Journal of Okayama Medical Association
Published by Okayama Medical Association

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家族性大腸腺腫症術後20年後に小腸癌を発症した1例

Sugihara, Yuusaku Department of Gastroenterology and Hepatology, Okayama University Hospital
Kawano, Seiji Department of Gastroenterology and Hepatology, Okayama University Hospital
Harada, Keita Department of Gastroenterological Surgery, Okayama University Hospital
Takashima, Shiho Department of Gastroenterology and Hepatology, Okayama University Hospital
Takei, Daisuke Department of Gastroenterological Surgery, Okayama University Hospital
Inokuchi, Toshihiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Takahara, Masahiro Department of Gastroenterology and Hepatology, Okayama University Hospital
Hiraoka, Sakiko Department of Gastroenterology and Hepatology, Okayama University Hospital
Mori, Yoshiko Division of Endoscopy, Okayama University Hospital
Kishimoto, Hiroyuki Division of Endoscopy, Okayama University Hospital
Nagasaka, Takeshi Division of Endoscopy, Okayama University Hospital
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Abstract
A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.
Keywords
家族性大腸腺腫症 (familial adenomatous polyposis)
小腸癌 (jejunal cancer)
小腸内視鏡検査 (small intestine endoscope)
Note
症例報告 (Case Reports)
ISSN
0030-1558
NCID
AN00032489
DOI