2. Anorectal Leiomyosarcoma:Report of 4 Surgical Cases and Review of the Japanese Literature

概要

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Four patients (36 to 74-year-old males) were admitted to Okayama University Hospital, with a chief complaint of increasing difficult defecation. In every case a hard submucosal tumor was able to palpate by digital examination on the lower rectum. Two patients underwent the abdominoperineal resection, one of whom the local excision was made at the first operation, and either the local excision or colostomy was performed to other cases. Histological findings revealed the leiomyosarcomas in all cases. Postoperative <SUP>60</SUP>Co irradiation was applied to the two patients. All died of the recurrence or a complication 2.4 to 7.8 years, 5.1 years in average after surgery.<BR>Review of 58 surgical cases in our country disclosed the following results : Ages of patients varied from 24 to 77 years, averaging 57 years. A ratio of men to women was 1.5:1 (actually 35 to 23). Bleeding (62%) and increasing difficult defecation (55%) were common complaints. In 88%, tumor was located within 6 cm above the anal verge. The diameter of the lesion was over 6.1 cm in 57%, and ulcer formation was observed in 55%. Abdominoperineal resection was perfomed to 71% of all cases. Although the reports on follow up studies were quite few, there were 5 local recurrences, 6 liver metastasis and 2 lymphnode metastasis, resulting in only 5 cases of five year survivors.
日本大腸肛門病学会の論文