Nomura Tomohisa, Katsumata Kenji, Kasahara Kenta, Wada Takahiro, Kuwabara Hiroshi, Shigoka Masatoshi, Enomoto Masanori, Ishizaki Tetsuo, Nagakawa Yuichi, Tsuchida Akihiko
Dept. of Surgery, Jinwakai General Hospital.
Gan To Kagaku Ryoho. 2020 Apr;47(4):649-651.
In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/mL, CRP levels of 5.69mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0 (0/27)Stage Ⅱa tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.
2015年9月,一名90岁女性以腹痛和呕吐为主诉就诊。除白细胞计数为10420/mL、CRP水平为5.69mg/dL、碱性磷酸酶水平为359 IU/L外,未发现其他异常值,癌胚抗原(CEA)和糖类抗原19-9(CA19-9)肿瘤标志物水平分别为3.9 ng/mL和5.7 U/mL,均正常。腹部CT显示右半结肠套叠,套叠部位有一实性肿瘤。对疑似结肠癌引起的套叠进行了手术。手术发现升结肠有一突出病变,延伸至横结肠,套叠侵入至回肠末端的升结肠。因此,进行了右半结肠切除及淋巴结清扫。切除标本显示升结肠有一个直径为65×50×30mm的1型肿瘤。组织病理学检查结果显示为tub1>tub2、SS、ly0、v0、PM0、DM0、N0(0/27)Ⅱa期肿瘤。术后恢复顺利,患者于术后第12天出院。我们报告一例罕见的升结肠癌致肠套叠病例。