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A Case Report of Rectal Carcinoid with Two Primary Lesions K. Terada 1 , J. Ohida 1 , K. Kondo 1 , K. Iwata 2 , S. Ashihara 3 , M. Ishikawa 4 , K. Araki 4 1Dept. of Surgery, Kochi Prefectural Central Hospital 2Dept. of Clinical Pathology, Kochi Prefectural Central Hospital 3Dept. of Surgery, Hosogi Hospital 41st Dept. of Surgery, Okayama University Medical School pp.1345-1351
Published Date 1977/10/25
DOI https://doi.org/10.11477/mf.1403112522
  • Abstract
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 The patient, a 59-year-old male, had complained of unpleasant feeling in his anal region.

 Digital examination of the rectum revealed a small hard nodule. Roentgenographically, a submucosal tumorous shadow was demonstrated on the posterior wall of the ampullar region of the rectum. Endoscopically, a Ⅱa+Ⅱc-like lesion measuring 2.0×2.0 cm was found, located about 5 cm from the anus. A biopsy specimen was diagnosed as carcinoid histologically. The excretion of 5-HIAA into the urine was within normal limits.

 Radical operation (abdomino-perineal resection) was carried out because of the lack of mobility of the tumor mass. At the time of surgery, a tumor measuring 2.0 cm in width with superficial ulceration on its tip was excised (A). Moreover, another small tumor measuring 0.3×0.2 cm was recognized in the same surgical specimen 2 cm proximal to the anal ring (B).

 Histologically, the tumor A extended through the muscularis propria and the tumor B infiltrated the submucosal layer. Metastases to the regional lymph nodes were demonstrated histologically, but not to the liver. Electronmicroscopic examination of the tumor A showed numerous neurosecretory granules within the cytoplasma of the tumor cells, characteristic for carcinoid tumors.

 Rectal carcinoid is a rare disease and 28 cases excluding our case have been reported in Japan up to the present. Each of these cases had a solitary lesion of the rectum except for our case.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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