上行結腸印環細胞癌切除後再発例に対してftd/Tpi療法が奏効した1例

Abstract

The patient was an 80-year-old man. He visited our hospital because elevated tumor marker levels were noted during a physical examination. Lower gastrointestinal endoscopy showed a type 0-Ⅱa lesion in the ascending colon, and a biopsy indicated the presence of adenocarcinoma (por/sig). A computed tomography scan showed many enlarged lymph nodes in the ileocecum. Therefore, he was diagnosed as having a cT1bN2bM0-stage ascending colon carcinoma. On performing laparoscopic ileocecal resection, a 20-mm-large mass was detected in the subserosa of the resected tissue. It was identified as a lymph node that had enlarged due to metastasis of the mucinous carcinoma. On performing additional resection, a signetring cell carcinoma lesion was detected in the ascending colon near the metastatic site. Therefore, the patient was diagnosed as having a pT3 (Ly) N2bM0-stage ascending colon carcinoma. After adjuvant chemotherapy with CAPOX, paratracheal lymph node metastasis and peritoneal dissemination recurrence were confirmed. However, after switching to FTD/ TPI, the peritoneal dissemination reduced and tumor marker levels normalized. Although signet-ring cell carcinoma of the colon is rare and often difficult to treat, we experienced a patient who was successfully treated after recurrence. Thus, we report this case, with a review of the literature.