盲腸鱗狀腺癌以腸套疊為最初臨床表徵

Adenosquamous Carcinoma of Cecum Causing Intussusception

黃俊登(Chun-Teng Huang) ； 宋榮松(Jung-Sung Sung) ； 黃佳雯(Chia-Wen Huang) ； 游伯齡(Po-Ling Yu)

《台灣癌症醫學雜誌》 27卷4期 (2011/08) Pp. 177-180

https://doi.org/10.6323/JoCRP.2011.27.4.5

摘要

腸道的鱗狀腺癌在臨床上非常少見，在所有大腸直腸癌中所佔比例不到0.1%。本文所報告病患為85歲女性，來院求診時主訴為間歇性腹痛，經腸道鋇劑攝影、大腸鏡鏡檢，與腹部電腦斷層檢查，發現一分葉狀腫瘤阻塞於近端升結腸，導致嚴重腸阻塞。大腸鏡切片報告為慢性發炎，但因嚴重阻塞且無法排除惡性腫瘤之可能性，於是進行剖腹術探查，發現終末迴腸與盲腸有一明顯腫塊造成阻塞，並已有缺血性腸炎現象，於是進行右半結腸切除術。病理報告證實罕見的盲腸鱗狀腺癌。病患術後恢復平順並接受後續輔助性化療。藉由此少見病例，我們簡短回顧並探討腸道鱗狀腺癌的臨床表徵、治療、預後與相關文獻。

關鍵字

鱗狀腺癌 ； 腸套疊 ； 右半結腸切除術

並列摘要

Adenosquamous carcinoma (ASC) of the colon and rectum is rare and accounts for less than 0.1% of all colorectal malignancies. We report hereby a case of ASC of the cecum presenting with ileocolic intussusception. The patient was an 85-year-old female who presented with the chief complaint of intermittent abdominal pain. A lower gastrointestinal barium study and colonoscopy showed a lobulated mass with obstruction at the proximal ascending colon. An abdominal CT scan reported a huge mass with a heterogenous content in the ileocolic region. A right hemicolectomy was performed and the pathologist comfirmed the diagnosis of cecal cancer with ASC histology. The postoperative recovery was uneventful and adjuvant chemotherapy was administered. We have reviewed the literature with regard to the clinical presentation, treatment and prognosis of ASC.

並列關鍵字

adenosquamous carcinoma (ASC) ； intussusception ； right hemicolectomy