ERCPが診断の契機となった早期胆囊癌の1例

Early Carcinoma of the Gallbladder, Report of a Case

　これまで数多くの早期胆囊癌症例が報告されてきたが，術前診断のできた症例はまれであった．しかし，超音波検査法をはじめとする胆道疾患の診断が急速に進んだ結果，ようやく早期胆囊癌の明確な定義づけや術前の診断が論議を呼ぶようになった^1)～3)．

　われわれは上腹部痛で発症し，ERCPで可動性のない不整形の隆起性病変が描出され，術前に癌が強く疑われた深達度mの早期胆囊癌症例を経験した．その診断過程を報告すると共に，早期胆囊癌の自験6症例をもとにして術前診断の可能性を考察した．

　Recently, the definition of early carcinoma of the gallbladder and its diagnosis before the operation have often been discussed. We have concluded that the definition of early carcinoma of the gallbladder is indicated when carcinoma is localized in the gallbladder and confined to the mucosa or the propria muscularis.

　We present here one case highly suggestive of early carcinoma of the gallbladder before the operation because of demonstration of a single polypoid lesion with irregular surface by ERCP. This polypoid lesion proved to be carcinoma in adenoma with the size of 20～15 mm which was confined to the mucosa of the gallbladder as revealed by histological examination.