title: [A case of refractory inguinal lymphorrhea cured by lipiodol lymphangiography].
abstract: We report a case of inguinal lymphorrhea cured by Lipiodol lymphangiography. The patient was a 80-year-old female who underwent an abdomino-perineal resection with lateral pelvic lymph node dissection and inguinal lymph node extraction for anal canal cancer. Histologically, the tumor was a poorly differentiated adenocarcinoma and considered to be stage IV (a2, n3 (+), P0, H3, M (-), cur C) in the Japanese classification of colorectal cancer. We recognized a lot of lymph node metastases in dissected lateral pelvic lymph node and inguinal lymph node. By hepatic arterial infusion using 5-FU (1250 mg/body weekly), the liver metastases had a complete response after 15 courses. She noticed a left inguinal lymph node swelling and an elevation of serum CEA level (79.5 ng/mL) was observed. There was no evidence of recurrence except left inguinal lymph nodes. She underwent a left inguinal lymph node dissection. Serous discharge from a surgical site persisted despite of conservative therapy such as compression. She received lymphangiography using 8 mL of Lipiodol from left dorsum of foot. We found three lymph ducts heading to left groin and observed a lot of Lipiodol leakage from ducts. We determined not only the site of leakage but we also confirmed a gradual decrease and a complete stop of lypmphorrhea in 7 days after lymphangiography. Slight lymph edema of left lower extremity appeared but gradually relieved. Lymphangiography using Lipiodol helps determine the site of leakage and may be an effective therapeutic modality for treating refractory lymphorrhea.
authors.affiliation: Dept. of Gastrointestinal Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization.
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Seki
authors.forename: Kunihito
authors.initials: K
authors.lastname: Gotou
authors.forename: Masaaki
authors.initials: M
authors.lastname: Motoori
authors.forename: Kentarou
authors.initials: K
authors.lastname: Kishi
authors.forename: Kou
authors.initials: K
authors.lastname: Takachi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.forename: Isao
authors.initials: I
authors.lastname: Miyashiro
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohigashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Shingi
authors.initials: S
authors.lastname: Imaoka
authors.forename: Kouhei
authors.initials: K
authors.lastname: Murata
authors.forename: Masao
authors.initials: M
authors.lastname: Kameyama
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007459:Iodized Oil; D008206:Lymphatic Diseases / Q000175:diagnosis*; D008220:Lymphography; D008279:Magnetic Resonance Imaging
chemical_list: D007459:Iodized Oil