A CASE OF MINUTE INTRAEPITHELIAL ESOPHAGEAL CANCER

Abstract

On gastroesophagoscopy during a routine medical examination, a 57-year-old woman was found to have a minute depressed lesion with reddening of the surrounding mucosa on the wall of the thoracic esophagus. The lesion was subsequently identified by biopsy as squamous cell carcinoma and was referred to us. X-ray examination on admission failed to delineate the lesion, but endoscopy disclosed a minute erosion-like depressed lesion of the esophageal mucosa situated at a distance of 25cm from the incisors. Under the diagnosis of early esophageal cancer she underwent total thoracic esophagectomy and an operation of retrosternal quasi-total gastric reconstruction. In the excised portion of the esophagus there was a shallow depressed lesion, 4×2mm in size, surrounded by a slightly reddened area of mucosa. This was shown histologically to consist of a squamous cell carcinoma 1mm in diameter confined within the mucosal epithelium and haloed by an area of dysplasia 3mm in diameter. Leukoplakia and chronic inflammatory cell infiltration were also present as concomitant changes. Of all cases of intraepithelial cancer of the esophagus so far reported in Japan, data compiled from 28 well documented cases were analyzed for pathological and other conditions.