潰瘍性大腸炎診断後早期に多発性大腸癌を認めた1例

Early Diagnosed Ulcerative Colitis with Multiple Colonic Cancers, Report of a Case

要旨　潰瘍性大腸炎診断後6か月で大腸癌を認めた症例を経験した．患者は66歳，女性で，貧血を主訴に来院し，全結腸炎型の潰瘍性大腸炎と診断され，6か月後の大腸内視鏡検査で多発性ポリープを指摘され，手術を施行した．切除標本では3個のm癌と，3個の腺腫内癌，および24個の腺腫を認めた．潰瘍性大腸炎に伴う大腸癌は全結腸炎型で10年以上経過例に多いとされるが，本症例は6か月で癌を認めた点で珍しい．また，多数の腺腫の中に癌を認めたが，いずれもm癌であった．潰瘍性大腸炎においては観察期間が短くても，腺腫を認める場合は癌病変の存在を念頭に置き，詳細に頻繁に観察をし，生検で癌と診断されたら，早急に手術を含めた積極的な治療を施行すべきである．

　A 66-year-old female was admitted with anemia as her chief complaint. She was suffering from ulcerative colitis (total colonic type). Six months later, multiple polypoid lesions were recognized by colonofiberscope, and an operation was performed. In the resected specimen, there were three cancers (all of them were mucosal cancer), three adenomas with focal cancer, and 24 adenomas. Colonic cancer with ulcerative colitis is more often recognized in cases of total colonic type and with more than ten years of suffering from the complaint. However, in this case we recognized colonic cancers six months after ulcerative colitis had been diagnosed. Colonic cancers were recognized among the multiple adenomas. All of them were mucosal cancers. Even if the follow-up time of ulcerative colitis with adenoma is short, biopsy examination is necessary. If cancer is recognized, we recommend an operation.