Saeki Shingo, Maeda Yoshinari, Nishida Yuki, Kitamura Yoshinori, Ando Seiichiro, Yamamoto Tatsuhito
Dept. of Surgery, Tsushimi Hospital.
Gan To Kagaku Ryoho. 2023 Apr;50(4):511-513.
The patient is a 79-year-old woman who visited her local doctor with a chief complaint of abdominal pain. A lower gastrointestinal endoscopy revealed a circumferential type 3 mass in the transverse colon. The patient was diagnosed with transverse colon cancer (cT3N0M0, cStage Ⅱa)and underwent laparoscopic transverse colectomy(D3). The postoperative course was good, and she was discharged on POD 9. Pathological results showed a diagnosis of medullary carcinoma(pT3N0M0, pStage Ⅱa)with MSI-high. The patient was treated with UFT/UZEL for 6 months as postoperative adjuvant chemotherapy. The patient has been recurrence-free for 1 year and 6 months postoperatively and is under outpatient follow-up. Medullary carcinoma is a rare histologic type that is estimated to account for 2-3% of all colorectal cancers. Medullary carcinoma of the colon is more common in elderly patients, women, and the right side of the colon, with a relatively favorable prognosis. We report a case of medullary carcinoma of the transverse colon in which the patient had a relatively long survival, with some discussion of the literature.
该患者为一名79岁女性，因腹痛为主诉就诊于当地医生。下消化道内镜检查显示横结肠有一环形3型肿物。患者被诊断为横结肠癌（cT3N0M0，cⅡa期），并接受了腹腔镜横结肠切除术（D3）。术后恢复过程顺利，患者于术后第9天出院。病理结果显示为髓样癌（pT3N0M0，pⅡa期），微卫星高度不稳定（MSI-high）。患者接受了6个月的优福定/尿嘧啶替加氟（UFT/UZEL）辅助化疗。患者术后1年6个月无复发，正在门诊随访。髓样癌是一种罕见的组织学类型，估计占所有结直肠癌的2%-3%。结肠髓样癌在老年患者、女性及结肠右侧更为常见，预后相对较好。我们报告一例横结肠髓样癌患者生存时间相对较长的病例，并对相关文献进行一些讨论。
