Kagaya Hideo, Kitayama Joji, Hidemura Akio, Kaisaki Shoichi, Ishigami Hironori, Takei Junko, Kanazawa Takamitsu, Nagawa Hirokazu
Department of Surgical Oncology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Jpn J Clin Oncol. 2007 Aug;37(8):628-31. doi: 10.1093/jjco/hym078. Epub 2007 Sep 4.
A 55-year-old man developed progressive dysphagia 14 months after palliative colectomy and subsequent systemic chemotherapy for advanced cecal cancer with carcinomatosis peritonei. Radiologic and endoscopic examinations suggested a submucosal tumor in the lower esophagus causing a severe luminal stricture. A self-expanding metal stent was placed for palliation. The prosthesis was effective for several months, but ingrowth of the tumor caused re-stricture of the esophagus. Since his general condition was quite good without any evidence of recurrence of the cecal cancer, we performed bypass surgery for palliation. The pathological appearance of the tumor was compatible with the metastasis of cecal cancer. Our case suggests that a surgical approach can be considered as a therapeutic method for metastatic esophageal tumor, even in patients with advanced cancer, as long as the primary tumor is satisfactorily controlled.
一名55岁男性在因晚期盲肠癌伴腹膜转移接受姑息性结肠切除及后续全身化疗14个月后，出现进行性吞咽困难。影像学和内镜检查提示食管下段有一黏膜下肿瘤，导致严重的管腔狭窄。放置了自膨式金属支架以缓解症状。该假体在几个月内有效，但肿瘤向内生长导致食管再次狭窄。由于他的一般状况良好，没有盲肠癌复发的任何迹象，我们进行了姑息性旁路手术。肿瘤的病理表现与盲肠癌转移相符。我们的病例表明，即使是晚期癌症患者，只要原发肿瘤得到满意控制，手术方法可被视为转移性食管肿瘤的一种治疗方法。
