6年間の経過で増大した十二指腸腺腫内癌の1例

Duodenal Cancer Enlargement Over a Six-year Period, Report of a Case

要旨●患者は，70歳代，女性．検診目的で近医を受診し，上部内視鏡検査で十二指腸球部に大きさ約10mm，発赤調の亜有茎性病変を認めたため，精査目的で当科に紹介され受診となった．低異型度腺腫と診断し内視鏡治療を勧めたが，症状もなく心疾患などの合併症もあるため経過観察を希望された．以後，6か月〜1年ごとの内視鏡検査による定期経過観察となった．6年後，大きさは約30mmに増大し，食後の上腹部不快感も出現したため内視鏡治療を施行した．病理組織学的診断は，0-Isp，well differentiated tubular adenocarcinoma in tubulovillous adenomaで，粘液形質は胃腺窩上皮型であった．このように6年間の定期的な経過観察を行い，顕著な増大を認めた十二指腸腺腫内癌を経験したので報告する．

　A female in her 70s, was referred to our department for a detailed examination. An erythematous raised lesion of 〜10mm in size was found in the duodenal bulb on upper endoscopy that was diagnosed as an adenoma, requiring endoscopic treatment. She had no symptoms or underlying diseases, such as heart disease, so follow-up was requested. Six years later, she complained of upper abdominal discomfort after eating, and the size of the lesion had increased to 〜30mm, requiring endoscopic treatment. The histopathological diagnosis was a 0-Isp, well-differentiated tubular adenocarcinoma in a tubulovillous adenoma of the gastric phenotype.