食道粘表皮癌の1例

Mucoepidermoid Carcinoma of the Esophags, Report of a Case

要旨　患者は53歳，男性．軽度の吐血を主訴に当科受診．食道内視鏡，食道造影検査にて胸部上部食道から中部食道にかけての2型の進行食道癌と診断された．生検の組織診断は扁平上皮癌であった．術前化学療法を1コース行ったが，明らかな効果は得られなかった．右開胸開腹胸部食道全摘術および3領域リンパ節郭清術を施行したが，術後早期に再発死亡した．切除標本の病理組織診断は粘表皮癌であった．画像上，典型的な特徴を示さなかったが，臨床経過は治療に抵抗性であり，食道粘表皮癌の予後不良の特徴を示した．最近経験した食道粘表皮癌の貴重な1症例として臨床経過と病理組織学的特徴について報告した．

　A 53-year-old man was diagnosed, by esophagography and esophagoscopy, as having an advanced tumor with localized ulceration in the upper to middle portions of the esophagus. A biopsy specimen was shown to contain squamous cell carcinoma. One course of preoperative chemotherapy was performed, but there was no discernable response. Right trans-thoracic esophagectomy with lymphadenctomy of the neck, mediastinum and abdomen was performed, and the operative specimen showed mucoepidermoid carcinoma. The patient died due to the early recurrence of the tumor. Although the gross appearance was not typical, therapy resistance and poor prognosis were compatible with the features of mucoepidermoid carcinoma.