粘膜下腫瘍様の食道表在癌の2例

Basaloid-Squamous Carcinoma of the Esophagus Mimicking the Submucosal Tumor, Report of Two Cases

要旨　粘膜下腫瘍に類似した発育形態を呈した食道表在癌を2例紹介する．〔症例1〕は57歳，女性．軽い嚥下障害を主訴として発見されたEiの0-Ⅰsep＋0-Ⅱc型食道癌．Basaloid- (squamous) carcinoma，長径3.5×3.5cm，深達度sm3，ly₂，v₂，n（－）．根治切除術後33か月で再発，死亡した．〔症例2〕は63歳，男性．多発食道癌の副病巣として発見されたIuの0-Ⅰsep＋0-Ⅱc型食道癌．Basaloid- (squamous) carcinoma，長径1.6×2.5cm，深達度sm3，ly₀，v₀．この病変からのリンパ節転移はなかった．根治切除術後37か月で再発，死亡した．これらは食道癌の発生母地と発育様式を考えるうえで興味ある症例と思われる．

〔Case 1〕 was a 57-year-old woman with complaints of slight swallowing disturbance. A 3.5×3.5 cm sized 0-Ⅰsep＋0-Ⅱc type lesion was located in the lower intrathoracic esophagus (Ei). Histologically, the main lesion was a basaloid- (squamous) carcinoma, deeply invading the submucosal layer (sm₃) . A squamous cell carcinoma in situ accompanied it in the surface epithelium. No metastasis in the dissected lymph nodes was found at the time of the radical esophagectomy. However, the patient developed lung metastases and died 33 months after the radical operation.

〔Case 2〕 was a 63-year-old man with no complaints. Some esophageal lesions were discovered during endoscopic examination. He had a history of chronic pancreatitis and peptic gastric ulcer. Three cancerous lesions were found in his esophagus. One of them was a 1.6×1.6 cm sized 0-Ⅰsep type basaloid- (squamous) carcinoma invading the deep submucosal layer (sm₃). It was located in the upper intrathoracic esophagus(Iu), with a 1.1×2.5 cm sized 0-Ⅱc type squamous cell carcinoma (m₂) spread over it. Other lesions were an advanced squamous cell carcinoma and superficial carcinoma, both in the lower intrathoracic esophagus. No metastasis to the dissected lymph nodes from the former lesion was found at the time of the radical esophagectomy. However, the patient died of recurrence of the cancer 37 months after the radical operation.