後頚部軟部組織に初発転移をきたしたｎｅｕｒｏｅｎｄｏｃｒｉｎｅ分化を示した直腸低分化腺癌の１例

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  • Solitary Cervical Metastasis of Poorly Differentiated Adenocarcinoma with Neuroendocrine Differentiation of the Rectum: Report of a Case

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Colorectal cancer metastasis of to the soft tissue of the head and neck is rare, while unusual colorectal cancer metastatic sites have included the pancreas, spleen, larynx, tonsil, and thyroid gland. Since only 8 cases have been reported primary at this site in the English literature, we report a case with solitary cervical metastasis from rectal carcinoma.<BR>A 73-year-old Japanese woman who underwent abdominoperineal resection and was pathologically diag-nosed with pT2pN1 adenocarcinoma was treated postoperatively with 5-fluorouracil but developed a left cer-vical induration grew 2 months later, there after that progressively grew. CT and magnetic resonance imaging indicated a large soft tissue mass contacting cervical vertebrae apart from Virchow's lymphnode. Since biopsy of the cervical mass revealed metastatic adenocarcinoma, similar to that of the primary rectal adenocar-cinoma, and there was no other metastatic lesion, we resected the cervical tumor and treated her with 5-fluorouracil, leucovorin, and radiation to the cervical area. She lived for 16 months after cervical tumor re-section. This case is extremely rare as the site of solitary metastasis of colorectal cancer controlled by radicalsurgery, and chemotherapy.

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