辺縁隆起を伴う0-Ⅱc型（0-Ⅱc＋Ⅱa型）食道癌の1例

Esophageal Cancer Appearing as 0-Ⅱc with the Ridge Elevation (0-Ⅱc+Ⅱa), Report of a Case

要旨　患者は72歳，女性．胆石胆囊炎で近医入院中，術前検査の食道内視鏡検査で病変を指摘され，紹介入院となる，食道造影では，辺縁隆起を伴う浅い陥凹性病変を胸部中部食道に認めた．食道内視鏡検査では上切歯列から27cmに1cmに満たない発赤した陥凹を認め，陥凹の周囲はごくわずかに隆起していた．以上より非常に小さい病変であるが0-Ⅱc＋Ⅱaであり深達度はm₃で手術が必要と考えられた．低肺機能，虚血性心疾患，総胆管結石の合併などがあり検査で明らかなリンパ節転移も認めなかったことから，EMRが行われた．病理診断は，中分化扁平上皮癌でm₃，ly₀，v₀であった．

　A 72-year-old female was transferred to the present hospital after it being pointed out during preoperative examinations in another hospital that she had an esophageal lesion. The upper GI series showed a shallow depressed lesion accompanied with ridge elevation. Endoscopy revealed a red depression smaller than 1 cm with ridge elevation, 27 cm from the incisor. From the findings of apparent 0-Ⅱc+Ⅱa, suspected to be m₃ in depth, a surgical operation was considered to be necessary. However EMR was chosen instead because of poor respiratory function in the patient and the existence of ischemic heart disease and commmon bile duct stone. Pathology revealed a moderately differentiated squamous cell carinoma of m₃, ly₀, v₀.