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原发性食管腺癌源于异位胃黏膜:病例报告。

Primary esophageal adenocarcinoma arising from heterotopic gastric mucosa: report of a case.

机构信息

Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan.

出版信息

Surg Today. 2013 Apr;43(4):446-51. doi: 10.1007/s00595-012-0206-9. Epub 2012 Jun 17.

Abstract

Adenocarcinoma arising from heterotopic gastric mucosa (HGM) is exceedingly rare. This report presents the case of a 57-year-old male who presented with the chief complaint of dysphagia. Endoscopy and computed tomography revealed a locally advanced tumor of the cervical esophagus and swollen mediastinal lymph nodes. He underwent chemoradiotherapy followed by esophagectomy with three-field lymph node dissection. The resected tumor was a circumferentially scarred lesion located 1.5 cm from the proximal margin. The tumor was identified to be a well-differentiated adenocarcinoma arising from HGM with invasion to the muscularis propria. Postoperative chemoradiotherapy was performed because positive surgical margins were observed in the resected tissue. The patient has remained alive for more than 4 years after surgery, without any evidence of recurrence.

摘要

由异位胃黏膜(HGM)发生的腺癌极为罕见。本报告介绍了 1 例 57 岁男性患者,主要症状为吞咽困难。内镜和计算机断层扫描显示颈段食管局部晚期肿瘤和纵隔淋巴结肿大。患者接受了放化疗,随后进行了颈胸腹三野淋巴结清扫的食管癌切除术。切除的肿瘤是位于近端边界 1.5cm 处的环状瘢痕病变。肿瘤被确定为来源于 HGM 的高分化腺癌,侵犯至固有肌层。由于在切除组织中观察到阳性手术切缘,因此进行了术后放化疗。患者手术后已存活 4 年以上,无复发迹象。

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