RECTAL CANCER WITHOUT LIVER METASTASIS IN A CASE OF LIVER ABSCESS

症例は79歳，男性．平成19年2月上旬より発熱があり，その後悪寒戦慄，意識状態の低下があり近医を受診．CRPの上昇を認め，腹部CTにて肝左葉に低吸収域を認めたため肝膿瘍の診断に入院．入院後抗生剤投与と膿瘍ドレナージにて軽快．肝膿瘍の原因検索として胆道系に異常を認めず，大腸内視鏡でRsに全周性の2型病変を認め，生検にて高分化型腺癌であった．3月に当科入院．CTにて肝膿瘍は消失しており他に肝腫瘍の所見は認めず．直腸癌の診断にて高位前方切除を施行．病理所見は高分化型腺癌，ss，ly1，v0，n0，stageIIであった．術後経過は良好で術後17日目に退院．現在術後3年経過するが直腸癌，肝膿瘍の再燃は認めていない．本症例の様に胆道系異常の認めない原因不明の肝膿瘍では大腸癌合併などを想定した消化管精査が必要と思われた．

[1]  N. Shigemoto,et al.  A CASE OF RECTAL CANCER WITH A SOLITARY LIVER ABSCESS , 2006 .

[2]  K. Sugihara,et al.  A CASE REPORT OF RECTAL CANCER WITH LIVER ABSCESS DIAGNOSED WITH DIFFICULTIES BEFORE SURGERY , 2005 .

[3]  Makoto Taga,et al.  A Case of Vena Cava Filter for Sigmoid Colon Cancer Complicated by Deep Venous Thrombosis for Preventing Pulmonary Embolism-Review of the Japanese Cases of Vena Cava Filter for Colon Cancer- , 2005 .

[4]  K. Sakurai,et al.  A CASE OF SOLITARY LIVER ABSCESS ASSOCIATED WITH TRANSVERSE COLON CANCER , 2004 .

[5]  A. Matsumoto,et al.  PYOGENIC LIVER ABSCESSES SECONDARY TO CARCINOMA OF THE SIGMOID COLON-A CASE REPORT AND REVIEW OF THE LITERATURE- , 2000 .

[6]  A. Lonardo,et al.  Right Colon Adenocarcinoma Presenting as Bacteroides fragilis Liver Abscesses , 1992, Journal of clinical gastroenterology.

[7]  R. Howard,et al.  Pyogenic liver abscess , 1980, World Journal of Surgery.

[8]  H. Takada,et al.  A RARE CASE OF CONCOMITANT CARDIAC INSUFFICIENCY, AND RECTAL CANCER WITH LIVER ABSCESS , 2009 .

[9]  Y. Une,et al.  A CASE OF RECTAL CANCER COMPLICATED WITH LIVER ABSCESS , 2009 .

[10]  Y. Fujiyoshi,et al.  A Case of Appendiceal Adenoendocrine Cell Carcinoma , 2009 .

[11]  Y. Hiasa,et al.  Three cases of liver abscesses complicated with colon cancer without liver metastasis: importance of screening for digestive disease. , 2007, Internal medicine.

[12]  K. Narita,et al.  A Case of Gastric Cancer and Sigmiod Colon Cancer Complicated by Liver Abscess , 2005 .

[13]  Manabu Takano,et al.  Ascending Colon Cancer with Direct Invasion to the Liver Causing a Pyogenic Liver Abscess: Report of a Case. , 2001 .

[14]  K. Sakurai,et al.  A Case of Rectal Cancer with Solitary Liver Abscess , 1998 .

[15]  S. Nomi,et al.  A Case of Rectal Carcinoma Considered as Pyogenic Liver Abscess , 1994 .

[16]  A. Masamune,et al.  A Caxe of Sigmoid Colon Cancer Accompanied by Liver Abscess , 1992 .