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Endoscopic Studies on Oral Side Invasions of Esophageal Carcinoma T. Kouzu 1 , H. Sato 1 , H. Takahashi 1 , K. Onozawa 1 , K. Kuga 1 1Second Surgical Department, Chiba University, School of Medicine pp.1371-1378
Published Date 1975/10/25
DOI https://doi.org/10.11477/mf.1403112262
  • Abstract
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 Precise endoscopic confirmation of oral side invasion of esophageal carcinoma is very useful for deciding the resective line and irradiation field, and moreover is one of the important measures for finding out early carcinoma and for promoting therapeutic results.

 We classified the oral side changes accompanying esophageal carcinoma into slight small elevation, fold-like elevation, erosion and flat changes, such as reddening, roughness, discoloration and hardening.

 We studied endoscopically and histologically the oral side changes of 134 cases of thoracic esophageal carcinoma in our 9 years' experience, excluding adenocarcinoma in histological type. For confirming the lesions, we used the pre-operative mucosal tattooing.

 Slight small elevations, proven to be malignant histologically, are mostly yellow or not different from surrouuding tissues in color, and are in size over rice grain and have ill-defined margin. When the carcinoma is exposed over the epithelial layer, the elevation becomes white and its margin becomes welldefined. We experienced a lesion of intramural metastasis 9 cm orally apart from the maintumor.

 Malignant fold-like elevation has a shift of the origin over to the oral side of the main tumor center. When the origin is situated on the margin, it has yellow elevation on a fold or a widening of folds.

 Malignant erosions are mostly observed already before pre-operative irradiation, and they are welldefined in margin and slightly or moderately reddened and are observed in a lesion with wide area. They are often observed at some distance from the main tumor, in one case even 6 cm orally.

 Flat lesions are not usually observed singly. They rea seen as reddening in carcinoma in situ and as discoloration or hardening in subepithelial cancer infiltration. Preoperative confirmation of submucosal cancer infiltration reems to be future problems for endoscopic examination.


Copyright © 1975, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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