대장암의 근치적 절제 후 감시 중 혈청 CEA 상승으로 발견한 원발성 십이지장 선암 1예
A Case of Primary Duodenal Adenocarcinoma Identified by Serially Elevated Serum CEA Levels after Curative Resection for Colon Cancer
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초록
대장암의 근치적 절제 후의 추적 경과 관찰은 매우 중요하지만 이상적인 감시체계는 알려져 있지 않다. 정기적인 신체 검진, 혈액 검사, 방사선 검사, 대장내시경 검사, 종양 표지자 측정이 감시를 위해 이용되어 왔으며, 이 중 CEA의 순차적 측정이 질병의 재발 진단에 있어 비용적인 측면과 비침습적이라는 장점 때문에 널리 사용되고 있다. 그러나 CEA는 위암이나 십이지장암과 같은 이차 소화기 원발암에서도 상승한다. 대장암의 근치적 절제 후에 CEA의 상승으로 발견한 이시성 원발 십이지장선암 1예를 경험하여 보고하는 바이다.
Abstract
The follow-up of patients after performing potentially curative resection for colon cancer is important, yet the ideal surveillance strategy has not been defined. Periodic clinical examinations, laboratory tests, radiographic imaging, colonoscopy and carcinoembryonic antigen (CEA) testing have been utilized for surveillance, and the serial CEA measurement is the most cost-effective test for identifying the recurrence of disease. However, this test also indicates the development of secondary gastrointestinal malignancy such as gastric cancer or duodenal cancer. We report here on a case of metachronous duodenal adenocarcinoma that was revealed by the serial measurement of the serum CEA after we performed curative resection for colon cancer.
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