皮膚筋炎を合併した食道癌の1例 A CASE OF ESOPHAGEAL CANCER ASSOCIATED WITH DERMATOMYOSITIS

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皮膚筋炎を合併した食道癌の1例を経験した.症例は68歳の男性. 1993年1月,顔面,前胸部,上肢,手指に浮腫性腫張を伴う紅斑が出現. 3月,当院皮膚科を受診, heliotrope疹, Gottron sign, CK, Aldolaseの高値を認め,生検の結果,皮膚筋炎と診断された.ステロイド療法を開始しつつ全身の悪性腫瘍の検索を行ったところ,胸部中部食道 (Im) に扁平上皮癌が発見された. 5月11日,右開胸開腹,胸部食道全摘,胸骨後食道胃吻合術を施行した.摘出標本では, Imに大きさ3.5×1.5cmの腫瘍を認めた.病理組織学的にはsquamous cell carcinoma, poorly differentiated, moderately invasive, a<sub>2</sub>, ie(-), ly(+), v(-), n(-), stage IIIであった.腫瘍摘出後, CK, Aldolaseなどの筋原性酵素は正常値に復し,皮膚症状は軽快し,ステロイドの投与を必要としなくなった.皮膚筋炎の診断と同時に積極的に悪性腫瘍の検索を行い,早期発見に努めることが肝要と思われた.

A case of esophageal cancer associated with dermatomyositis is presented. The patient was a 68-year-old man. In January 1993, edematous erythema appeared on the face, upper arm and fingers. In March, the patient was seen at the hospital and heliotrope erythema, Gottron's sign and elevated CK and aldolase were detected. He was diagnosed with dermatomyositis by skin biopsy. Upon starting steroid therapy, a squamous cell carcinoma was discovered at the middle thoracic esophagus (Im) by examination for the purpose of detecting the malignant tumor. On May 11, a total thoracic esophagectomy under right thoracotomy was performed with gastric tube reconstruction via the posterior sternal route. The resected specimen showed a tumor measuring 3.5×1.5cm in Im. Pathological examination of the specimen revealed poorly differentiated squamous cell carcinoma, moderately invasive, a<sub>2</sub>, ie (-), ly (+), v (-), n (-), in stage III. After resection of the tumor, the elevated CK, elevated aldolase and dermatomyositis were improved. He did not require steroid. We should carry out examinations for detecting the malignant tumor soon after the diagnosis of dermatomyositis.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 56(8), 1605-1609, 1995-08-25

    Japan Surgical Association

参考文献:  19件中 1-19件 を表示

被引用文献:  3件中 1-3件 を表示

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各種コード

  • NII論文ID(NAID)
    10008514921
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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