Hirai K, Taruishi M, Ike K, Takahashi A, Shibata Y, Namiki M
Department of Internal Medicine, Kushiroshi Ishikai Hospital, Kushiro.
Hokkaido Igaku Zasshi. 1989 Mar;64(2):119-24.
We here report a case of juvenile esophageal cancer which developed with a chief complaint of hematemesis. The case was a 36-year-old male patient who was admitted to the hospital because of dysphagia and repeated hematemesis episodes. Through various imaging studies, the patient was diagnosed as having advanced esophageal carcinoma. Since it was considered to be impossible to perform a curable surgical treatment, we tried, using a Laser apparatus, to alleviate the stenosis of the esophageal lumen and to control the bleeding from the cancerous lesion. However, an operation was finally performed after observing that the Laser therapy had not been so effective. Hematemesis is an uncommon symptom among primary complaints of esophageal cancer. The present case developed a protuberant cancerous mass which considerably obstructed the esophageal lumen. It is speculated that the patient repeatedly vomited blood which had gradually originated from ruptured capillary vessels in the tumor and had accumulated in the esophageal lumen. The histological type of the cancer was poorly-differentiated squamous cell carcinoma which partially contained an undifferentiated element. This histological nature might have accelerated the growth of the esophageal cancer in the present case.
我们在此报告一例以呕血为主诉的青少年食管癌病例。该病例为一名36岁男性患者,因吞咽困难和反复呕血发作入院。通过各种影像学检查,该患者被诊断为晚期食管癌。由于认为无法进行根治性手术治疗,我们尝试使用激光设备来缓解食管腔狭窄并控制癌灶出血。然而,在观察到激光治疗效果不佳后,最终还是进行了手术。呕血在食管癌的主要症状中并不常见。本病例出现了一个突出的癌块,严重阻塞了食管腔。据推测,患者反复呕血,这些血液逐渐源自肿瘤内破裂的毛细血管,并积聚在食管腔内。该癌症的组织学类型为低分化鳞状细胞癌,部分含有未分化成分。这种组织学特征可能在本病例中加速了食管癌的生长。