早期虫垂癌の1例

Early Appendiceal Cancer, Report of a Case

要旨　右下腹痛を主訴とする76歳の男性に対し，注腸造影および大腸内視鏡検査を施行し，虫垂開口部周辺の粘膜下腫瘍様隆起と虫垂開口部に小さな隆起性病変を認めた．生検所見は，中等度異型を有す腺管絨毛腺腫であったが，癌の存在を否定できず回盲部切除を行った．切除標本の病理組織は，高分化腺癌で同じ病変内に腺管絨毛腺腫を伴っていた．癌の壁深達度は粘膜固有層にとどまるm癌で，リンパ節転移を認めず，大腸癌取扱い規約ではstage 0，早期癌に相当するものであった．

　A 76-year-old man with the chief complaint of right hypogastric pain underwent barium enema and endoscopy of the large intestine, which revealed protuberances resembling submucosal tumors around the ostium appendicis vermiformis and small protuberant lesions in the ostium appendicis vermiformis. Although biopsy specimen showed tubulovillous adenoma with moderate atypia, the presence of cancer could not be excluded, and he was treated by ileocecal resection. The lesions were pathologically well differentiated adenocarcinoma in tubulovillous adenoma, and were found to have invaded the wall of the mucosal proper layer. No lymph node metastasis was observed, and the lesions were stage 0.