[A case of advanced ascending colon cancer, curatively resected after complete response in left supraclavicular and paraaortic lymph nodes and liver metastases to FOLFOX4 therapy].
We report a resected case of ascending colon cancer with left supraclavicular and paraaortic lymph nodes and liver metastases which completely responded in terms of metastases but not the primary tumor to FOLFOX4 therapy. A 62-year-old woman with epigastric discomfort was initially diagnosed as malignant lymphoma by FDG-PET with abnormal accumulation at left supraclavicular and paraaortic lesions. Pathological examination of the supraclavicular lymph nodes showed undifferentiated adenocarcinoma, and ascending colon cancer was detected by colonoscopy which was a mixture of various types of differentiation. FOLFOX4 therapy was effective for metastatic lesions but colon tumor did not regress and was accompanied by abdominal pain. Macroscopically, a curative right hemicolectomy was performed, and microscopic examination revealed that the tumor had become a mass of undifferentiated cancer cells. Thus, the present case demonstrates the dedifferentiation of colon cancer during chemotherapy.
Dept. of Surgery, Kishiwada City Hospital.
Katsuyoshi
K
Furumoto
Hidenobu
H
Kojima
Haruo
H
Takaya
Masayuki
M
Okuno
Hiroaki
H
Fuji
Rei
R
Mizuno
Tomohiko
T
Mori
Daisuke
D
Ito
Masafumi
M
Kogire
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D003110:Colonic Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D012074:Remission Induction; D014057:Tomography, X-Ray Computed
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil