日本住血吸虫卵を認めた直腸癌の1例

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Several researchers have reported the possible association between colorectal cancer and schistosomiasis japonica. However, it remains to be determined whether this association is significant. We report a case of sigmoid colon cancer associated with schistosomiasis japonica and discuss the relationship between schistosoma japonica and the development of colorectal cancer from a review of the Japanese literature. An 82-year-old man was referred to our hospital because of bloody stool. He had worked as a fisherman for 30 years in an endemic schistosomal area. A tumor was detected in the sigmoid colon without distant metastases. Sigmoidectomy with lymph node dissection was performed. A type-1 tumor measuring 2.5 × 2 × 1.5 cm was revealed in the resected specimen. Histological findings demonstrated well differentiated adenocarcinoma with muscular invasion, moderately lymphatic vessel invasion and lymph node metastases (n1). Many calci-fied eggs of schistosomiasis japonica were also seen in the colonic wall of both the tumor and normal tissue, mainly in the submucosal layer. The eggs were more often seen in the tumor than in the normal tissue. The patient also underwent transanal local excision for rectal adenoma 16 months later and survived for 50 months after the initial operation without recurrence.
日本大腸肛門病学会の論文