Two Cases of Colorectal Cancer with Tumor Thrombus in the Inferior Mesenteric Vein

In colorectal cancer, progression with an intravenous tumor thrombus is very rare. Here, we report 2 cases of colorectal cancer which showed a tumor thrombus in the inferior mesenteric vein (IMV). Case 1: A 69-year-old woman was admitted for the treatment of advanced rectal cancer, and underwent a l...

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Published inGan to kagaku ryoho Vol. 42; no. 12; p. 2224
Main Authors Matsumura, Atsushi, Hatakeyama, Tomoya, Ogino, Shiro, Takemura, Manabu, Mugitani, Tatsuro, Akami, Toshikazu, Okano, Shinji, Ueda, Yuji
Format Journal Article
LanguageJapanese
Published Japan 01.11.2015
Subjects
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Female
Humans
Male
Mesenteric Veins - pathology
Rectal Neoplasms - complications
Rectal Neoplasms - drug therapy
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Sigmoid Neoplasms - complications
Sigmoid Neoplasms - drug therapy
Sigmoid Neoplasms - pathology
Sigmoid Neoplasms - surgery
Thrombosis - etiology
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Summary:In colorectal cancer, progression with an intravenous tumor thrombus is very rare. Here, we report 2 cases of colorectal cancer which showed a tumor thrombus in the inferior mesenteric vein (IMV). Case 1: A 69-year-old woman was admitted for the treatment of advanced rectal cancer, and underwent a low anterior resection. Six months of post-operative therapy was carried out with mFOLFOX6, but a metachronous lung metastasis was detected and a lung partial resection was performed. Case 2: A 67-year-old man was admitted for the treatment of advanced sigmoid colon cancer with simultaneous liver metastasis, and underwent a laparoscopic high anterior resection. Four courses of mFOLFOX6+bevacizumab chemotherapy were carried out after surgery, and subsequently he underwent a partial hepatectomy. In both cases IMV tumor thrombus was suspected from abdominal contrast-enhanced computed tomography (CT). Tumor thrombus filling the lumen of the IMV was confirmed on histopathological examination. Colorectal cancer with IMV tumor thrombus is a form of advanced cancer with advanced vascular invasion, and there is a high risk of simultaneous or metachronous hematogenous metastasis. Combined modality therapy should therefore be given to improve the prognosis.
ISSN:0385-0684