Lee M Y, Jensen E, Kwak S, Larson R A
Department of Medicine, Pritzker School of Medicine, University of Chicago, Illinois, USA.
Am J Clin Oncol. 1998 Feb;21(1):64-6. doi: 10.1097/00000421-199802000-00014.
Benign tumors and cysts of the esophagus are rare, and malignant transformation of esophageal cysts is even more rare. In this article, we report on the first case to our knowledge of a patient presenting with metastatic adenocarcinoma arising in a congenital foregut cyst of the esophagus. A 37-year-old woman had multiple cysts along the aerodigestive tract and diffuse soft tissue metastases. Endoscopic biopsies of a mediastinal mass revealed an enteric cyst with a spectrum of columnar epithelium ranging from benign through adenomatous to frankly malignant. There was only transient response to radiotherapy and chemotherapy. Only three other cases of carcinoma arising from esophageal duplication foregut cysts have been reported, and none of these were metastatic. Given the rarity of malignant transformation within an esophageal cyst, prophylactic excision of known esophageal cysts is not warranted. However, biopsy of the cyst may be useful to exclude the possibility of malignancy, particularly if the onset of symptoms has been recent.
食管良性肿瘤和囊肿较为罕见，食管囊肿发生恶变则更为罕见。在本文中，据我们所知，我们报告了首例食管先天性前肠囊肿发生转移性腺癌的病例。一名37岁女性沿气道消化道有多个囊肿及弥漫性软组织转移。纵隔肿物的内镜活检显示为肠囊肿，其柱状上皮呈现从良性到腺瘤性再到明显恶性的谱系。放疗和化疗仅产生短暂反应。仅另有3例食管重复前肠囊肿发生癌变的病例报告，且均无转移。鉴于食管囊肿内恶变罕见，不建议对已知的食管囊肿进行预防性切除。然而，囊肿活检可能有助于排除恶变可能性，特别是在症状近期出现时。
