直腸癌術後に発症した原発性小腸癌の1例

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  • A CASE OF PRIMARY ADENOCARCINOMA OF THE SMALL INTESTINE AFTER RESECTION OF RECTAL CANCER

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We report a case of primary adenocarcinoma of the small intestine after resection of rectal cancer with a review of the literature.<br>A 54-year-old man underwent a low anterior resection for rectal cancer in November 1998, of which pathological diagnosis was moderately differentiated adenocarcinoma, sm, ly0, v0, n0, stage I. Four years and two months later, follow up abdominal CT scan revealed wall thickening of the jejunum. Small bowel endoscopy showed circular stenosis of the jejunum. Endoscopic biopsy allowed a histological diagnosis of poorly differentiated adenocarcinoma. The patient was operated on under a diagnosis of carcinoma of the small intestine. Partial resections of the small intestine and transverse colon with pancreaticosplenectomy were done. On the resected material a 4×6cm type 2 tumor was identified which invaded the colonic mucosa. Pathological findings included poorly differentiated adenocarcinoma, si, n0. It is important to pay attention to associated carcinomas of other organs including the small intestine in postoperative surveillance of colorectal carcinoma.

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