title: [Total Pelvic Exenteration for Local Recurrence of Rectal Cancer Appearing 12 Years after Curative Operation--A Case Report].
abstract: A 49-year-old man had undergone Hartmann's operation for rectal cancer in August 2002. The disease stage (TNM 7th) was T3, N1, M0, Stage ⅢB. He was treated with UFT and Krestin for a year as adjuvant chemotherapy. No recurrence had been detected after the surgery. In July 2014, he presented with symptoms of acute renal failure. A CT scan showed bilateral hydronephrosis and a pelvic tumor between the urinary bladder and rectum. The pathological diagnosis based on biopsy specimens was adenocarcinoma. Because immunostaining studies of the tumor biopsy specimen revealed that CK20, CEA, CA19-9, and p53 were positive and CK7 and PSA were negative, this pelvic tumor was diagnosed as a local recurrence of rectal cancer. Total pelvic exenteration and ileal conduit urinary diversion were carried out for the recurrent tumor with curative intent. The reported recurrence rate of Stage Ⅲ colorectal cancer 5 years after the initial curative operation is 0.67%. Local recurrence of rectal cancer 12 years after the initial operation is quite rare. Immunostaining is helpful to discriminate between rectal cancer and a tumor of the urinary organs. It is important to consider that recurrence of rectal cancer might still occur a long time after the initial operation.
authors.affiliation: Dept. of Surgery, Tohoku University School of Medicine.
authors.forename: Megumi
authors.initials: M
authors.lastname: Obara
authors.forename: Shinobu
authors.initials: S
authors.lastname: Ohnuma
authors.forename: Hideaki
authors.initials: H
authors.lastname: Karasawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Kudoh
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishida
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Imoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aoki
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Munenori
authors.initials: M
authors.lastname: Nagao
authors.forename: Tomoya
authors.initials: T
authors.lastname: Abe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Musha
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naitoh
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008297:Male; D008875:Middle Aged; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000556:secondary / Q000601:surgery*; D012004:Rectal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome