Superficial pT1b-SM2 Esophageal Squamous Cell Carcinoma with Lymphnode Metastasis after ESD followed by Chemoradiotherapy, Report of a Case Manabu Takeuchi 1 , Takashi Kato 2 , Junji Kohisa 1 , Aiko Yoshioka 3 , Takeshi Ito 4 , Hiroyuki Usuda 5 , Yoichi Ajioka 2 1Department of Gastroenterology, Nagaoka Red Cross Hospital, Nagaoka, Japan 2Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan 3Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan 4Department of Radiology, Nagaoka Red Cross Hospital, Nagaoka, Japan 5Department of Pathology, Nagaoka Red Cross Hospital, Nagaoka, Japan Keyword: 表在型食道癌 , ESD , 化学放射線療法 , JCOG0508試験 , CK7 pp.1295-1302
Published Date 2020/9/25
DOI https://doi.org/10.11477/mf.1403202142
  • Abstract
  • Look Inside
  • Reference

 A man in his 60s undergoing conventional esophagoscopy for surveillance was found to have a deeply depressed lesion(7mm)with marginal elevation. After observation with insufficient air supply, the lesion had no vertical fold and a firm consistently because of the loss of change in form. Narrow-band imaging with magnification of the depressed area revealed Type B2 microvessels throughout, and endoscopic ultrasound showed that the low echoic lesion extended around the muscular layers, suggesting a massive invasion of the submucosal layer. ESD(endoscopic submucosal dissection)followed by CRT(chemoradiotherapy)was planned according to the study protocols(study ID JCOG0508). Histopathology revealed poorly differentiated squamous cell carcinoma with massive submucosal invasion, infiltrative growth pattern, and lymphovascular involvement. Immunohistochemistry showed diffuse cytokeratin 7. Although additional CRT was applied(RT 40 Gy including Long T field, FP 2 course), multiple lymph node metastases in the radiotherapy field occurred 8 months after CRT. The patient died of primary cancer at 22 months after ESD despite additional chemotherapy.

Copyright © 2020, Igaku-Shoin Ltd. All rights reserved.


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