最大径31mmの陥凹型早期大腸癌の1例―深達度診断を含めて

Large Depressed Type of Colonic Cancer with Diagnosis of Depth of Invasion, Report of a Case

要旨　患者は59歳，男性．血便を主訴に当院外来を受診し，注腸X線検査と内視鏡検査でS状結腸に径約30mmのⅡc＋Ⅱa型病変が認められた．sm深層に浸潤した癌と診断し，S状結腸切除術を施行した．病理組織学的には径31×16mm，Ⅱc＋Ⅱa型，壁深達度smの高分化腺癌であった。リンパ節転移は認めなかった．大きな陥凹型早期大腸癌の報告は少なく，また，早期胃癌の際に行うのと同様の手法で術前の注腸X線所見，内視鏡所見と病理組織学的所見とを対比できたので報告した．

　A 59-year-old man visited us for hematochaesia. Endoscopy and double contrast barium enema revealed a Ⅱc+Ⅱa type of depressed lesion of approximately 30 mm in size. Since the lesion was suspected to have invaded to the deeper submucosal layer, a resection of the sigmoid colon was performed. Morphologically, the lesion was Ⅱc+Ⅱa type of depressed lesion, measuring 31×16mm in size. Histologically, the tumor was well differentiated adenocarcinoma with submucosal invasion. No lymph node metastasis was found.

　We have reported this case because reports on large depressed-type early colonic cancer have been rare, and since comparative study between preoperative roentgenographic and endoscopic findings and postoperative pathological findings were able to be carried out.