11か月の経過で急激に大きさと形態の変化を来した大腸癌の1例

Colon Cancer Which Rapidly Changed in Configuration and Size, Report of a Case

要旨　患者は下血を主訴に当科を受診し，緊急大腸内視鏡検査を施行した．Rsに凝血塊の付着した粘膜のびらん性変化を認めたため，HSE(hypertonic saline and epinephrine)を局注し止血を得た．11か月後に施行した大腸内視鏡検査にて同部位に中等度の発赤を示し，立ち上がりが急峻で緊満感を伴う粘膜下腫瘍様形態の病変を認めた．生検にて中分化腺癌であったため，腹腔鏡下低位前方切除術を施行した．摘出標本では腫瘍は大きさ22×15mmで病理学的診断は中分化腺癌，リンパ節転移陽性であった．

　The patient was a 38-year-old male. His chief complaints were rectal bleeding and dizziness. The colonoscopic examination revealed erosion and edematous swelling in the rectum with coagulation adhesive to the surface. We injected hypertonic saline and epinephrine (HSE) in order to prevent further bleeding. A punch biopsy showed some clot only. The patient did not present himself at the next appointment. Eleven months later, the lesion had increased in size to about 2.0 cm in diameter and looked like a submucosal tumor . The resected specimen revealed a well defined elevated lesion, 2.2×1.5 cm in size in the rectum. The histology was moderately differentiated adenocarcinoma. We reported this case because its course of development seemed unusual and interesting.