Iwata Yoshinori, Matsuhashi Nobuhisa, Takahashi Takao, Suetsugu Tomonari, Fukada Masahiro, Yasufuku Itaru, Imai Takeharu, Tanahashi Toshiyuki, Mori Ryutaro, Matsui Satoshi, Imai Hisashi, Tanaka Yoshihiro, Yamaguchi Kazuya, Futamura Manabu, Miyazaki Tatsuhiko, Yoshida Kazuhiro
Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.
Pathology Division, Gifu University Hospital, Gifu, Japan.
Int Cancer Conf J. 2020 May 27;9(3):162-167. doi: 10.1007/s13691-020-00419-1. eCollection 2020 Jul.
A 75-year-old woman was diagnosed with anemia during hospitalization for the treatment of right superior ophthalmic arteriovenous fistula. Colonoscopy revealed an entire circumference of type 2 tumor in the ascending colon. Computed tomography showed ascending colon wall thickening, a tumor with a maximum diameter of 32 mm on the right external iliac artery and multiple low-density nodules in the spleen. We performed right hemicolectomy with D3 lymph node dissection, splenectomy and right external iliac lymph node dissection. Histopathological finding revealed moderately-differentiated adenocarcinoma in ascending colon and right external iliac lymph node. The lesion of spleen was diagnosed as splenic lymphangioma. The patient was discharged on postoperative day 18. Additional treatments, including chemotherapy, were not performed, and no recurrences were seen up to 66 months after surgery. We herein report an uncommon event of ascending colon cancer with synchronous right external iliac lymph node metastasis, which was successfully treated by surgical resection, made feasible when the distant lymph node metastasis is localized.
一名75岁女性在因治疗右上眼动脉动静脉瘘住院期间被诊断为贫血。结肠镜检查显示升结肠有2型肿瘤环绕一周。计算机断层扫描显示升结肠壁增厚，右髂外动脉处有一个最大直径为32毫米的肿瘤，脾脏有多个低密度结节。我们进行了右半结肠切除术加D3淋巴结清扫、脾切除术和右髂外淋巴结清扫。组织病理学检查发现升结肠和右髂外淋巴结为中分化腺癌。脾脏病变诊断为脾淋巴管瘤。患者术后第18天出院。未进行包括化疗在内的其他治疗，术后66个月未见复发。我们在此报告一例罕见的升结肠癌伴同步右髂外淋巴结转移病例，当远处淋巴结转移局限时，通过手术切除成功治疗。
