2010 年 35 巻 6 号 p. 915-919
We report a case of sigmoid colon cancer with congenital antithrombin III (AT III) deficiency. The patient was a 72–year–old man who had been diagnosed with AT III deficiency 15 years ago, at the same time that his nephew was diagnosed with lower limb thrombosis. Anemia was found in a medical checkup and sigmoid colon cancer was diagnosed after closer examination. At admission, the AT III activity and AT III antigen level were decreased to 47.0% and 14.4 mg/dl, respectively. AT III concentrates were administered before and after surgery to maintain the AT III activity at 80 to 120%. Consequently, no thrombosis occurred before or after surgery. AT III deficiency is an autosomal dominant inherited disease and the risk of thrombosis in patients with this condition is increased by surgery. Therefore, both heparin and AT III concentrates are essential for perioperative management of the disease. We present this case as a relatively rare example of surgery for gastrointestinal cancer in a patient with congenital AT III deficiency.
