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内镜下黏膜下剥离术治疗合并食管扁平苔藓及食管表皮化生的浅表性食管鳞状细胞癌

Superficial esophageal squamous cell carcinoma with esophageal lichen planus and esophageal epidermoid metaplasia treated with endoscopic submucosal dissection.

作者信息

Masuda Naoya, Yamazaki Kenji, Kushima Ryoji, Hirota Daiki, Taniguchi Hiroki, Ozawa Noritaka, Shimizu Shogo, Shimizu Masahito

机构信息

Department of Gastroenterology, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu, 500-8717, Japan.

Department of Gastroenterology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.

出版信息

Clin J Gastroenterol. 2025 Oct;18(5):825-831. doi: 10.1007/s12328-025-02190-3. Epub 2025 Jul 28.

Abstract

We present a case of a 70-year-old female patient who was initially diagnosed with oral lichen planus at a dental and oral surgery clinic. She underwent an upper gastrointestinal endoscopy for further evaluation of her dysphagia. Endoscopic and histopathological examinations revealed that she had superficial esophageal squamous cell carcinoma, coexisting with a background of esophageal lichen planus and esophageal epidermoid metaplasia. She underwent endoscopic submucosal dissection, recovering with minimal stenosis symptoms. Recent reports suggest that esophageal involvement associated with lichen planus is often unrecognized or misdiagnosed. Another esophageal disease with a similar chronic inflammatory background is esophageal epidermoid metaplasia. The coexistence of esophageal squamous cell carcinoma with esophageal lichen planus and esophageal epidermoid metaplasia have been reported; however, few studies with detailed endoscopic and pathologic findings are available. We present an interesting case of squamous cell carcinoma against a background of esophageal lichen planus and esophageal epidermoid metaplasia, while also considering the carcinogenic processes involved.

摘要

我们报告一例70岁女性患者,她最初在口腔颌面外科诊所被诊断为口腔扁平苔藓。她接受了上消化道内镜检查以进一步评估吞咽困难。内镜和组织病理学检查显示她患有浅表性食管鳞状细胞癌,同时伴有食管扁平苔藓和食管表皮化生背景。她接受了内镜下黏膜下剥离术,术后狭窄症状轻微。最近的报告表明,与扁平苔藓相关的食管受累常常未被认识或误诊。另一种具有类似慢性炎症背景的食管疾病是食管表皮化生。食管鳞状细胞癌与食管扁平苔藓和食管表皮化生并存的情况已有报道;然而,很少有具有详细内镜和病理结果的研究。我们呈现了一例在食管扁平苔藓和食管表皮化生背景下的鳞状细胞癌有趣病例,同时也考虑了其中涉及的致癌过程。

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