Okitsu H, Saitou T, Monden Y
Department of Surgery, Kagawa Prefectual, Shirotori Hospital, Kagawa, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Apr;39(4):480-4.
A 64-year-old male admitted with feeling of a foreign body at the esophagus in swallowing. Esophageal radiologic findings showed a serrated type shadow defect 6 cm in diameter at the middle thoracic esophagus. Endoscopic findings revealed a elevated type tumor at a site 32 cm from the incisor dentition. The biopsy specimens showed squamous cell carcinoma. The operation was performed with right thoracotomy, subesophagotomy, and reconstruction of gastric tube via substernum. Macroscopically, a elevated type tumor of 5.5 x 4.0 x 2.0 cm covered by normal esophageal mucosa at the periphery was recognized. Histologically, most of the tumor was adenoid cystic carcinoma differentiating to squamous cell carcinoma in the epithelium. Immunohistological stain of actin, S-100 protein indicated that the tumor may have originated from an esophageal gland. Histologic stage was mp, ly(-), v(-), n(-), stage I. Surgical curability was CIII. Postoperative irradiation for prevention of recurrence has been conducted. The patient survives without tumor at present 4 months later.
一名64岁男性因吞咽时食管有异物感入院。食管放射学检查结果显示，在胸段食管中部有一个直径6厘米的锯齿状充盈缺损阴影。内镜检查发现，在距切牙32厘米处有一个隆起型肿瘤。活检标本显示为鳞状细胞癌。手术采用右胸切开术、食管下切开术，并经胸骨后重建胃管。肉眼可见，一个5.5×4.0×2.0厘米的隆起型肿瘤，周边被正常食管黏膜覆盖。组织学检查显示，肿瘤大部分为腺样囊性癌，上皮部分分化为鳞状细胞癌。肌动蛋白、S-100蛋白的免疫组织化学染色表明，肿瘤可能起源于食管腺。组织学分期为mp，ly（-），v（-），n（-），I期。手术可切除性为CIII级。已进行术后放疗以预防复发。4个月后，患者目前无瘤存活。
