子宮体癌術後の放射線性大腸炎に合併した直腸癌の1例

Rectal Cancer Associated with Radiation Colitis after Treatment for Cancer of Uterine Corpus, Report of a Case

要旨　62歳，女性．32歳時に子宮体癌に対し子宮全摘，両付属器切除，骨盤リンパ節郭清，およびラジウム針挿入を受けた．以後数年間放射線性腸炎のため少量の下血が持続したが，自然消退した．29年を経て下血で発症．注腸造影および大腸内視鏡で直腸潰瘍性病変を指摘された．Miles手術，腔合併切除を施行され，切除標本では主病変は周堤形成のない小さい潰瘍性病変であったが，固有筋層外に一部浸潤する高分化腺癌であった．背景では直腸病変周囲に広範な線維化と壁肥厚，内腔閉塞などの動脈変化を認め放射線性腸炎による変化が認められた．

　A 62-year-old woman who had received extended hysterectomy and radium-needle insertion for cancer of the uterine corpus at 32 years of age. Following that episode, rectal bleeding persisted for several years before it spontaneously cleared up. Rectal bleeding recurred 29 years later, and a small ulcer was revealed radiographically and endoscopically. The surgically resected specimen showed well differentiated adenocarcinoma penetrating the proper muscle layer. The effect of former radiotherapy remained as around the lesion intimal thickening and obstruction of small arteries.