3）粘表皮癌の1例

Mucoepidermoid Carcinoma, Report of a Case

要旨　患者は52歳，男性．胃潰瘍の経過観察で行った内視鏡検査にて食道表在癌を指摘された．胸部中部食道の長径2cmの0-IIc型で，病変全体に厚みと硬さを認めた．内視鏡治療（EMR）を先行し，病理組織学的診断は深達度SM2の粘表皮癌であった．根治的外科切除を追加し，術後5年間無再発生存中である．極めてまれとされる食道粘表皮癌で，長期予後の得られた表在癌症例であった．その発育形式や粘液形質の発現から，扁平上皮が発生母地と推測された．

　A 52-year-old man was diagnosed, by follow-up endoscopy of a gastric ulcer, as having a superficial and slightly depressed tumor（0-IIc）with a 2cm major axis in the middle thoracic esophagus. It had overall thickness and hardness. First, the tumor was excised endoscopically and diagnosed histopathologically as mucoepidermoid carcinoma with SM2 cancer invasion. Then minimal invasive esophagectomy with lymphadenctomy of the neck, mediastinum and abdomen was performed radically. The operative specimens showed neither cancer remains nor lymphnode metastases. The clinical course of the patient has been uneventful and he has shown no local recurrence or distant metastasis for the five years since the treatment.

　We report this very rare case, because it was the superficial mucoepidermoid carcinoma of the esophagus had a long term prognosis. In addition, it suggested a histogenesis from the squamous epithelium on the basis of the mucin phenotypes, immunohistochemically.