腹腔内孤立性リンパ節転移を認め一期的切除を施行した両側性同時性多発肺癌の1例

金沢大学附属病院内分泌・総合外科A case of one-stage operation consisting of right lower lobectomy, segmentectomy of left upper lobe, mediastinal lymph node dissection, and cardiac lymph node excision is described. A 75-year-old man was referred to our hospital because of an abnormal shadow in the lung field on the chest X-ray films. Because of elevated serum CEA, we performed examination in detail and a single tumor was found at the cardiac lymph node in abdomen. The pathological diagnosis of the left lung lesion was well differentiated adenocarcinoma, and the right one was poorly differentiated squamous cell carcinoma. The right cardiac lymph node was single metastasis from the right lung carcinoma. In spite of advanced age, no complication developed after the operation. The pathological stage was T1N1M1, Stage IV, but by one-stage operation by the median sternotomy, both tumors were removed completely and this patient has been alive 2 years after the operation without recurrence. 両側の同時性多発肺癌,右噴門リンパ節孤立性転移に対し,胸骨正中切開により一期的に右肺下葉切除,左肺区域切除,右噴門リンパ節摘出術を施行した一例を経験した.症例は75歳男性で胸部異常陰影を指摘され来院.高CEA血症を認め全身精査にて,腹腔内にも腫瘍陰影を認めた.手術の結果,右肺は低分化型扁平上皮癌,左肺は高分化型腺癌であり,縦隔リンパ節転移は認めず右噴門リンパ節に右肺癌よりの孤立性転移を認めた.高齢であったが、術後良好に経過した.本症例は,病理病期がTlNlM1,StageIVにも拘らず,胸骨正中切開による一期的切除により術後2年経過し再発を認めず経過良好であり,臨床的に興味深く報告した