狭いshort segment Barrett's esophagusに発生したBarrett腺癌の1例

An Adenocarcinoma in Short Segment Barrett's Esophagus, Report of a Case

要旨　患者は73歳，男性．下部食道に2/3周が扁平上皮に囲まれた径1cm強のわずかに陥凹した発赤面がみられた．他院の生検で腺癌と診断され，当院を紹介された．腺癌の1/3周は狭いshort segment Barrett's esophagusに連続しており，Barrett腺癌と診断した．EMRを行ったが，切除標本では一部sm1であり，2か所が断端陽性であった．しかし，本人の希望により辺縁にレーザー照射を追加し，経過観察中であるが2年間再発はみられない．

　A case of 73-year-old man. A slightly depressed reddish lesion over one centimeter in diameter was detected in the lower esophagus. Two thirds of the lesion was surrounded by squamous mucosa. Biopsy specimens in another hospital revealed adenocarcinoma and the patient was introduced to our hospital. The lesion was diagnosed as Barrett's adenocarcinoma because one third of the lesion extended into the short segment Barrett's esophagus. EMR was performed. The resected specimen revealed that its invasion was partly sm1, and the cut end was positive for carcinoma in two places. Laser irradiation was applied to the surrounding mucosa because the patient rejected an operation. Recurrence hasn't been observed in the two years since the diagnosis.