18歳の若年者にみられた食道胃境界領域の早期小胃癌の1例

Small Early Gastric Cancer Near the Esophagogastric Junction in an Eighteen-year-old Boy, Report of a Case

要旨　患者は18歳男性で上腹部痛のためX線検査を受け十二指腸潰瘍を疑われ，引き続き行われた内視鏡検査によって，食道胃境界部小轡に薄い白苔と，にじむような出血を伴う小さな不整型の陥凹型の病変を認めた．初回生検ではGroup Ⅳ，2回目の生検ではGroup Ⅴであった．切除標本では食道胃境界部に3×7mmのⅡcが認められ深達度mの高分化型腺管腺癌であった．

　An 18-year-old boy developecl epigastric pain after dinner on May 23, 1984. The pain continued for five days. Upper gastrointestinal x-ray examination was performed by his family doctor, showing the findings suggestive of duodenal ulcer.

　He was then referred to us for upper gastrointestinal endoscopy. Endoscopically, a small irregular-shaped ulcer with thin coat was seen on the lesser curvature of the cardia. Biopsy specimens taken from the ulcer strongly suggested adenocarcinoma.

　Biopsy was repeated 10 days later, which showed well differentiated adenocarcinoma.

　Examination of the resected stomach showed a small irregular-shaped ulcer, 0.3×0.7 cm in size, on the lesser curvature of the cardia within 1 cm from esophagogastric junction. Histologically it was intramucosal well differentiated adenocarcinoma.