リウマチ性多発筋痛症の経過中に発見された早期食道癌（0-Ⅱb）の1例

Early Esophageal Carcinoma (0-Ⅱb) Accom-panied by Polymyalgia Rheumatica, Report of a Case

要旨　患者は63歳の女性．2か月間持続する発熱，両肩のとう痛を主訴に来院した．著明な赤沈の亢進と臨床症状などよりリウマチ性多発筋痛症（polymyalgia rheumatica；PMR）が強く疑われ，少量のステロイドが奏効した．外来通院時赤沈は正常化し，症状も安定していた。初診時より9か月後スクリーニングの上部消化管内視鏡にて早期食道癌（0-Ⅱb）が発見され，内視鏡的粘膜切除術が施行された．組織学的に上皮内癌と診断され完全切除が確認された．PMRに伴う早期食道癌の報告は検索したかぎり見当たらず，本症例が第1例目である．

　A 63-year-old woman was admitted to our hospital because of shoulder stiffness/pain and intermittent high-grade fever for 2 months. Based on her clinical manifestation and the marked elevation of erythrocyte sedimentation rate, polymyalgia rheumatica (PMR) was strongly suspected. This was confirmed by the patient's drastic response to small doses of corticosteroid. After 9 months, screening endoscopic examination revealed an early carcinoma (0-Ⅱb) in the upper thoracic esophagus. Endoscopic mucosal resection was performed. Histological analysis demonstrated that the lesion was squamous cell carcinoma confined to the epithelium (m1) and had been completely excised.

　This is the first report of an early esophageal carcinoma accompanied by PMR.