A CASE OF PRIMARY ESOPHAGEEAL MUCOEPIDERMOID CARCINOMA ASSOSIATED WITH AN EARLY GASTRIC CANCER

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  • 早期胃癌を合併した食道粘表皮癌の1例

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Abstract

A 68-year-old man was seen at the hospital because of hematemesis. Castroendoscopic examination revealed no evidence of bleeding, but a flat and slightly elevated lesion in the middle of the intrathoracic esophagus, diagnosed as squamous cell carcinoma by the biopsy specimen and an elevated lesion in the posterior wall of the lesser curvature of the upper part of the gastric body, diagnosed as well differentiated adenocarcinoma. Total thoracic esophagectomy and a total gastrectomy with regional lymph node dissection were performed. Pathologically the esophageal lesion was partially covered with a normal squamous cell epithelium and presented wide submucosal spreading but remained in the submucosal layer. And the carcinoma was composed of squamous cell carcinoma and adenocarcinoma which has a d-PAS and alcian-blue positive mucin. Therefore the diagnosis of mucoepidermoid carcinoma of the esophagus was made. There was n2 lymph node metastasis (stage III). The gastric lesion presented slight submucosal invasion and was diagnosed as well differentiated adenocarcinoma (stage Ia). Immunohistochemically, p53 was positive in almost all cells of the gastric cancer, but negative in both squamous cell carcinma and adenocarcinoma components. Adjuvant chemotherapy and radiation therapy were not performed. The patient is alive 1 year after the operation.

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