ポリペクトミーされた径10mmの進行大腸癌の1例

Small Advanced Colon Cancer, 10 mm in Diameter, Removed by Endoscopic Resection, Report of a Case

要旨　患者は58歳の男性．最大径10mmのⅡa＋Ⅱc様の大腸癌を認め，ポリペクトミーを施行したが断端陽性にて追加切除を行った．深達度漿膜下層（以下ss）の高分化型腺癌でn₀，ly₀，v₁であった．切除標本組織上，腺腫の合併を認めない．S₀P₀H₀N₀，stage Ⅰ，Dukes A．絶対的治癒切除であった．UFT300mg/日を内服し，外来通院中であるが，術後2年6か月経過した現在再発はない．10mm以下の進行大腸癌はまれで，しかもss以下に達している症例は自験例が本邦で6例目であるので若干の文献的考察を加え，報告した．

　A 58-year-old man experienced occasional episodes of anal pain from February 1990. Colonoscopic examination revealed a small elevated lesion with a central depression in the descending colon. The tumor was round-shaped and steeply elevated with a central depression, 10×10 mm in size. The edge of the elevation was partly covered with normal mucosa. The tumor was resected by endoscopic polypectomy. The resected specimen was 10 mm in size and microscopically well differentiated adenocarcinoma invading the deep layers. Surgical resection of the descending colon was performed due to positive cancer invasion on the cutting edge. We report this case because a small advanced cancer less than 10 mm in size subserosal invasion is quite rare.