Schmitz Klaus Jürgen, König Christoph, Riesener Klaus Peter
Pathologisches Institut, Recklinghausen, Recklinghausen, Germany.
BMJ Case Rep. 2012 Jul 11;2012:bcr0320126080. doi: 10.1136/bcr.03.2012.6080.
Most oesophageal carcinomas (>70%) are squamous cell carcinomas (SCC) arising from the surface epithelial lining. In the gastro-oesophageal junction (GEJ) adenocarcinomas occur in the setting of Barrett oesophagus (BE). These carcinomas typically present with surface ulceration. The authors report a rare case of a SCC of the GEJ with completely intramural growth underneath intact non-dysplastic oesophageal squamous epithelium and BE without dysplasia. The sharply demarcated tumour was located in the muscularis propia with infiltration of perioesophageal tissue nearly reaching the diaphragm. Intramural squamous carcinomas are very rare with only three reported cases. In this study, the authors discuss this finding and review the relevant literature. Intramural carcinomas are a diagnostic challenge for clinicians and pathologist, since preoperative biopsies mostly fail to establish the diagnosis and surgical explorations must be considered.
大多数食管癌（>70%）是源自表面上皮衬里的鳞状细胞癌（SCC）。在胃食管交界（GEJ）处，腺癌发生于巴雷特食管（BE）的背景下。这些癌通常表现为表面溃疡。作者报告了1例罕见的GEJ鳞状细胞癌病例，肿瘤完全位于壁内生长，其上方食管鳞状上皮完整且无发育异常，同时BE也无发育异常。边界清晰的肿瘤位于固有肌层，食管周围组织浸润几乎达膈肌。壁内鳞状细胞癌非常罕见，仅有3例报告。在本研究中，作者讨论了这一发现并回顾了相关文献。壁内癌对临床医生和病理学家来说是一个诊断挑战，因为术前活检大多无法确诊，必须考虑手术探查。
