Nata Toshie, Fujiya Mikihiro, Tanabe Hiroki, Ueno Nobuhiro, Konno Youkou, Ishikawa Chisato, Inaba Yuhiei, Ito Takahiro, Sato Ryu, Moriichi Kentaro, Okamoto Kotaro, Maemoto Atsuo, Mizukami Yusuke, Watari Jiro, Ashida Toshifumi, Kohgo Yutaka
Asahikawa Medical College, 3rd Department of Internal Medicine, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2009.2048. Epub 2009 Dec 9.
Small cell carcinoma of the oesophagus (SCCE) is an infrequent tumour associated with a poor prognosis. We herein propose the first case of SCCE treated by endoscopic mucosal resection (EMR) and its endoscopic images with narrow band imaging (NBI) and autofluorescence imaging (AFI). A 63-year-old man complained of a loss of appetite. An upper endoscopic examination revealed a 7 mm nodule located 33 cm from the incisors. A weakly stained area was shown by iodine staining. NBI detected brownish amorphous dots with irregular vessels on the surface of the nodule and AFI distinctly embossed the lesion magenta. A biopsy specimen obtained from the lesions revealed typical SCCE. The patient underwent EMR to remove the SCCE and thereafter remained in a state of clinical remission for 18 months. In summary, NBI and AFI may be useful for detecting and differentially diagnosing SCCE from the squamous cell carcinoma of the oesophagus. EMR is therefore considered to be a potentially useful therapeutic option for removing SCCE instead of performing an oesophagotomy.
食管小细胞癌(SCCE)是一种罕见的肿瘤,预后较差。我们在此报告首例经内镜黏膜切除术(EMR)治疗的SCCE病例及其窄带成像(NBI)和自体荧光成像(AFI)的内镜图像。一名63岁男性主诉食欲不振。上消化道内镜检查发现距门齿33 cm处有一个7 mm的结节。碘染色显示一个淡染区域。NBI检测到结节表面有褐色无定形点及不规则血管,AFI则清晰地将病变凸显为品红色。取自病变的活检标本显示为典型的SCCE。患者接受EMR切除SCCE,此后临床缓解状态持续了18个月。总之,NBI和AFI可能有助于检测SCCE并与食管鳞状细胞癌进行鉴别诊断。因此,EMR被认为是切除SCCE而非进行食管切开术的一种潜在有用的治疗选择。