憩室切除を行った憩室内食道表在癌の1例

Superficial Esophageal Carcinoma within a Diverticulum Resected by Diverticulectomy, Report of a Case

要旨　患者は62歳，男性．慢性肝炎の経過観察中の上部消化管造影で胸部中部食道の憩室と憩室内の粘膜粗糙を指摘された．内視鏡検査では憩室内に発赤を伴う不整な陥凹性病変を認め，生検で扁平上皮癌と診断された．深達度m2からm3と診断し右開胸，憩室切

除術を施行した．大きさ44×22mm，0-Ⅱcで，病理組織学的検索では中分化扁平上皮癌，深達度はm3，ly0，v0で，術中採取した憩室周囲のリンパ節には転移を認めなかった．現在術後4年8か月であるが無再発生存中である．

　A 62-year-old male had been followed up for chronic hepatitis, and he was diagnosed by esophagogram as having a middle thoracic esophageal diverticulum with mucosal irregularity. Endoscopically, a reddish and irregular depressed lesion was recognized in the diverticulum. A biopsy specimen showed squamous cell carcinoma. Synthetically, the depth of cancer invasion was estimated as m2 or m3 in the preoperative period, so a diverticulectomy through right thoracotomy was performed. The resected specimen showed a slightly depressed type carcinoma (0-Ⅱc), measuring 44 × 22 mm in size. Histological examination revealed a moderately differentiated squamous cell carcinoma with invasion of m3. Although lymphatic invasion was detected, there was no evidence of venous invasion or lymph node metastasis around the diverticulum. Four years and eight months after surgery, the patient is doing well without any recurrence.