多発性大腸癌の1例

Multiple Cancers of the Colon, a Case Report

　近年のわが国における大腸診断は，胃疾患部門に比べて著しく立ち遅れており，早期大腸癌についてみても，その報告例はきわめて少ない．このことは，大腸検査方法の確立と普及の遅れによるところが大きいと考えている．

　われわれは，注腸検査をブラウン氏変法に統一して日常の診療にたずさわっているが，最近，多発性大腸癌の1例を経験し，大腸の発癌を考える際に，非常に興味深い資料と考えたので，若干の文献的考察を加えて報告する．

　This is a report of multiple cancers of the colon seen in a 51-year-old man. The patient visited us with chief complaints of sense of abdominal distention and pain in the lower abdomen. X-ray diagnosis by barium enema examination of the large intestine was multiple cancers of the colon. Cancer lesions extended all along the colon, totalling to ten lesions. Of these, two in the sigmoid were left untouched. Histological examination showed two advanced carcinomas in the ascending and transverse colon, both reaching the subserosa. Other changes were as follows : a pedun-culated cancer with mulberry-like surface, 5.6×3.4 cm, with the depth of invasion sm ; a sessile cancer of uneven surface, 0.7 cm in diameter, m; a pedunclated cancer of uneven surface, 0.7 cm in diameter, m; a sessile lesion of slightly uneven surface, 1.3 cm in diameter, atypicality Ⅳ ; a sessile lesion of smooth surface, 0.6 cm in diameter, atypicality Ⅲ ; and two lesions of smooth surface, 0.4 cm in length, both free from malignancy.

　Correlation was seen in some measure between the degree of atypicality and the size of tumors along with the nature of their surface. In our opinion these lesions furnish us with very significant information in the genesis of cancer of the colon.