第7巻 2011年6月　第3号

■症例報告

盲腸腺扁平上皮癌の1例
杉浦　篤^1,2, 内田　英二¹, 松谷　毅^1,3, 丸山　弘^1,3, 横山　正^1,3, 鈴木　成治³, 吉田　寛^1,3, 笹島　耕二^1,3
1日本医科大学大学院医学研究科臓器病態制御外科学
²東京リバーサイド病院外科
³日本医科大学多摩永山病院外科

A Case of Adenosquamous Carcinoma of the Cecum
Atsushi Sugiura^1,2, Eiji Uchida¹, Takeshi Matsutani^1,3, Hiroshi Maruyama^1,3, Tadashi Yokoyama^1,3, Seiji Suzuki³, Hiroshi Yoshida^1,3 and Koji Sasajima^1,3
1Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
²Department of Surgery, Tokyo River Side Hospital
³Department of Surgery, Nippon Medical School Tama Nagayama Hospital

Adenosquamous carcinoma of the colon is rare, accounting for approximately 0.1% of all colon cancers. We present a case of primary adenosquamous carcinoma of the cecum treated with resection. A 73-year-old woman was admitted to the hospital because of abdominal pain and vomiting, and ileus was diagnosed on the basis of colonic obstruction suggested by abdominal X-ray examination. Colonoscopy revealed type 2 advanced cancer of the cecum, and a biopsy confirmed adenocarcinoma. Computed tomography (CT) of the chest and abdomen revealed no distant metastases. The levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) before the operation were 17 ng/ml and 101 U/ml, respectively. Ileocecal resection (D3) was performed, and the clinical stage of the tumor was IIIb (T3N2H0P0). Pathological examination showed adenosquamous carcinoma (moderately differentiated adenocarcinoma and well-differentiated squamous cell carcinoma) and regional lymph node metastases (No. 201 and 202, positive; No. 203, negative). Adjuvant chemotherapy with 5-fluorouracil (5-FU)/leucovorin (LV) was performed, and the patient was disease-free for 15 months after the operation. However, metastasis to the para-aorta lymph nodes was detected with CT examination 16 months after the operation. The patient received best supportive care and died 22 months after surgery.

日医大医会誌 2011; 7(3), 129-132

Key words
colon cancer, adenosquamous carcinoma

Correspondence to
Atsushi Sugiura, Department of Surgery, Tokyo River Side Hospital, 8-4-4 Minami-senjyu, Arakawa-ku, Tokyo 116-0003, Japan
E-mail：as681227@nms.ac.jp

受付：2011年1月27日　受理：2011年4月11日