ＣＤＤＰ＋５‐ＦＵ療法が著効したこう門管内分泌細胞癌肺転移の１例

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  • Effectiveness of Chemotherapy with Cisplatin and 5-Fluorouracil against Lung Metastasis from Anal Neuroendocrine Cell Carcinoma

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Anal neuroendocrine cell carcinoma is extremely rare. To our knowledge, only 4 cases have been reported in Japan, all of which had early metastases and a poor outcome. We report a case of anal endocrine cellcarcinoma with early pulmonary metastases that responded to a combination of 5-fluorouracil (5-FU) and cisplatin (CDDP). A 51-year-old woman was admitted beccause of bleeding at defecation. A palpable mass waspresent in the left inguinal region. Rectal endoscopy revealed a protruding lesion extending to the dentate lineand left inguinal lymph node enlargement. Biopsy showed a poorly-differentiated anorectal adenocarcinomametastacizing to the left inguinal lymph nodes. An abdominoperineal resection with a lateral excision and bilateral inguinal lymph node dissection was perfomed. Histopathological examination of the surgical specimensrevealed positive Grimelius and chromogranin A staining in tumor tissue, indicating a neuroendocrine cell carcinoma. On discharge, treatment with 600 mg/day p.o. of tegafur was begun. About 1 month after surgery, plain chest radiography and computed tomography showed multiple lung metastases. Continuous intrave-nous infusion of 5-FU (500mg/m2/day) with daily CDDP (15mg/m2/day) was given on days 1 to 5 of a 4-weekcycle. Tegafur (600mg/day) was administered orally on days 6 to 28. Pulmonary metastatic nodes had resolved completely at the end of the first cycle. A total of six cycles of chemotherapy were given. To date, 1year and 6 months after surgery, there is no evidence of metaastatic recurrence.

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