performed partial resection of the jejunum with regional lymph node dissection. As the tumor appearance and histological findings were similar to those of the previous rectal cancer, the tumor was diagnosed as hematogenous metastasis of rectal cancer with lymph nodes metastasis. The hematogenous metastasis of rectal cancer to the small intestine is rare; however, it may cause metastasis to regional lymph nodes. Therefore, lymph node dissection may be necessaryin surgical interventions for metastatic tumors of the small intestine.
患者为一名63岁男性。他60岁时接受了直肠癌腹腔镜前切除术。肿瘤被诊断为T3N0M0，Ⅱ期，未接受辅助化疗并进行随访。术后两年零九个月，发现贫血且肿瘤标志物水平升高。CT扫描显示肠系膜有肿物。我们怀疑是直肠癌复发，遂行空肠部分切除术并进行区域淋巴结清扫。由于肿瘤外观及组织学表现与之前的直肠癌相似，该肿瘤被诊断为伴有淋巴结转移的直肠癌血行转移。直肠癌血行转移至小肠较为罕见；然而，其可能导致区域淋巴结转移。因此，对于小肠转移性肿瘤的手术干预可能有必要进行淋巴结清扫。
