Case Of Esophageal Adenocarcinoma Research Articles

Barrett食道に発生した早期食道腺癌の1例―Barrett上皮の発癌に関する考察―

症例は48歳男性で，胸部不快感，嚥下困難にて来院した。食道内視鏡検査にて下部食道に発赤部位を認め，滑脱型ヘルニアも認めた。発赤部位の中に小陥凹域を認め，その部位よりの生検で高分化型管状腺癌の診断を得た。外科的切除標本では，腫瘍の大きさは5×18mmで，癌は粘膜内に留まっていた。癌は種々の程度の異型性を有する腸上皮化生により囲まれていた。以上の組織学的な検討から，最初胃粘膜に置き換えられた食道粘膜が次に腸上皮化生に置き換えられ，最後に腸上皮化生の中に腺癌が発生したと考えられた。本症例においては，胃粘膜組織は萎縮が高度で，腺窩上皮のみ存在し，腺管はほとんど消失していた。Barrett食道に発生する腺癌の発生率は0-47％と著者により様々である。高度異型上皮は癌への変換のハイリスク状態と考えられ，生検による厳重な経過観察が必要である。

A CASE OF PRIMARY UPPER INTRA-THORACIC ESOPHAGEAL ADENOCARCINOMA IN ECTOPIC GASTRIC MUCOSA IN AN ELDERLY PATIENT

A surgical case of primary esophageal adenocarcinoma in ectopic gastric mucosa which was located in the upper intrathoracic region of the eosphagus is described in this report. The patient was an 85-year-old male. He started to suffer from difficulty of swallowing since April of 1991. Endoscopy was performed and a tumor narrowing the entire circumference was observed on the left side of the posterior wall of the esophagus located 20cm from the incisor line. Biopsy diagnosed this case as poorlydifferentiated adenocarcinoma. On May 9, 1991, blunt dissection without thoracotomy was performed, followed by postmediastinum esophagogastrostomy. The surgical findings were A2NxM0Plx. The postoperative course was unevent ful and the patient was discharged from the hospital on the 39th day after surgery. Histopathologically this tumor was adenocarcinoma with a variety of histological patterns such as highly-moderately and poorlydifferentiated and mucinous types. Stratified squamous epithelium was present on the oral and anal sides of the lesion. Columnar epithelium resembling that of gastric mucosa was also found in the tumor. Given these findings, this case was diagnosed as having an adenocarcinoma in ectopic gastric mucosa. Only five cases of malignancy originating from ectopic gastric mucosa have been reported in Japan including the present case. The course of the patient with ectopic gastric mucosa should be carefully observed.

A case of early esophageal adenocarcinoma arising in Barrett's epithelium

A case of early esophageal adenocarcinoma arising in Barrett's epithelium

Esophageal adenocarcinoma 20 years after esophageal atresia repair

We report a case of esophageal adenocarcinoma 20 years after esophageal atresia repair. From one case report it is premature to recommend cancer surveillance for all esophageal atresia patients. However, the first survivors are now reaching an age when esophageal cancer related to chronic esophagitis may become more prevalent.