Namba Yosuke, Hirata Yuzo, Mukai Shoichiro, Nishida Toshihiro, Ishikawa Syo, Kai Azusa, Kohata Akihiro, Okimoto Syo, Fujisaki Seiji, Fukuda Saburo, Takahashi Mamoru, Fukuda Toshikatsu
Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.
Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
J Surg Case Rep. 2020 Jul 31;2020(7):rjaa118. doi: 10.1093/jscr/rjaa118. eCollection 2020 Jul.
Most cases of peritoneal dissemination of colorectal cancers are from T3 or T4 tumors. A 61-year-old woman was admitted for examination of a positive fecal occult blood test. Colonoscopy showed an ascending colon tumor that was diagnosed as an adenocarcinoma with massive submucosal invasion. Imaging modality revealed numerous nodules throughout the abdominal cavity. Peritoneal dissemination of the ascending colon or ovarian cancer and pseudomyxoma peritonei were considered in the preoperative differential diagnoses, and laparoscopic ileocecal resection was performed. Intraperitoneal observation revealed numerous white nodules in the peritoneum, omentum and Douglas fossa. Both the nodules and tumor were diagnosed as mucinous carcinoma based on a pathology report. The tumor invasion depth was limited to muscularis propria, and no regional lymph node metastasis was detected. Peritoneal dissemination of the ascending colon cancer was considered. We report a rare case of multiple peritoneal dissemination of T2 colorectal cancer without lymph node metastases.
大多数结直肠癌腹膜播散病例来自T3或T4肿瘤。一名61岁女性因粪便潜血试验阳性入院检查。结肠镜检查显示升结肠肿瘤,诊断为伴有大量黏膜下浸润的腺癌。影像学检查发现腹腔内有大量结节。术前鉴别诊断考虑为升结肠癌或卵巢癌腹膜播散以及腹膜假黏液瘤,并进行了腹腔镜回盲部切除术。腹腔内观察发现腹膜、大网膜和Douglas窝有大量白色结节。根据病理报告,结节和肿瘤均诊断为黏液癌。肿瘤浸润深度局限于固有肌层,未检测到区域淋巴结转移。考虑为升结肠癌腹膜播散。我们报告一例罕见的T2期结直肠癌无淋巴结转移的多发性腹膜播散病例。