Tanaka Hiroto, Matsutani Shinji, Iwauchi Takehiko, Uchima Yasutake, Miyamoto Hironari, Okada Takuma, Tsujio Gen, Kurihara Shigeaki, Nagashima Daisuke, Hirakawa Toshiki, Hirata Keiichiro, Morimoto Junya, Yamagata Shigeto, Takeuchi Kazuhiro
Dept. of Surgery, Fuchu Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2219-2221.
A 77-year-old man with rectal cancer was admitted to our hospital. After neoadjuvant chemotherapy, laparoscopic abdominoperineal resection of rectum with D3 dissection was performed. The pathological diagnosis was poorly differentiated carcinoma, pT3, N1a, M0, pStage Ⅲa. Adjuvant chemotherapy was not performed. Fifteen months after operation, his chief complaint was fatigue. Thrombocytopenia and elevation of tumor maker was detected by blood test and disseminated intravascular coagulation(DIC)was suspected. He was admitted to our hospital and we started anti DIC therapy immediately. Bone scintigraphy revealed multiple bone metastases, then we diagnosed disseminated carcinomatosis of the bone marrow. He died 10 days after hospitalization. Disseminated carcinomatosis of the bone marrow with colon cancer is rare and prognosis is very poor. It is important to diagnose and start treatment as early as possible.
一名77岁的直肠癌男性患者入住我院。新辅助化疗后，行腹腔镜腹会阴联合直肠癌根治术并D3淋巴结清扫。病理诊断为低分化癌，pT3，N1a，M0，pⅢa期。未进行辅助化疗。术后15个月，他的主要诉求是疲劳。血液检查发现血小板减少和肿瘤标志物升高，怀疑发生了弥散性血管内凝血（DIC）。他入住我院，我们立即开始抗DIC治疗。骨闪烁显像显示多发骨转移，随后我们诊断为骨髓播散性癌病。他住院10天后死亡。结肠癌骨髓播散性癌病罕见，预后很差。尽早诊断并开始治疗很重要。
