前立腺癌・虫垂癌・胃癌の3重複癌を罹患した高齢者の1例

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  • An Elderly Patient with Three Primary Cancers of Prostate Cancer, Appendix Cancer and Gastric Cancer : A Case Report
  • ゼンリツセンガン チュウスイガン イガン ノ 3 チョウフクガン オ リカンシタ コウレイシャ ノ 1レイ

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We reported an 85-year-old male with triple primary cancers: prostate cancer, appendix cancer and gastric cancer, who was successfully treated by non-surgical therapies. 1)　In 2003 (79-year-old), prostate cancer was found by blood test (high PSA level: 64.9 ng/dl) and the following pathological examination (poorly differentiated adenocarcinoma with Gleason score 8). The clinical stage was T2b N0M0 (Stage II).Maximal androgen blockade was started on July,　2003 and PSA level was reduced to 0.006 ng/dl on October, 2008. No relapse has been observed. 2)　In 2005, he had right lower abdominal pain. CT revealed a tumorous lesion (5cm in size) at the iliocaecum area. The lesion was speculated to invade the right iliopsoas muscle and the right ureter. The inflammatory tumor was ruled out, because the numbers of leucocyte and the CRP level were normal. Although the pathologic diagnosis could not be obtained, appendix cancer (clinical Stage IIIb: V Si N2P0H0M-) was strongly suspected. Oral UFT/LV therapy has been given and the　therapeutical effectiveness was estimated as complete response (CR). 3)　He was also diagnosed as having simultaneous early gastric cancer by the endoscopic examination on 2005. The lesion was 0-IIc type and was spreaded at esophagogastric junction (Stage Ia; T1N0M0). The patient refused gastrectomy. We chose a therapy with Argon plasma coagulation (APC). 0ne year later, 2nd APC therapy was added due to the relapse of the lesion. Thereafter, no recurrent lesion was observed on the following endoscopic examination. 　　Despite his advanced age and the continuous treatment, he is doing well and is keeping the activities of daily living (ADL) at present.

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