[A Case of Complete Cured by Multidisciplinary Treatment for Repeated Recurrent of Primary Peritoneal Cancer].

Abstract

A 56-year-old female received the low anterior resection for RS rectal cancer(T4aN1M0)in June 2010. In February 2011, abdominal CT showed paraaortic lymph node swelling, we resected it, because of lymphatic metastasis from rectal cancer suspected. The resected specimen showed the histological feature similar with ovarian cancer rather than rectal cancer. But uterus and adnexa were not unremarkable on gynecologic examination. She received FOLFOX therapy. In December 2012, abdominal CT revealed a growing mass lesion at posterior to the rectosigmoidal anastomosis. We suspected local recurrence of rectal cancer, chemoradiotherapy(S-1+39 Gy)was administrated, a recurrent lesion was reduced and was followed up. In September 2014, abdominal CT showed the local recurrent lesion enlarged, then we started FOLFIRI+cetuximab. However, tumor progressed with no effect of chemotherapy. In May 2015, we performed the low anterior resection with excision of the local recurrent lesion. Histopathological evaluation of the resected specimen revealed a serous adenocarcinoma, like an origin of ovarium on immunohistochemical examination, highly suspected primary peritoneal cancer. Systemic chemotherapy with 4 courses of carboplatin and docetaxel(DC)therapy was administrated as adjuvant chemotherapy. In December 2016, CA125 level increased, PET-CT showed FDG accumulation in the local recurrent lesion, so we started DC therapy again. The recurrent lesion was disappeared rapidly, followed by 9 courses. She is still alive without recurrence 7 years after DC therapy.