内視鏡的粘膜切除しえた食道カルチノイドの1例

Endoscopic Removal of Esophageal Carcinoid Tumor, Report of a Case

要旨　患者は68歳，女性で，心窩部痛，胸やけ，体重減少を主訴に当科を受診した．上部消化管内視鏡検査にて胸部下部食道に径1．5cm大の中心陥凹を伴う発赤した粘膜下腫瘍様の隆起性病変を認めた．超音波内視鏡検査で病変の主座は粘膜固有層と判断し，内視鏡的食道粘膜切除術を施行した．組織学的にはカルチノイドで，深達度はm，水平断端，垂直断端とも陰性であった．

　A 68-year-old woman was examined in our department because of epigastric pain in addition to heartburn and weight loss of 4 kg. Since upper gastrointestinal endoscopy revealed a red and soft elevated lesion with a relatively gentle slope from the posterior esophageal wall, a delle at the center and smooth surface at about 30 cm from the cuspid; the lesion was diagnosed as a submucosal tumor. The patient was hospitalized in our department for detailed examination. On endoscopic ultrasonography, the lesion was isoechoic with uniform content and was present mainly in the first and second layers. The third layer was intact. Thus, a tumor restricted to the mucosal layer proper was suspected, and endoscopic mucosal resection was performed. The resected specimen was a carcinoid restricted to the mucosal layer proper.