深達度診断が困難であった大腸のⅡc＋Ⅱa型m癌の1例

Ⅱc＋Ⅱa Type Colonic Cancer with Mucosal Invasion the Depth of Which Was Difficult to Diagnose Clinically, Report of a Case

要旨　患者は51歳，男性．S状結腸癌術後9か月目の注腸造影で，下行結腸に径約20mmの，周囲に隆起を伴った陥凹性病変を認めた．内視鏡では陥凹部に白苔と結節状の隆起を認め，周囲には幅の狭い隆起を伴っていた．pmまで浸潤した進行癌と診断し，手術を施行したが，病理組織学的には径18×13mmのⅡc＋Ⅱa型を示す陥凹型のm癌であった．蠕動が比較的良く通り，周囲の隆起に凹凸不整がなく平滑であることを考えると，進行癌と診断したのは読み過ぎであった．しかし，比較的大きく，また，陥凹部に白苔と結節状隆起を認める陥凹型のm癌はまれと考えられた．

　A 51-year-old man had a Ⅱc＋Ⅱa type colonic cancer in the descending colon, measuring 18 mm in diameter. The depth of invasion was limited to the mucosa. It was difficult to diagnose the depth of invasion clinically, because the size of the lesion was relatively large and there were a white coat and a nodular protrusion in the depressed area. It was considered that the relatively large depressed type colonic cancer with a white coat, the depth of invasion of which was limited to the mucosa, was rare.