乳癌が大腸へ転移した1例

Colon Cancer Metastated from Breast Cancer, Report of a Case

要旨　患者は72歳の女性．2001年1月に腹痛，便秘にて近医を受診した．注腸造影検査にて横行結腸に長さ約13cmの辺縁に細かな毛羽立ちを有する全周性狭窄認め，精査目的にて入院となった．腹部造影CT検査にて腸管壁肥厚および同部位の造影効果が認められた．大腸内視鏡検査ではmelanosis coliが存在し，同部に狭窄が認められたが，生検ではGroup Ⅰであった．既往歴として1995年に乳癌にて右乳房切除術がされており，乳癌の転移による狭窄を強く疑い，左半結腸切除術を行った．病理組織学的診断は乳癌による転移性腺癌であった．4型大腸癌と鑑別が必要である大腸転移腫瘍の1例を経験したので報告した．

　The patient was a 72-year-old female. She visited a nearby clinic with abdominal pain and constipation in January, 2001. Since a contrast enema exhibited a 13 cm long bilateral lesion with nap-like appearance on the inner surface in the transverse colon, she was hospitalized for detailed examination. Abdominal contrast imaging CT demonstrated hypertrophy and enhancement of the colonic wall. Colonoscopy demonstrated Melanosis coli, and stenosis was observed at the same portion of the transverse colon. Biopsy, however, showed Group Ⅰ. Since she had received right mastectomy in 1995, we strongly suspected stenosis ascribable to metastasis of breast cancer, so we carried out left hemicolectomy. Histopathological diagnosis of this patient was metastatic adenocarcinoma.

　This report is about our encounter with a patient with metastatic colorectal carcinoma which needed to be differentiated from Type 4 colorectal carcinoma.