Abstract
62歳，女性．検診で便潜血陽性を指摘され，当科に紹介となった．大腸内視鏡検査にて下部直腸に10mm大のI sp型腫瘍を認め，内視鏡的粘膜切除術を施行した．tub1，T1b（2,000μm），ly0，v1，budding grade1，HM0（250μm），VM0（500μm）であり，腹腔鏡補助下低位前方切除術+D2郭清術を施行した．病理組織学的に腫瘍の遺残は認めず，総合所見はT1b，N0，M0，Stage Iであった．術後6カ月のCT検査で両側第9肋骨に腫瘤を指摘され，FDG-PET検査を施行したところ，異常集積（SUVmax7.8）を認めた．CTガイド下生検を施行したところ高分化管状腺癌であり，直腸癌の転移と診断した．早期直腸癌術後で肝臓や肺転移を伴わない骨転移は稀であり，文献的考察を加え報告する．
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