急速な発育を呈した0-I sep 型食道表在癌の1例 A CASE OF 0-I sep TYPE SUPERFICIAL CARCINOMA OF THE ESOPHAGUS WITH RAPID GROWTH

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症例は68歳,男性.上腹部不快感にて平成12年12月に上部消化管内視鏡検査を施行した.上門歯列より37cm,下部食道右壁に粘膜下腫瘍様の隆起性病変と胃体下部小彎前壁に0-IIa+IIc型早期胃癌を認めた.胃病変に対し内視鏡的粘膜切除術を施行した後経過観察していた.食道病変は約4カ月間粘膜下腫瘍様の肉眼形態を維持しており, 2回の生検で悪性所見は得られなかった.その1カ月後に2型進行癌へと急速に発育し,生検で扁平上皮癌と診断された.同病変に対し左開胸開腹下部食道胃噴門側切除術, 2群リンパ節郭清を施行した.病理組織所見は低分化型扁平上皮癌, pT2, pN2, pStage IIIであった.術後2年5カ月現在無再発生存中である. 0-I sep型食道表在癌が5カ月間で2型進行癌に発育進展した1例を経験したので文献的考察を加えて報告した.

A 68-year-old man, who underwent upper gastrointestinal endoscopy for upper gastric discomfort in December 2000, was found to have a submucosal tumor-like elevated lesion on the right wall of the lower esophagus 37cm distal to the upper incisor line, and 0-IIa+IIc type early gastric cancer at the anterior wall of the stomach along the lesser curvature of the lower portion of the body. Endoscopic mucosal resection was carried out for the gastric lesion, and thereafter the patient was followed in the clinic. As for the esophageal lesion, the submucosal tumor-like macroscopic morphology had been kept for about 4 months and no malignant findings were seen in the second biopsy. One month later, the esophageal lesion rapidly grew to be type 2 advanced cancer, of which biopsy resulted in squamous cell carcinoma. Under left thoracotomy and laparotomy, esophagogastrectomy with dissection of the group 2 lymph nodes was performed. Histopathological diagnosis was poorly differentiated squamous cell carcinoma, pT2, pN2 and in pStage III. The patient has been free from recurrence, as of 2 years 5 months after the operation.<br>This paper presents this case of 0-I sep type superficial carcinoma of the esophagus which rapidly grew and progressed to type 2 advanced cancer in 5 months, together with a review of the literature.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 65(5), 1227-1231, 2004-05-25

    日本臨床外科学会

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各種コード

  • NII論文ID(NAID)
    10013165456
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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