Takano Y, Koyama S, Yokota H, Nakahara A, Fukutomi H, Osuga T, Horiuchi S, Todoroki K, Iwasaki Y, Ishidoh T
Dept. of Int. Med., Univ. of Tsukuba.
Gan No Rinsho. 1989 Jul;35(8):948-54.
Reported is a case of 61-year-old man with a superficial esophageal cancer that was associated with an intramural metastasis to the stomach. Examination of the upper G.I. tract revealed a slightly elevated lesion with an irregular surface at the left wall of the lower esophagus, and a large submucosal tumor with an ulcerous formation that had developed and had increased rapidly within a month. Thus a resection of the lower esophagus and a total gastrectomy were performed. Histopathologically, the tumor of the lower esophagus was determined as being a moderately differentiated squamous cell carcinoma with a deep invasion to the submucosal tissue. The submucosal tumor of the stomach also was found to be a moderately differentiated squamous carcinoma. Neither provided evidence, however, of a direct involvement of the gastric serosa may have metastasized from the neighboring lymph nodes or from other organs, nor of any continuous mucosal metastasis between the primary lesion of the esophagus and the submucosal tumor of the stomach. Judging from these findings, the case was diagnosed as an esophageal cancer with an intramural metastasis to the stomach.
报告了一例61岁男性浅表性食管癌病例,该病例伴有胃壁内转移。上消化道检查发现食管下段左壁有一处表面不规则的轻度隆起病变,以及一个有溃疡形成的大的黏膜下肿瘤,该肿瘤在一个月内发展并迅速增大。因此,实施了食管下段切除术和全胃切除术。组织病理学检查显示,食管下段肿瘤为中分化鳞状细胞癌,侵犯至黏膜下组织深层。胃黏膜下肿瘤也被发现为中分化鳞状癌。然而,两者均未提供胃浆膜直接受累的证据,胃浆膜可能是从邻近淋巴结或其他器官转移而来,也未提供食管原发灶与胃黏膜下肿瘤之间存在连续黏膜转移的证据。根据这些发现,该病例被诊断为伴有胃壁内转移的食管癌。