Abstract
This paper deals with a case of cancer of the ascending colon with tumor embolism of the superior mesenteric vein (SMV).
A 78-year-old woman was seen at the hospital because of a right lateral abdominal tumor. Colonoscopy showed cancer of the ascending colon, and abdominal CT scan disclosed tumor cell embolism of the SMV. The patient underwent an operation on June 18, 2003. Operative findings included that the tumor had partly invaded the descending portion of duodenum and involved the right ovarian artery and vein and that the swollen regional lymph nodes were suggestive of metastasis. The tumor embolism of the SMV extended up to the confluence with the splenic vein. Thus the SMV was incised, the tumor emboli which were movable were removed, and the vein which was peripheral since there was excised. At the same time, extended right hemicolectomy with the resection of the small intestine was performed, with which the residual small intestine came to about 1m in length. The patient's postoperative course was mostly uneventful. Oral ingestion was started on the 7th hospital day. Four courses of postoperative chemotherapy with LV-5FU were conducted, when the patient did not want further chemotherapy and was discharged from the hospital. About 4 months later the patient developed multiple hepatic metastases and died on the 5th month after the operation.
