[A case of no recurrence over 10 years in advanced rectal cancer with bleeding treated by urgent arterial embolization followed by synchronous liver resection and extended lymph node dissection].
A 68-year-old woman was brought by ambulance due to abrupt anal bleeding. Elastic hard and solid mass was found in rectal examination. The pathological diagnosis of the tumor revealed adenocarcinoma. The metastatic 40 × 40 mm liver tumor was also found at CT scan. Acute bleeding with hemoglobin level of 6 .0 g/dL necessitated an urgent arterial embolization of bilateral internal iliac artery and superior rectal artery. After recovery from the systemic condition, radical operation was performed, comprising abdomino-perineal resection of the rectum with extended lymph node dissection involving paraaortic area followed by synchronous liver resection. Arterial infusion of 5-FU (11.0 g in total) via proper hepatic artery was added postoperatively. She was followed for over 12 years, and no recurrence was observed.
Dept. of Surgery, Fukuoka Tokushukai Medical Center.
Satoshi
S
Umemoto
Shunji
S
Kawamoto
Norihisa
N
Yoshida
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil