肝転移を認めた盲腸早期癌の1例

概要

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Liver metastasis is a rare condition in early carcinoma of the large bowel. Recently, we have experienced such a patient who had early carcinoma of the cecum with multiple small liver metastases. The patient was a 80-year-old woman with a compaint of ilcocecal abdominal pain. There was no relevant family history. A cecal tumor was detected by screening total colonoscopy. It was proved carcinoma in adenoma by histological study of 4 biopsies. Preoperative CT scann showed multiple small liver metastases in the S-4, S-5, S-7 and S-8 areas. Ileocecal resection and intraportal cannulation were performed. The histological findings revealed submucosal carcinoma in villous adenoma with venous invasions. There were no lymphatic invasion and metastasis. An association of cystic lymphangioma, 35 X 20 mm in size was recognized next to the cecal tumor. This case suggests that CTscann and ultrasonography are necessary not only in surgical treatment for early carcinoma with venous invasion, but also in colonoscopic polypectomy.