Kitabayashi K, Akiyama T, Tomita F, Saitoh H, Kosaka T, Kita I, Takashima S
Department of Surgery II, Kanazawa Medical University, Ishikawa, Japan.
Surg Today. 1998;28(10):1051-5. doi: 10.1007/BF02483960.
We report herein the unusual case of a 59-year-old woman with Plummer-Vinson syndrome who developed gastric cancer. The patient had a longstanding history of dysphagia and iron deficiency anemia, for which she had sporadically taken iron supplements that improved the dysphagia to some extent, but not completely. Owing to her tolerance of the dysphagia, she had not been taking iron supplements for the past 17 years. On admission, she was in fair nutritional condition and not anemic. Blood chemistry results were all normal, including the serum iron level. Gastrointestinal radiographic series demonstrated cervical esophageal webs and advanced gastric cancer. Her dysphagia was successfully treated by endoscopic bougienage through the webs, and a distal partial gastrectomy with nodal dissection was performed. Histology of the resected stomach revealed atrophic mucosal change and, by chance, an adenomatous lesion in addition to adenocarcinoma. Her postoperative course was uneventful and she is now well, without any signs of recurrence. Although Plummer-Vinson syndrome is known to be associated with upper alimentary tract cancers, gastric cancer is extremely rare. A discussion on the etiology of Plummer-Vinson syndrome and its link with potential carcinogenesis follows this case report.
我们在此报告一例罕见病例，一名59岁患有普卢默-文森综合征的女性罹患胃癌。该患者有长期吞咽困难和缺铁性贫血病史，曾间断服用铁剂补充剂，这在一定程度上改善了吞咽困难，但未完全缓解。由于她对吞咽困难有一定耐受性，在过去17年中未服用铁剂补充剂。入院时，她营养状况尚可，无贫血。血液化学检查结果均正常，包括血清铁水平。胃肠道造影系列检查显示有颈段食管蹼和进展期胃癌。通过内镜扩张术成功治疗了她的吞咽困难，并行远端胃部分切除术加淋巴结清扫术。切除胃的组织学检查显示有萎缩性黏膜改变，偶然还发现除腺癌外有一个腺瘤性病变。她术后恢复顺利，目前状况良好，无任何复发迹象。虽然已知普卢默-文森综合征与上消化道癌症有关，但胃癌极为罕见。本病例报告之后将对普卢默-文森综合征的病因及其与潜在致癌作用的联系进行讨论。
