食道粘膜下腫瘍の経過観察中に発見された0-Ⅱa型早期胃癌の1例

Type Ⅱa Early Gastric Cancer Incidentally Found During the Follow-up Study of a Submucosal Tumor of Esophagus, Report of a Case

要旨　患者は64歳，男性．食道粘膜下腫瘍を6年間経過観察中にⅡa型早期胃癌を発見し，遡及的にX線・内視鏡所見を検討した．病変部は6年前のX線で既に顆粒状不整が認められた．その後5年間変化に乏しく，2年前に生検されているが診断に至らなかった．6年目にX線・内視鏡とも明らかなⅡa型早期胃癌に変化した．深達度m，高分化型管状腺癌であった．本症例は，癌が粘膜内にとどまったまま緩徐に発育し，最後の1年間で急激に形態変化を来したと考えられた．

　A type Ⅱa early gastric cancer at the gastric angle was found in a 64-year-old male in 1997, who has been followed for six years because of a submucosal tumor of the esophagus. Retrospectively, the lesion can be detected on the x-ray films examined in 1991 as the granular mucosal change. Little change had been observed for five years since the initial examination. In 1994, the endoscopic biopsy of the lesion showed Group Ⅰ. In 1996, the lesion changed to a more prominent protrusion and was diagnosed type Ⅱa early gastric cancer. The histological examination of the resected specimen revealed that it was well differentiated tubular adenocarcinoma, and cancer invasion was limited within the mucosal layer. We speculated the cancer has growed very slowly in the mucosal layer and rapidly changed during the last one year.