RECTAL CARCINOMA IN THE YOUNG ADULT WHO HAD SPHINCTER RESERVING OPERATION COMBINED WITH PREOPERATIVE RADIOTHERAPY

It has been well understood that rectal carcinoma in the young adults has poor prognosis due to its low resectability. In this case, rectal tumor could be removed curatively by sphincter reserving operation in combination with preoperative radiation therapy. The patient is a 23-year-old female who had a tumor with ulceration in its center locating about 4cm proximal to the anal verge. It could be completely resected by pull-through operation combined with preoperative radiotherapy at a total dose of 42.6 Gy. Pathological examination showed that lymph nodal involvement was negative and that the margin of resection was free from cancer cells. The tumor was found to be decreased by 26% roentgenographyically, or by 33% in volume ultrasonographically. Histologically, radiation effect was assessed moderately. A marked postoperative decline in serum CEA from as high as 10.22ng/ml to the normal level has been observed. The patient is well and alive up to present.