Ito Yoshiro, Shingai Tatsushi, Okimura Shumpei, Taniguchi Yoshiki, Fukata Tadafumi, Nishida Hisashi, Toyoda Yasuhiro, Takayama Osamu, Yoshioka Setsuko, Hojo Shigeyuki, Fukuzaki Takayuki, Ohigashi Hiroaki
Dept. of Surgery, Saiseikai Senri Hospital.
Gan To Kagaku Ryoho. 2021 Apr;48(4):602-604.
A 77‒year‒old man came to our hospital with complaints of abdominal pain and difficulty to defecate. Abdominal CT scan showed an abnormal region in the ascending colon, which was suspected to be an ascending colon cancer. D‒dimer was remarkably high, and the platelet count was 63,000/μL; these results suggested disseminated intravascular coagulation caused by tumor activation. After he was admitted, we performed a contrast enhanced CT, and found no signs of remote metastasis. We decided to resect the tumor without colonoscopy examination in order to release the DIC state. After the surgery, the platelet count did not increase, and leukopenia was observed. We conducted a bone marrow biopsy, and made a diagnosis of disseminated carcinomatosis from colon cancer. The patient's condition did not improve, and he died on day 42 after admission. Pathological autopsy was performed and several minimal remote metastases were found throughout the body.
一名77岁男性因腹痛和排便困难前来我院就诊。腹部CT扫描显示升结肠有异常区域，怀疑为升结肠癌。D - 二聚体显著升高，血小板计数为63,000/μL；这些结果提示肿瘤激活导致弥散性血管内凝血。入院后，我们进行了增强CT检查，未发现远处转移迹象。为解除弥散性血管内凝血状态，我们决定在未进行结肠镜检查的情况下切除肿瘤。术后，血小板计数未升高，且出现白细胞减少。我们进行了骨髓活检，诊断为结肠癌播散性癌病。患者病情未改善，入院42天后死亡。进行了病理尸检，发现全身有多处微小远处转移。
