치료적 절제술 후 문합부에서 재발한 대장의 반지세포암 1예

A primary signet ring cell cancer (SRCC) is a rare form of an adenocarcinoma of the large intestine. The prognosis of SRCC of the colon has been reported to be worse than classic adenocarcinoma of the colon; however, there is no difference in the post-operative surveillance for SRCC. We report a case of SRCC of the colon with negative resection margins that recurred at the anastomosis site 26 months after curative resection. A 55-year-old male presented to the hospital with abdominal pain. The initial colonoscopy and abdominal computed tomography revealed SRCC of the proximal ascending colon. He underwent extensive curative surgical resection and adjuvant chemotherapy for 8 months. However, 26 months post-operatively, the cancer recurred at the anastomosis site without peritoneal dissemination. Physicians should be aware that SRCC may have different recurrence patterns compared with classic adenocarcinoma, and may need more vigorous surveillance, even after curative surgery. (Intest Res 2010;8:58-62)