噴門部多発早期胃癌の1例  [in Japanese] A CASE OF MULTIPLE EARLY CARDIAC CANCER  [in Japanese]

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Abstract

診断技術の進歩により早期胃癌症例数は増加しているが,噴門部癌の早期発見は依然として容易ではない.今回,噴門部の胃粘膜と食道粘膜に,それぞれ独立した腺癌病巣を認める稀な多発早期噴門胃癌症例を経験したので文献的考察を加え報告する.症例は78歳,女性,心窩部不快感を主訴に近医を受診.上部消化管内視鏡検査にて食道胃接合部に隆起性の病変を認め精査治療のため入院となる.術前精査の結果,噴門部 [UE] 領域の二峰性IIa早期胃癌,深達度SMと診断し噴門側胃切除術,食道胃吻合術を施行した.術後の病理組織学的所見から胃粘膜内と食道粘膜内にみられる,それぞれ深達度MのIIa多発早期胃癌と診断された.進行癌になると予後不良となることの多い噴門癌も,噴門部の注意深い検索により早期癌の状態で検出され適切な治療を行うことにより,高い治療効果を得ることが可能となる.従って噴門部における慎重なる検索が常に必要である.

The number of patients with early gastric cancer are increasing owing to a recent progress of clinical diagnosis technology. However, it is still difficult to get early detection of cardiac cancer even in this technological progression. We report a rare case of multiple early gastric cancer of which lesions limited in the esophago-gastric junction, together with a review of the relevant literature. A 78-year-old woman visited a physician because of epigastric discomfort. Results of the examination of the upper gastrointestinal tract revealed a mucosal elevated lesion in the esophago-gastric junction. According to the results of careful examination of the esophago-gastric junction after her admission to the hospital, the mucosal elevated lesion was diagnosed as early cardiac cancer, Type IIa, with the tumor depth of submucosal layer. The patient underwent a proximal gastrectomy and an esophagogastrostomy. Postoperative pathological findings revealed that there were very rare two mucosal early cardiac cancer lesions, localized in gastric mucosa and esophageal mucosa, respectively. Although advanced cardiac cancer often has a poor prognosis, early detection of cardiac cancer with careful exploration of the cardiac and resultant early appropriate treatments will promise a favorable outcome. Careful exploration of the cardia is usually required.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(5), 1171-1174, 2002-05-25

    Japan Surgical Association

References:  9

Codes

  • NII Article ID (NAID)
    10008913048
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    13452843
  • Data Source
    CJP  J-STAGE 
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