石灰化を伴った食道平滑筋腫と隆起性早期胃癌の合併例

A Case of Calcified Leiomyoma of the Esophagus Coexisting with Elevated Early Gastric Carcinoma

　石灰化を伴った食道平滑筋腫と早期胃癌の合併症例を経験したので報告する．本例のような合併例はわれわれの調べえた範囲内では文献上報告例は見あたらなかった．

症例

　患　者：70歳　女性

　主　訴：軽度の嚥下障害

　家族歴：特記すべきことなし

　既往歴：38歳，子宮筋腫にて摘除術を受ける．67歳より糖尿病と診断され，食事療法を続けていた．

　現病歴：1978年4月中旬より固形物を摂取するときに嚥下困難を感じ近医を受診した．食道・胃X線検査の結果，食道癌の疑いにて当科を紹介され，1978年5月25日当科初診，6月9日精査のため入院した．入院時には自覚症状は消失していた．

　This is a report of a case of calcified esophageal leiomyoma coexisting with elevated early gastric carcinoma.

　The patient was a 70-year-old female with the chief complaint of slight dysphagy. A shadow of calcified tumor measuring 4×5 cm, located just above the dyaphragma, was revealed on the chest film. A smooth-lined filling defect was discernible on the greater curvature side of the portion extending from the lower esophagus to the esophago-gastric junction on the esophago X-ray film. Esophago endoscopy disclosed a smoothly elevated, slightly whitish elevation with a central depression.

　Various-sized elevations were found circularly in the antrum on the gastric X-ray film. Endoscopy also disclosed reddish, irregular elevations.

　Operation was performed to prove esophageal tumor to be leiomyoma with calcification and the gastric lesions to be histologically Type Ⅱa adenocarcinoma tubulare limited in the mucosa.

　Very few cases are reported of leiomyoma of the esophagus with calcification. The case presented here may he of interest as there is no record of the calcified esophageal leiomyoma coexisting with early gastric caricnoma in the literature.