SOLITARY ADRENAL METASTASIS AFTER OPERATION FOR RECTAL CANCER-REPORT OF A CASE-
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We report here a patient with rectal cancer who had solitary adrenal metastasis 28 months after the first operation. A 56-year-old man underwent an high anterior resection with nodal dissection (D3) for rectal cancer in September 2001. Pathological study revealed that the tumor was moderately differentiated adenocar-cinoma with no nodal metastasis. Thirteen months after the first operation, he presented with a mass measuring 25mm in diameter, locating at the right adrenal gland by abdominal CT scan. At this point, he had stable CEA level. In January 2003, we found that the mass was gradually increased in size and the serum concentration of CEA was elevated. He had no any clinical complains except for these findings. Radiological examinations detected no other tumors suggestive of metastasis. Based on these findings, a diagnosis of distant metastasis to the right adrenal gland from the original tumor was made and a right adrenalectomy was performed. In accordance with the preoperative diagnosis, pathological study revealed that the tumor was moderately differentiated adenocarcinoma compatible with the primary focus. Over 13 months after the second operation, he has been doing well and have no recurrent signs. The present case suggests that periodic examinations of the serum CEA level and CT scans may be crucial for early diagnosis of adrenal metastasis after surgery for primary colorectal cancer, because adrenal metastasis has few characteristic clinical findings.
- 日本臨床外科学会の論文
日本臨床外科学会 | 論文
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