腹腔鏡下に根治切除を行った肺癌大腸転移の1例

Laparoscopic curative resection for metastatic colon cancer derived from lung cancer : a case report

◆要旨：患者は73歳，男性．肺癌術後2年経過した際のfluoro-2-deoxyglucose positron emission tomography （FDG-PET）検査にて下行結腸に集積を認め，下部消化管内視鏡検査にて下行結腸に腫瘍を指摘された．生検から肺癌の弧発性大腸転移と診断した．根治切除可能と判断し，腹腔鏡下左結腸切除，D3郭清を施行した．術後4か月無再発で経過している．肺癌の転移臓器として大腸は少なく，さらに弧発性であることはきわめて稀である．今回，肺癌の大腸転移と術前診断し，腹腔鏡下に根治切除を施行しえた1例を経験したので，若干の文献的考察を加えて報告する．

　During the follow-up after lung cancer operation, a 73-year-old man received fluoro-2-deoxyglucose positron emission tomography （FDG-PET） which showed a marked accumulation of FDG at descending colon. Metastatic colon carcinoma from lung cancer was diagnosed by colonoscopy and pathological examinations. Laparoscopic left colectomy with D3 lymphadenectomy was performed to achieve curative resection. The patient is still alive without any sign of metastasis four months after the operation. Metastatic colon cancer from lung cancer is rare. Even if detected, most of these patients have multiple metastases, thus solitary colon metastasis is extremely rare. Colon metastasis derived from lung cancer was diagnosed preoperatively, and laparoscopic curative resection was performed safely.