チュウスイ ゲンパツ フクゴウガタ セン シンケイ ナイブンピツ ガン ノ イチチケンレイ

A５２-year-old man visited our hospital because of epigastralgia. The colonoscopic examination revealed an about ４cm-protruded lesion like SMT on the appendix and findings of the biopsy specimen were compatible with the disgnosis of signet ring cell carcinoma. The primary lesion was unknown by upper gastrointestinal endoscopy, CT and PET, and the tumor markers were normal revel. At laparotomy, severe peritoneal metastasis was revealed in the abdominal cavity, especially appendix. Severe stenosis of ileocecum was found, so we conducted ileocecal resection. The histopathological diagnosis was primary signet ring cell caicinoma of appendix, SE, N２, M０, P３, pStage Ⅳ. Postoperatively mFOLFOX was started, but allergic reaction was seen after１cycle. We started Panitumumab/CPT-１１and the patient attended our emergency department with shivering chill and fever on treatment day１０. The next day he became shock state and CT revealed free air. Operation might not save his life and we started supportive care. He died on the day. The cause of his death was peritonitis by cancer perforation