A CASE OF DIFFUSELY INFILTRATING CARCINOMA OF THE LARGE INTESTINE ASSOCIATED WITH INTUSSUSCEPTION.

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We report a case of type 4 colonic carcinoma associated with intussusception.A 54-year-old woman was admitted to the hospital because of abdominal pain. On admission, her abdomen was flat and soft and a fist-sized tumor was palpable in the right lateral abdomen. Hematological study revealed an increase of CEA to 4100 ng/ml. Abdominal ultrasonic study and CT scan visualized a concentric lamellar structure in the ascending colon, and intussusception was diagnosed. Barium enema study showed a filling defect like a crab's claw in the ascending colon. After admission, intestinal obstruction progressed and abdominal pain became serious. Colonic cancer associated with intussusception was suspected, and surgery was performed on the 4th hospital day. Upon laparotomy, ascites and peritoneal dissemination were present and a fist-sized tumor in the ascending colon and ileocecal type intussusception were identified. A right hemicolectomy was performed. The resected material disclosed the type 4 tumor extending to the ascending colon and ileum, centering the cecum. Histopathologically it was moderately to poorly differentiated adenocarcinoma, with pronounced lymphatic invasion. The patient died of cancer 5 months after the operation.
日本臨床外科学会の論文