Ⅱc型早期大腸癌の1例

Type Ⅱc-like Early Colonic Cancer, Report of a Case

要旨　患者は70歳，男性．胃体上部後壁のⅡc型早期胃癌の手術目的で紹介入院した．術前検査としてS状結腸内視鏡検査を施行し，S状結腸にⅡc型の肉眼的形態をとる大腸癌を認めた．total colonoscopyを施行したが，大腸に他の病変は認めなかった．胃全摘，およびS状結腸部分切除合併手術を行った．切除標本の肉眼所見は，15×9mmの全周に蚕食を認めるIIc型de novo癌を呈していた．病理組織型は，高分化腺癌で，深達度はsmで，ly，v因子はなく，その拡がりは15×4mmであった．

　A 70-year-old man was admitted to our hospital to undergo gastrectomy because of Ⅱc-like early cancer in the posterior wall of the upper body.

　Routine sigmoidoscopy showed another type Ⅱc-like early cancer in the sigmoid colon. Total colonoscopy showed no other abnormality.

　Accordingly, partial sigmoidectomy as well as total gastrectomy were concurrently carried out.

　Gross observation of the resected specimen of the colon showed type Ⅱc-like de novo cancer, 15×9mm in size, which was demarcated from normal mucosa by a small step formation.

　Histologically, well differentiated cancer cells have infiltrated to the submucosal layer involving 15×4mm in width.