2）食道癌肉腫の1例

Esophageal Carcinosarcoma, Report of a Case

要旨　患者は70歳代，女性．嚥下困難を主訴に近医を受診し，食道腫瘍と診断されて当科に紹介となった．食道X線写真では胸部上部食道に約5cmの立ち上がり急峻な棍棒状の隆起性病変を認め，内視鏡検査では同部位に表面は平滑な有茎性の隆起性病変を認め，その基部から口側にかけて軽度隆起を伴った不整な粘膜を認めた．同部位生検にて扁平上皮癌を認め，胸部食道癌の診断で手術を行った．病理組織学的には粘膜下層に浸潤する食道癌肉腫と診断された．食道癌肉腫は形態的に有茎性隆起性腫瘍とその基部に表在癌が存在することが特徴的であり診断に有用と考えられた．

　The patient was a 72-year-old woman. She was admitted to our hospital with complaints of dysphagia. Barium esophagogram showed a large polypoid lesion in the upper thoracic esophagus. Endoscopic examination showed a pedunculated tumor with coarse mucosa at the bottom of it. The coarse mucosa was diagnosed as squamous cell carcinoma by endoscopic biopsy, so subtotal esophagectomy was performed. Histological study of the surgical specimen revealed carcinosarcoma of the esophagus. This lesion showed typical features of esophageal carcinosarcoma as a large pedunculated tumor with nodular or smooth surface and an early carcinoma lying at the bottom of it.