A case of Meigs’syndrome resulting from ovarian metastasis of sigmoid colon cancer

卵巣転移によるMeigs症候群を来すも無再発を維持しているS状結腸癌の1例 : 大腸癌卵巣転移によるMeigs症候群本邦報告34例の集計

A case of Meigs’syndrome resulting from ovarian metastasis of sigmoid colon cancer

Creators Kubo Hidefumi

Creators Nagaoka Chisato

Creators Tada Kosuke

Creators Miyahara Makoto

Creators Hasegawa Hiroyasu

Creators Yamashita Yoshimi

Meigs症候群を呈したS状結腸癌の1例を経験したので報告する.症例は55歳,女性.性器出血を主訴に近医を受診され,当院にて精査を行った.大腸内視鏡検査でS状結腸に2型の腫瘍を認め生検でgroup5腺癌の診断であった.CTで右卵巣に多房性嚢胞と充実性部分が混在する腫瘤と右側優位の両側胸水貯留を認めた.S状結腸癌の同時性卵巣転移,あるいはS状結腸癌と卵巣癌の重複癌の疑いにてD3郭清を伴うS状結腸切除と単純子宮全摘を伴う両側子宮付属器摘出術を施行した.免疫染色にて大腸癌卵巣転移の診断確定となった.術後胸腹水の再貯留は認めず,術後14病日に軽快退院した. bevacizumab+XELOX療法による術後化学療法を投与し,術後14ヵ月経過する現在無再発にて生存中である.胸腹水を伴う骨盤腫瘤のある患者ではMeigs症候群も念頭において精査を進めるとともに,消化器系の悪性腫瘍の検索をする必要がある.また本症候群を大腸癌の終末期である癌性胸･腹膜炎と誤診しないことも重要である.

We report a rare case of Meigs syndrome caused by ovarian metastases from sigmoid colon cancer. A 55-year-old woman was admitted to our hospital for investigation of genital bleeding. Colonoscopy showed type2 tumor in sigmoid colon. CT scan demonstrated bilateral pleural effusion and a right ovarian tumor with mixed cystic and solid portions. A laparotomy was performed based on the suspicion of colon cancer with ovarian metastasis or synchronous cancers of the colon and ovary. A sigmoidectomy with D3 and bilateral oophorectomy with hysterectomy were performed. Ovarian metastasis of colon cancer was diagnosed by immunostaining. The postoperative course was uneventful, pleural effusion decreasing remarkably. The patient discharged on 14 postoperative day. She underwent postoperative chemotherapy consisting of bevasizumab and XELOX in outpatient clinic. She is still alive without any evidence of recurrence 14 months postoperatively. When we encounter female patients who have a pelvic tumor with pleural effusion and ascites, we need to guess Meigs’ syndrome. It is necessary for the patients to have close examination of the alimentary tract. We may not make a wrong diagnosis of this syndrome as terminal stage of carcinomatosa of colorectal cancer.

[ISSN]0513-1731

[NCID]AN00243156