胃原発性Adenosquamous carcinoma（Adenoacanthoma）の2例―胃生検にて診断しえた1例を含めて

Two Cases of Primary Adenosquamous Carcinoma (Adenoacanthoma) of the Stomach

　胃の原発性上皮性悪性腫瘍は，胃の腺上皮に由来し，その大部分は腺癌であり，腺扁平上皮癌は極めてまれである．

　われわれは最近，内視鏡的に胃生検にて診断しえた1例を含めて計2例のadenosquamous carcinomaを経験したので，多少の文献的考察を加えてここに報告する．

　症　例

〔症例1〕柴○博，47歳，男．

　主　訴：心窩部痛．

　既往歴，家族歴：特記すべきことなし．

　現病歴：1977年4月ごろから心窩部痛が出現したため近医受診し，胃透視にて胃潰瘍の診断の下に治療を行い，多少縮小するも再燃．6月2日胃生検でadenosquamous carcinmaと診断され（Fig. 3），手術のため6月16日大分市医師会立アルメイダ病院に入院．

　Two cases of primary adenosquamous carcinoma (adenoacanthoma) of the stomach, a 47 year-old male and a 69 year-old female, were reported.

　Adenoacanthoma of the stomach is a neoplasm of very rare occurrence, being reported only 90 cases including our two cases in Japan.

　Statistically, there is a peak of occurrence of gastric adenoacanthoma in 7th decade and the average of age is 57.5. It occurs more in males than in females at the ratio of 62 to 26. The highest incidence of the tumor location is in the pyloric region (50.0%).

　In both two cases of ours, adenocarcinomatous parts were seen mainly in the surrounding surface areas of the ulcer and squamous cell carcinomatous areas spread mainly in the ulcerous tissue, submucosa and in muscles. It would be suggested that the ulcer formation could be one of the causes inducing squamous metaplasia of adenocarcinoma.

　Our first case is the second report in Japan that was preoperatively diagnosed by the endoscopic biopsy.