食道癌切除術後，再建胃管に発生した早期胃癌の１例

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  • A Report of Early Cancer of the Reconstructed Gastric Tube after Radical Resection for Early Esophageal Cancer.

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A 64-year-old man underwent total thoracico-abdominal esophagectomy and lymph node dissection followed by reconstruction with a retrosternal gastric tube due to an esophageal cancer located in the middle and lower thoracic esophagus. Pathological diagnosis of the resected specimen was poorly differentiated squamous cell carcinoma, involving the epithelial layer, and without lymph mode metastasis. About 10 years later, he was admitted to a hospital because of nausea and vomiting. An upper gastrointestinal endoscopic examination revealed a protruded polyp (Yamada type III) in the reconstructed gastric tube. The biopsy specimen showed a moderately differentiated adenocarcinoma. Endoscopic ultrasonogram demonstrated the tumor was restricted to the mucosal layer, so endoscopic polypectomy was performed. Pathological diagnosis of the resected polyp was papillary adenocarcinoma, involving only the mucosal layer, and without invasion of the base of the polyp. Cases of early cancer of the reconstructed gastric tube after surgery for early esophageal cancer are rare, and only two cases have been reported. But according to our study of 46 cases of gastric cancer in the reconstructed gastric tube reported in Japan, follow-up on the reconstructed gastric tube is necessary for early detection.

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