Satoh Shintaro, Nakashima Toshiyuki, Watanabe Keiko, Toda Shuji, Kuratomi Yuichiro, Sugihara Hajime, Inokuchi Akira
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
Auris Nasus Larynx. 2007 Mar;34(1):135-9. doi: 10.1016/j.anl.2006.05.014. Epub 2006 Sep 1.
Ectopic gastric mucosa of the cervical esophagus, referred to as inlet patch (IP), is considered to be a common development abnormality of the esophagus. We report here a case of hypopharyngeal squamous cell carcinoma bordering on IP of the cervical esophagus.
A 44-year-old female underwent partial pharyngectomy, total laryngectomy, cervical esophagectomy, and bilateral neck dissection under the diagnosis of hypopharyngeal carcinoma.
Resected specimens of the hypopharynx revealed a well-differentiated squamous cell carcinoma in the ulcerative tumorous lesion (3.5 cm x 0.5 cm). A brown patch (2 cm x 1.5 cm) bordering the anal aspect of the tumor comprised ectopic gastric mucosa of fundic type epithelium. Immunohistochemistry revealed the surface mucosal cells of this lesion were strongly positive for human gastric mucin (HGM) and the fundic cells were positive for gastrin.
The hypopharyngeal squamous cell carcinoma likely developed in association with chronic irritation due to gastric acid from the IP. To our knowledge, this is the first reported case of squamous cell carcinoma related to IP.
颈段食管异位胃黏膜，称为入口斑（IP），被认为是食管常见的发育异常。我们在此报告一例毗邻颈段食管入口斑的下咽鳞状细胞癌病例。
一名44岁女性在被诊断为下咽癌后接受了部分咽切除术、全喉切除术、颈段食管切除术及双侧颈清扫术。
下咽切除标本显示溃疡性肿瘤病变（3.5厘米×0.5厘米）内为高分化鳞状细胞癌。肿瘤肛门侧毗邻的一个褐色斑（2厘米×1.5厘米）由胃底型上皮的异位胃黏膜组成。免疫组化显示该病变表面黏膜细胞人胃黏蛋白（HGM）呈强阳性，胃底细胞胃泌素呈阳性。
下咽鳞状细胞癌可能因入口斑的胃酸长期刺激而发生。据我们所知，这是首例与入口斑相关的鳞状细胞癌报道病例。
