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pubmed:abstractText |
The patient was a 64-year-old female who underwent an abdomino-perineal resection for advanced lower rectal carcinoma. The tumor was a mucinous adenocarcinoma, type 2 in the Japanese classification of colorectal carcinoma, and was measured 4.5 cm in size. Histologically, the tumor was considered to be stage II (a2, n1, P0, H0). She received adjuvant chemotherapy with 5-FU/LV. After 7 months from the surgery, the patient developed a hip pain. Pelvic CT scan revealed a 4.5 x 6.0 cm mass anterior to the sacrum. Consequently, a diagnosis of local recurrence with sacrum invasion was made. An operation, involving tissue expander placement in the pelvis and pelvic floor was made by dexon mesh, was performed. Radiotherapy was given to the pelvic region at a total dose of 65 Gy (given 2.5 or 3 Gy each x 25 fragments). Chemotherapy with CPT-11 (100 mg/body) and 5'-DFUR (800 mg/body) was administered for 3 cycles. CEA (ng/ml) was decreased within a normal range from maximum 13.8. No progression was detected on CT, and Hip pain had disappeared. Abscess in the pelvis by tumor necrosis was managed conservatively. In this case, tumor marker is within a normal range over 2 years and QOL was improved, suggesting that chemoradiation with a tissue expander may be effective.
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