喉摘者検診で発見された早期肺癌（重複癌）の1症例

Early Lung Cancer (Multiple Primary Cancer) in a Patient with Laryngeal Carcinoma:Report of a Case

　I．はじめに

　近年悪性腫瘍の診断，治療の進歩に伴う早期発見，早期治療により治癒および長期生存しうる症例が数多くみられるようになった。その一方治癒に伴う患者の高齢化などのために他の悪性腫瘍との合併例，いわゆる重複癌の症例が増加している。このため第一癌を治療後，局所再発および転移病変ばかりでなく，第二癌の発生も考慮した注意深い経過観察が重要となってくる。今回，第一癌である喉頭の扁平上皮癌術後経過観察中に，喀痰細胞診にて肺癌を早期に発見し，第二癌に対しても根治治療し得た1例を経験したので報告する。

Early lung cancer was found by sputum cytol-ogy and bronchofiberscopy in the postoperative follow-up of a patient who had received total laryngectomy for laryngeal carcinoma. Although both lesions were squamous cell carcinoma histo-logically, the pulmonary lesion was diagnosed as a second primary malignancy rather than a meta-static lesion, because of its location and differ-ence in the pathological differentiation. The pulmonary lesion was successfully treated by left upper lobectomy.

Sputum cytology and endoscopy of high risk areas should be advocated as screening examina-tions for second primary malignancy in the patients with head and neck cancer.