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A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery
BACKGROUND: There are few reports describing the unusual origin of the inferior mesenteric artery (IMA). We report a rare case of advanced sigmoid colon cancer with the IMA arising from the superior mesenteric artery. CASE PRESENTATION: A 59-year-old man with diarrhea and abdominal distention was di...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209364/ https://www.ncbi.nlm.nih.gov/pubmed/37222955 http://dx.doi.org/10.1186/s40792-023-01671-2 |
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author | Mizoguchi, Kiyotaka Nagayoshi, Kinuko Mizuuchi, Yusuke Tamura, Koji Sada, Masafumi Nakata, Kohei Ouchida, Kenoki Nakamura, Masafumi |
author_facet | Mizoguchi, Kiyotaka Nagayoshi, Kinuko Mizuuchi, Yusuke Tamura, Koji Sada, Masafumi Nakata, Kohei Ouchida, Kenoki Nakamura, Masafumi |
author_sort | Mizoguchi, Kiyotaka |
collection | PubMed |
description | BACKGROUND: There are few reports describing the unusual origin of the inferior mesenteric artery (IMA). We report a rare case of advanced sigmoid colon cancer with the IMA arising from the superior mesenteric artery. CASE PRESENTATION: A 59-year-old man with diarrhea and abdominal distention was diagnosed with advanced sigmoid colon cancer. Colonoscopy revealed a semi-circumferential cancer lesion in the sigmoid colon. Enhanced CT scan and CT angiography showed that the IMA directly originated from the superior mesenteric artery at the level of the second lumbar vertebra. PET-CT suggested metastases in the para-intestinal lymph nodes and the liver, but not in the central lymph nodes along the IMA. Preoperative diagnosis was sigmoid colon cancer cT4aN2aM1a cStage IVA(UICC, 8th edition). We performed laparoscopic complete resection as the radical treatment of the primary region prior to resection of the liver metastases. Intraoperative findings showed that the IMA was running parallel to the abdominal aorta; meanwhile, the colonic autonomic nerve was supplied from the lumbar splanchnic nerve at the caudal side of the duodenum. Central lymph nodes around the colonic autonomic nerve were dissected en bloc with the regional lymph nodes. Pathological radical resection including the regional lymph nodes metastasis was achieved. Two months later, complete resection of the liver metastasis was performed. After the adjuvant chemotherapy, no recurrence was observed 1.5 years after the liver resection was performed. CONCLUSIONS: Preoperative confirmation of the anatomy helped us to safely complete radical surgery in a patient with unusual bifurcation of the IMA. |
format | Online Article Text |
id | pubmed-10209364 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-102093642023-05-26 A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery Mizoguchi, Kiyotaka Nagayoshi, Kinuko Mizuuchi, Yusuke Tamura, Koji Sada, Masafumi Nakata, Kohei Ouchida, Kenoki Nakamura, Masafumi Surg Case Rep Case Report BACKGROUND: There are few reports describing the unusual origin of the inferior mesenteric artery (IMA). We report a rare case of advanced sigmoid colon cancer with the IMA arising from the superior mesenteric artery. CASE PRESENTATION: A 59-year-old man with diarrhea and abdominal distention was diagnosed with advanced sigmoid colon cancer. Colonoscopy revealed a semi-circumferential cancer lesion in the sigmoid colon. Enhanced CT scan and CT angiography showed that the IMA directly originated from the superior mesenteric artery at the level of the second lumbar vertebra. PET-CT suggested metastases in the para-intestinal lymph nodes and the liver, but not in the central lymph nodes along the IMA. Preoperative diagnosis was sigmoid colon cancer cT4aN2aM1a cStage IVA(UICC, 8th edition). We performed laparoscopic complete resection as the radical treatment of the primary region prior to resection of the liver metastases. Intraoperative findings showed that the IMA was running parallel to the abdominal aorta; meanwhile, the colonic autonomic nerve was supplied from the lumbar splanchnic nerve at the caudal side of the duodenum. Central lymph nodes around the colonic autonomic nerve were dissected en bloc with the regional lymph nodes. Pathological radical resection including the regional lymph nodes metastasis was achieved. Two months later, complete resection of the liver metastasis was performed. After the adjuvant chemotherapy, no recurrence was observed 1.5 years after the liver resection was performed. CONCLUSIONS: Preoperative confirmation of the anatomy helped us to safely complete radical surgery in a patient with unusual bifurcation of the IMA. Springer Berlin Heidelberg 2023-05-24 /pmc/articles/PMC10209364/ /pubmed/37222955 http://dx.doi.org/10.1186/s40792-023-01671-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Report Mizoguchi, Kiyotaka Nagayoshi, Kinuko Mizuuchi, Yusuke Tamura, Koji Sada, Masafumi Nakata, Kohei Ouchida, Kenoki Nakamura, Masafumi A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title | A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title_full | A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title_fullStr | A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title_full_unstemmed | A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title_short | A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
title_sort | case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209364/ https://www.ncbi.nlm.nih.gov/pubmed/37222955 http://dx.doi.org/10.1186/s40792-023-01671-2 |
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