短期間に急速に増大した咽頭表在癌の症例

A Case of Superficial Pharyngeal Carcinoma which Rapidly Enlarged in a Limited Period of Time

要旨●患者は60歳代，男性．Barrett食道表在癌に対する内視鏡治療後のため，定期的に上部消化管内視鏡検査を施行していた．Barrett食道表在癌治療7年後に，中咽頭右側壁に2mm程度の白色調の付着物を有する淡いbrownish areaを認めた．咽頭病変の指摘から6か月後の内視鏡検査では，NBI観察で茶色の色調がやや目立つようになったものの，サイズや形態に大きな変化は認めなかった．咽頭病変指摘から1年3か月後，サイズが増大し，病変に厚みのある発赤調の平坦隆起へ急速に形態が変化した．経口的切除術を施行し，切除組織は上皮下層へ浸潤する病巣の厚み300μmの扁平上皮癌であった．

　The patient was a male in his 60s who had been undergoing regular upper gastrointestinal endoscopy after endoscopic treatment for superficial Barrett's esophageal cancer. Seven years after the treatment, a pale brownish area approximately 2mm in size was found on the right wall of the oropharynx. Six months after the pharyngeal lesion was identified, no significant change in size or shape was observed on endoscopy although the brownish color was slightly more obvious on narrow-band imaging examination. One year and three months after the pharyngeal lesion was identified, the lesion became enlarged, and its shape changed abruptly to a flattened elevated lesion with a thick surface. The lesion was excised with an oral resection. Pathological results showed that the lesion was a 300-μm thick squamous cell carcinoma invading the subepithelial layer.