A Case of Rectal Cancer with Submucosal Invasion, Hens-Egg-Sized Number 251 Lymphnode Metastasis, and a High Level of Serum Carcinoembryonic Antigen

Kunio Takeuchi, Tetsu Ando, Masao Sekihara, Takashi Hara, Minako Yoshikawa and Yasushi Tsuzuki

Department of Surgery, Tone Chuoh Hospital

A 60-year-old male was admitted with melena. Colonoscopy revealed a I sp lesion in the posterior wall of the lower rectum and an SMT-like lesion immediately proximal to it. The serum CEA level was 128.5 ng/ml. Miles operation was performed. The I sp tumor was 25×20 mm in size and the SMT-like lesion was 60×40×30 mm in size. Histological examination of the resected specimen showed that the I sp lesion was a well-differentiated adenocarcinoma in the mucosal layer, but showed the features of mucinous carcinoma in the submucosal layer. The lymph node metastasis in node number 251 measuring 60×40×30 mm in diameter was a mucinous carcinoma. The findings in this carcinoma with a high propensity for case suggest that mucinous carcinoma is a highly invasive metastasis.

Key words
colorectal mucinous carcinoma, lymph node metastasis of colorectal cancer, carcinoembryonic antigen

Reprint requests
Kunio Takeuchi Department of Surgery, Tone Chuoh Hospital 1855-1 Higashiharashin-machi, Numata-shi, 378-0053 JAPAN

Accepted
September 20, 2000

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