Suto R, Enjoji A, Okudaira S, Furui J, Matsuo T, Kanematsu T
Second Department of Surgery, Nagasaki University School of Medicine, Japan.
J Gastroenterol. 2001 Jul;36(7):495-9. doi: 10.1007/s005350170074.
We report a rare case of advanced carcinoma and a second primary carcinoma of the esophagus, both of which were successfully cured by chemotherapy and operation at different times. In 1991, a 38-year-old Japanese man was diagnosed with advanced esophageal cancer, which was unresectable because of the bronchial invasion of the tumor. He was given chemotherapy with cisplatin (CDDP), combined with radiotherapy. During a 4-year follow-up, neither regrowth of the primary tumor nor distant metastasis occurred. In 1995, esophagoscopy demonstrated a lugol-unstained region located 3 cm distal from the area of radiation to the primary lesion shown by esophagography. Histological examination of a biopsy specimen showed the mucosa to be normal. Nevertheless, yearly surveillance by endoscopy and histological examinations showed that the mucosa of the esophagus gradually began to demonstrate mild dysplasia, followed by severe dysplasia; in 1998, a diagnosis of squamous cell carcinoma was made. Esophagectomy with lymph node dissection was performed. Microscopic examination revealed that there had been pathologic complete response for the original advanced esophageal cancer.
我们报告一例罕见的晚期食管癌及食管第二原发性癌病例，二者均通过不同时期的化疗及手术成功治愈。1991年，一名38岁的日本男性被诊断为晚期食管癌，因肿瘤侵犯支气管而无法切除。他接受了顺铂（CDDP）化疗并联合放疗。在4年的随访期间，原发肿瘤既未复发，也未发生远处转移。1995年，食管镜检查发现距食管造影显示的原发灶放疗区域远端3 cm处有一个卢戈氏碘液不着色区。活检标本的组织学检查显示黏膜正常。然而，每年的内镜及组织学检查监测显示，食管黏膜逐渐开始出现轻度发育异常，随后发展为重度发育异常；1998年，诊断为鳞状细胞癌。遂行食管切除术及淋巴结清扫术。显微镜检查显示，原来的晚期食管癌已达到病理完全缓解。
