食道・胃・大腸に発生した3早期重複癌の1例

Triple Cancers at an Early Stage Occurring in the Esophagus, Stomach, and Colon, Report of a Case

要旨　患者は47歳，男性．胃集団検診の精査のため来院．初回胃内視鏡検査で胃の異型上皮巣を指摘される．その経過中に大腸癌および食道癌が発見され，また胃の病変も初回より約3年後に癌と診断された．以上より大腸のポリペクトミー，食道・胃全摘術が施行された．大腸病変は深達度smの癌，食道病変は深達度mmの表在平坦型の癌，胃病変は

深達度mの癌であった．文献上，消化管に発生した食道・胃・大腸の3重複癌の症例は，本例を含めて4例である．しかし今までに報告された症例はいずれも進行癌であり，食道・胃・大腸に発生した3早期重複癌の症例は本例のみと考えられた．

　A 47-year-old male visited our center to have a detailed examination of the stomach following a mass screening for gastric diseases.

　An atypical epithelial lesion was detected at the initial endoscopic examination of the stomach. While this lesion ran its course resulting in malignant change in three years, cancers were found in the colon and esophagus. Colon polypectomy, esophagectomy, and total gastrectomy were performed. Depth of invasion of cancer cells was shown to be sm, mm, and m for the colon, eshophagus, and stomach, respectively.

　In the leiterature, only four cases including the present one have been reported in which triple cancers in the gastrointestinal tract were demonstrated involving the esophagus, stomach and colon. However, three other cases so far reported had advanced cancers. Therefore, our case is the first one in which all triple cancers were at early stage.