第10巻 2014年6月　第3号

■症例報告

同時性6多発大腸癌の1切除例
武田　幸樹^1,3, 土屋　喜一^1,3, 高田　英志^1,3, 二階堂　孝², 秋丸　琥甫^1,3, 内田　英二^3
1立正佼成会附属佼成病院外科
²立正佼成会附属佼成病院病理科
³日本医科大学外科学(消化器外科学）

A Case of Six Synchronous Primary Colorectal Cancers
Kohki Takeda^1,3, Yoshikazu Tsuchiya^1,3, Hideyuki Takata^1,3, Takashi Nikaido², Koho Akimaru^1,3 and Eiji Uchida^3
1)Department of Surgery, Kosei General Hospital
²⁾Department of Pathology, Kosei General Hospital
³⁾Department of Surgery, Nippon Medical School

We report here a very rare case of six synchronous primary colorectal cancers. A 78-year-old male was admitted to our department for further examinations and treatment of rectal bleeding, anemia and general fatigue. Colonoscopy revealed an ulcerative and localized type tumor in the rectosigmoid. The tumor obstructed the lumen, and further observation of the oral side was not possible. The patient was preoperatively diagnosed as rectosigmoid cancer, and was operated. Besides the preoperatively diagnosed cancer, three tumors were detected in the sigmoid, descending and transverse colons, respectively. Subtotal colectomy was performed. Pathological examination revealed a total of six cancers. Such as in this case, advanced cancer of the distal colon sometimes prevents accurate diagnosis of the coexisting tumor in the proximal portion. Therefore, in this condition, we believe that careful palpation during the operation and intraoperative colonoscopy will contribute to accurate diagnosis and improving the prognosis of patients with synchronous multiple primary colorectal cancers.

日医大医会誌 2014; 10(3), 142-146

Key words
colorectal cancer, multiple cancer, synchronous

Correspondence to
Kohki Takeda, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：take-yokohama@nms.ac.jp

受付：2014年1月30日　受理：2014年3月1日