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A Type 0-Ⅱc Squamous Cell Esophageal Carcinoma with Massive Submucosal Invasion which Showed Complete Reaction to Chemoradiotherapy and Survived more than Five Years, Report of a Case Kumiko Momma 1 , Misao Yoshida 2 , Yoshiya Yamada 3 , Hisahito Kato 3 , Tamae Kazawa 1 1Department of Endoscopy, Tokyo Metropolitan Komagome General Hospital 2Department of Surgery, Tokyo Metropolitan Bokutoh Hospital 3Department of Gastroenterology, Tokyo Metropolitan Komagome General Hospital Keyword: 0-Ⅱc型食道表在癌 , 食道粘膜下層癌 , 放射線・化学療法 , 長期予後 pp.1327-1332
Published Date 2002/9/25
DOI https://doi.org/10.11477/mf.1403104551
  • Abstract
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 A 71-year-old woman was admitted to our hospital because of mild dysphagia. She had enjoyed good health until a gastric polyp was noted during an annual examination. She underwent a upper gastrointestinal endoscopy and a lesion in the middle and lower third of the esophagus was suspected to be a carcinoma. She was referred to our hospital for further examination and treatment. The esophageal lesion was estimated to be a type 0-IIc cancer as it had reddening and a slight depression which occupyed half the circumference of the esophagus. A massive cancer invasion into the submucosa was strongly suspected because it had many coarse granular components. Pathological studies on biopsy specimens from the lesion revealed a poorly differentiated squamous cell carcinoma. There were some small and elevated lesions covered by normal esophageal mucosa close to the main lesion, which suggested intramural metastases of the esophageal cancer. An ultrasonography on the neck detected a lymph node swelling in the left supraclavicular region. These facts suggested a superficial esophageal cancer with poor prognosis and so, radiochemotherapy was indicated. Irradiation of the bilateral supraclavicular regions and the whole mediastinum, paracardia and the caeliac axis was carried out. Although simultaneous chemotherapy using a low dose of CDDP (5mg daily) was planned, after the administration of CDDP only three times, leucopenia (WBC=1,600/μl) developed and it was not improved by the administration of G-CSF. Consequently, irradiation was carried out without chemotherapy. The esophageal cancer had completely disappeared after irradiation of 70 Gys. Her clinical course was uneventful. The patient is doing well five years after the treatment without any sign of recurrence.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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