内視鏡的粘膜切除術を施行した食道血管腫の1例

Esophageal Hemangioma Treated by Endoscopic Mucosal Resection, Report of a Case

要旨　68歳，男性．2年前より上部消化管内視鏡検査にて食道の隆起性病変を指摘されていたが，増大傾向を認めたため当院紹介となった．食道内視鏡検査にて軟らかい青色調の粘膜下隆起性病変を認め食道血管腫と診断した．EEMR-tube法を用い内視鏡的粘膜切除術（EMR）を施行し，出血なく安全に完全切除が可能であった．病理組織学的には食道粘膜下に著明に拡張した小静脈様血管群を認め，背景に粘膜固有層から粘膜下層の小動・静脈，毛細血管の拡張を伴っており，食道血管腫と診断した．食道血管腫は非常にまれであり，症状を呈することも少ないので，治療においては十分なインフォームドコンセントのうえで安全に施行しなければならない．

　In a 68-year-old male, upper digestive endoscopy revealed an elevated lesion in the esophagus. After 2 years follow-up, the size of the tumor had increased and the patient was referred to our hospital. Esophageal endoscopy revealed a soft bluish plateau lesion on the esophagus at 30 cm from the incisors, compatible with esophageal hemangioma. The tumor was completely treated by endoscopic mucosal resection (EMR), using the EEMR-tube method. Histopathological findings showed formation of a vascular lumen with irregular dilation below the lamina muscularis mucosa, suggesting hemangioma of the esophagus. Esophageal hemangioma is a rare benign esophageal tumor and most patients are asymptomatic. It is important to treat the tumor without complications under informed consent.