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在因腐蚀性物质摄入接受食管重建成形术29年后发生结肠移植部位的鳞状细胞癌。

Squamous cell carcinoma of a colon transplant 29 years after restorative esophagoplasty for caustic ingestion.

作者信息

Maouni Iliass, Bakali Youness, Jahid Ahmed, El Absi Mohamed, El Alami E H, Benammi Sarah

机构信息

University Hospital Ibn Sina, Rabat, Morocco; Mohamed V University of Rabat.

Mohamed VI University of Sciences and Health; International University Hospital Mohamed VI, Bouskoura, Morocco.

出版信息

Int J Surg Case Rep. 2025 Mar;128:111065. doi: 10.1016/j.ijscr.2025.111065. Epub 2025 Feb 17.

Abstract

INTRODUCTION

We aim to report a case of squamous cell carcinoma 29 years following restorative colonic transplant in esophagoplasty for caustic ingestion and to emphasize the importance of long-term follow-up.

PRESENTATION OF CASE

We report a case of a 59-yo patient with malignant degeneration of colon transplant squamous cell 29 years following restorative esophagoplasty for caustic ingestion. He reported symptoms of progressively worsening dysphagia, odynophagia, and left cervical mass with fistula. The assessment revealed a squamous cell carcinoma of the colon graft without a distant lesion.

DISCUSSION

Esophagoplasty by colonic transplant is a widely used surgical technique for the treatment of benign or malignant lesions of the esophagus. The degeneration of colonic transplant is exceptional, most reportedly into adenocarcinoma. Squamous cell carcinoma is very rare and scarcely reported. Preoperative colonic segment assessment is mandatory. Follow-up includes essentially endoscopic evaluation, which allows both visual inspection and histologic evaluation of the transplant.

CONCLUSION

The risk of carcinogenesis in colonic transplants after esophagectomy is exceptional. The cases published in the literature are scarce. Although rare, this risk justifies a long-term follow-up of these patients by performing an annual upper GI endoscopy.

摘要

引言

我们旨在报告一例在因腐蚀性物质摄入行食管成形术时进行结肠移植修复29年后发生鳞状细胞癌的病例,并强调长期随访的重要性。

病例介绍

我们报告一例59岁患者,在因腐蚀性物质摄入行食管重建术后29年,结肠移植发生鳞状细胞恶性变。他报告有吞咽困难、吞咽痛进行性加重以及左颈部肿块伴瘘管的症状。评估显示结肠移植物鳞状细胞癌,无远处病变。

讨论

结肠移植食管成形术是治疗食管良性或恶性病变广泛应用的外科技术。结肠移植退变罕见,多数报道为腺癌。鳞状细胞癌非常罕见,鲜有报道。术前必须对结肠段进行评估。随访主要包括内镜评估,其可对移植物进行视觉检查和组织学评估。

结论

食管切除术后结肠移植发生癌变的风险罕见。文献报道的病例很少。尽管这种风险罕见,但通过每年进行上消化道内镜检查对这些患者进行长期随访是合理的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cf5/11925180/a176b4c7a115/gr1.jpg

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