A case report of solitary adrenal metastasis from rectal cancer six years after rectal resection

進行直腸癌の集学的治療後6年以上経過して発生した孤立性副腎転移の1例

A case report of solitary adrenal metastasis from rectal cancer six years after rectal resection

Creators Kubo Hidefumi

Creators Nakasuga Chiyo

Creators Tada Kousuke

Creators Miyahara Makoto

Creators Hasegawa Hiroyasu

Creators Yamashita Yoshimi

症例は74歳,女性.多発肺転移を伴う直腸癌に対して低位前方直腸切除術を施行した.術後に6コースのmFOLFOXレジメンによる化学療法を行ったところ,多発肺転移は消失し完全奏効(以下,CR)が得られた.術後6年後までは治療効果CRを維持していたが術後6年6ヵ月目に腫瘍マーカーCEAが上昇した.腹部CTにて孤立性副腎転移と診断され,右副腎摘出術を行った.病理組織学的検査にて副腎腫瘍は大腸癌の副腎転移と確定診断された.大腸癌の孤立性副腎転移はまれとされており臨床症状を来しにくいため早期に診断することは困難である.大腸癌術後に副腎転移を来した症例は他臓器にも高率に再発を来しやすい.そのため副腎転移症例では手術同様に化学療法や放射線療法も検討する必要がある.

A 74-year-old woman underwent a low anterior resection for rectal cancer with multiple lung metastases. After she had received chemotherapy with six courses of mFOLFOX6 regimen, multiple lung metastases disappeared and she was judged to have a complete response, and maintained as a complete response for 6 years after the surgery. In 6 years and 6 months, CEA marker was elevated and abdominal CT revealed solitary right adrenal metastasis. She underwent a resection of right adrenal gland. The adrenal tumor was confirmed a metastasis from the rectal cancer by pathological examination. Solitary adrenal metastasis of colorectal carcinoma is rare and has no characteristic clinical symptoms, and thus early diagnosis based on imaging findings is difficult. There is a high risk of recurrence in other organs in patients who have undergone for cases of adrenal gland metastasis from colorectal cancer. Thus, chemotherapy and radiotherapy should be considered as treatment options as well as surgery for cases of adrenal gland metastasis from colorectal cancer.

[ISSN]0513-1731

[NCID]AN00243156