Radiation-associated colon cancer: A case report
Radiation-associated colon cancer: A case report
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DOI：
10.3892/mco.2017.1252
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发表时间：
2017-06-01
影响因子：
1.2
通讯作者：
Watanabe, Toshiaki
中科院分区：
文献类型：
--
作者：
Sasaki, Kazuhito;Ishihara, Soichiro;Watanabe, Toshiaki
放射线相关的结肠癌是一种罕见的临床实体。我们在此描述一位放射线相关的大肠癌患者，在术前放射线治疗后接受直肠癌低位前切除术。辐射相关的结肠癌的某些特点突出。患者为48岁男性，29岁，术前接受总剂量为50戈伊的放疗后接受直肠癌低位前切除术。当患者在手术后19年在东京大学医院就诊时，他抱怨严重的肛门疼痛和频繁排便。结肠镜检查发现乙状结肠有两个扁平肿瘤，位于吻合口口侧10 cm处，诊断为高分化腺癌。此外，结肠镜检查发现肿瘤附近有5个扁平息肉，并在内镜下切除。计算机断层扫描和磁共振成像显示在乙状结肠肿块，没有证据表明远处转移。在腹腔镜辅助下进行直肠和乙状结肠括约肌间切除术，并进行回肠造口术。无特定术后并发症，患者于术后第20天出院。经病理检查，切除的直肠和乙状结肠包含两个独立的肿瘤和六个扁平息肉。这两个肿瘤被诊断为分化良好的腺癌与浆膜下和粘膜下层的侵犯，分别。共切除17个无转移的区域淋巴结。6例扁平息肉诊断为管状腺瘤。我们在此提出一个放射相关的结肠癌的病人谁经历了低前切除术直肠癌术前放疗19年前。放射相关结肠癌的结肠镜监测可能适用于接受术前放射治疗的直肠癌患者，特别是长期放射性结肠炎患者。
Radiation-associated colon cancer is a rare clinical entity. We herein describe the case of a patient with radiation-associated colon cancer who had undergone low anterior resection for rectal cancer following preoperative radiotherapy. Certain characteristics of radiation-associated colon cancer are highlighted. The patient was a 48-year-old man who had undergone low anterior resection for rectal cancer following preoperative radiotherapy at a total dose of 50 Gy, at the age of 29 years. When the patient presented at the University of Tokyo Hospital, 19 years after the surgery, he complained of severe anal pain and frequent defecation. Colonoscopy revealed two flat tumors in the sigmoid colon, located 10 cm to the oral side of the anastomosis site, which were diagnosed as well-differentiated adenocarcinomas. In addition, colonoscopy identified five flat polyps near the tumors, which were resected endoscopically. Computed tomography and magnetic resonance imaging revealed a mass in the sigmoid colon and no evidence of distant metastasis. Laparoscopic-assisted inter-sphincteric resection of the rectum and sigmoid colon with diverting ileostomy was performed. There were no specific postoperative complications and the patient was discharged from the hospital on the 20th postoperative day. On pathological examination, the resected rectum and sigmoid colon contained two separate tumors and six flat polyps. The two tumors were diagnosed as well-differentiated adenocarcinomas with invasion of the subserosa and submucosa, respectively. A total of 17 regional lymph nodes without metastasis were resected. The six flat polyps were diagnosed as tubular adenomas. We herein present a case of a radiation-associated colon cancer in a patient who had undergone low anterior resection for rectal cancer following preoperative radiotherapy 19 years prior. Colonoscopic surveillance of radiation-associated colon cancer may be indicated for rectal cancer patients treated with preoperative radiotherapy, particularly for those with long-standing radiation-induced colitis.