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食管平滑肌瘤与同时存在的鳞状细胞癌:一例病例报告及文献综述

Esophageal leiomyoma and simultaneous overlying squamous cell carcinoma: a case report and review of the literature.

作者信息

Mehrabi Saadat, Yavari Barhaghtalab Mohammad Javad, Hejazinia Safoora, Saedi Hossein

机构信息

Department of General Surgery, Shahid Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

Department of Pathology, Shahid Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

出版信息

BMC Surg. 2021 Apr 29;21(1):221. doi: 10.1186/s12893-021-01214-2.

Abstract

BACKGROUND

Squamous cell carcinoma is the most common epithelial tumor of the esophagus. Upper endoscopy with multiple minimally invasive biopsies should be performed to confirm the diagnosis. Leiomyoma of esophagus is rare, but it's the most common benign submucosal mesenchymal tumor of the esophagus. The simultaneous occurrence of an overlying epithelial lesion and a mesenchymal lesion is very rare. This study aims to show a case operated due to squamous cell carcinoma of esophagus that was postoperatively diagnosed with coexistent esophageal leiomyoma and give a clear overview of the existing literature on it.

CASE PRESENTATION

The patient was a 41-year-old woman who underwent three field esophagectomy (McKeown). Pathological evaluation was done, and the patient had poorly differentiated squamous cell carcinoma and multiple leiomyomas. A leiomyoma was found with an invading overlying squamous cell carcinoma.

CONCLUSION

It is concluded that esophageal carcinomas may coexist with leiomyomas; preexisting benign tumors may have played an important role in the development of the carcinoma by inducing constant stimulation of the overlying mucosa; endoscopic ultrasonography is recommended to avoid overestimating the extent of tumor invasion and the resultant aggressive radical surgery. As the developing countries had limited equipment, esophageal resection could be the modality of choice in the treatment.

摘要

背景

鳞状细胞癌是食管最常见的上皮性肿瘤。应进行上消化道内镜检查并取多个微创活检以确诊。食管平滑肌瘤罕见,但却是食管最常见的良性黏膜下间叶组织肿瘤。上皮病变和间叶组织病变同时出现极为罕见。本研究旨在展示一例因食管鳞状细胞癌接受手术治疗的病例,该病例术后被诊断为合并食管平滑肌瘤,并对现有相关文献进行清晰概述。

病例介绍

患者为一名41岁女性,接受了三野食管癌切除术(麦克尤恩术式)。进行了病理评估,患者患有低分化鳞状细胞癌和多个平滑肌瘤。发现一个平滑肌瘤伴有浸润性鳞状细胞癌。

结论

得出结论,食管癌可能与平滑肌瘤共存;先前存在的良性肿瘤可能通过对上覆黏膜的持续刺激在癌的发生发展中起重要作用;建议进行内镜超声检查以避免高估肿瘤浸润范围以及由此导致的激进根治性手术。由于发展中国家设备有限,食管切除术可能是治疗的首选方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7b1/8086336/5d993e935e65/12893_2021_1214_Fig1_HTML.jpg

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