[A case of the long-term survivor of rectal cancer who suffered from successive metastases to ovarium, peritoneum, liver, bone and para-aortic lymphonode].
A 37-year-old female, who had undergone a low anterior resection for lower rectal cancer, had been received chemotherapy (FOLFOX4, FOLFIRI) for 2 years because of right ovarian metastasis occurred and removed 9 months after the first operation. One month after 2 years of continued chemotherapy, progressive metastases happened to occur successively (rt lunge, left ovarium, liver, para-aortic lymphonode, Virchow lymphonode and bone). Right upper lobe pnemonectomy was performed first, then, peritonectomy, total hysterectomy with left oophorectomy and a partial resection of the small bowel were done. IRIS, as postoperative chemotherapy, performed with hepatic arterial infusion (HAI) of CPT-11 and 5- FU resulted in getting a minimal response for about 10 months. Because of the hepatic arterial thrombosis at 10 months after the previous operation, we could not continue HAI with systemic chemotherapy, that was resulted in the progresion of mutiple metastases, and that the patient died 62 months after the first surgery. Immunohistochemical analyses with MIB-1 stainning of four surgical specimens revealed 80% positive cells in the cancerous tissues.
Dept. of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Toshima Hospital.
Masayuki
M
Ando
Yoshihisa
Y
Watayou
Hideaki
H
Ganno
Takeshi
T
Nagahama
Akira
A
Fukuda
Katsunori
K
Ami
Toshiaki
T
Kurokawa
Hidetoshi
H
Amagasa
Jun
J
Takasaki
Masahiro
M
Nakamura
Keiichi
K
Fujiya
Kuniyoshi
K
Arai
Shikofumi
S
Tei
Youichi
Y
Okada
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D013997:Time Factors