痔瘻癌の1例

Fistula Cancer, Report of a Case

要旨　患者は65歳，男性で，肛門部の排液，疼痛を主訴に当科を紹介された．痔瘻からコロイド様の分泌物がみられ，臨床所見，検査所見より痔瘻癌が疑われた．麻酔下に粘液および掻爬組織を病理検査に提出し，痔瘻に対してシートン手術を施行したところ，組織は粘液癌であった．術前化学放射線療法（50.4Gy，UFT^® 500mg/日，ホリナートカルシウム錠75mg/日）施行1か月後に，腹会陰式直腸切断術を施行した．剥離面切除断端（－）で，化学放射線療法の組織学的治療判定はGrade 2であった．術後2年が経過しており，再発なく外来通院中である．術前化学放射線療法を施行した痔瘻癌の1例を，文献的考察を加えて報告する．

　A 65-year-old man was referred to our hospital complaining of discharge and pain in his anus. Colloid-like mucin secretion was identified from anal fistula, and carcinoma with anal fistula was suspected. Under anesthesia mucin and scratched tissue were obtained and sent to the Pathology Department, and turned out to be mucinous carcinoma. Preoperative chemoradiation（50.4Gy, UFT^® 500mg/day, calcium folinate 75mg/day）was performed, and 1 month later abdoperineal excision of the rectum was performed. Pathological examination revealed ew－ and Grade 2 of the histological evaluation of chemoradiation. The patient is now doing well without recurrence 2 years after the operation. We report this case with a brief review of the literature.