title: [A case of lateral lymph node metastasis of submucosal rectal cancer].
abstract: We report a case of lateral lymph node metastasis of submucosal rectal cancer. A 54-year-old man was pointed out with stool occult blood reaction positive. Screening colonoscopy revealed an 18 mm 0-Is rectal cancer in Rb 6 cm from anal verge. Endoscopic mucosal resection (EMR) was performed. Tumor appeared to be well treated, but pathological findings demonstrated the tumor invasion into submucosally (1,300 µm) with lymphovascular invasion ie ly (+) and v (+). Laparoscopic low anterior resection was then performed and no metastasis of lymph nodes (pSM, N0/stage I) was found. But he suddenly had an elevation of CEA (4 ng/mL to 26 ng/mL) after 14 months and following MRI and PET-CT revealed a recurrence in a right lateral lymph node (#283). Chemoradiation therapy (CRT) with CPT-11, UFT and LV was performed. After CRT, lateral lymph nodes and para aortic lymph nodes dissection were performed. Despite of the chemotherapy, he died after 13 months from a recurrence of lateral lymph node metastasis.
authors.affiliation: Dept. of Gastroenterological Surgery, Osaka University Graduate School of Medicine.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamashita
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Kim
authors.forename: Hajime
authors.initials: H
authors.lastname: Hirose
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kagawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.forename: Hideshi
authors.initials: H
authors.lastname: Ishii
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D007413:Intestinal Mucosa; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy