食道・胃重複癌術後，異時性頬部・遺残食道癌治療の1例

After Operative Synchronous Double Cancer of the Esophagus and Stomach, Metachronous Buccal Cancer and Multiple Cancers of the Residual Esophagus, Report of a Case

　患者は66歳，男性．進行食道癌と早期胃癌の診断で，1993年6月左開胸開腹下部食道胃全摘術施行した．経過観察中，早期頬粘膜癌が発生し，1995年3月他院口腔外科にて腫瘍切除術施行された．1995年6月より，遺残食道に粘膜内癌が異時性に多発し，計4回5病変に対し内視鏡的粘膜切除術(EMR)施行し治療しえた．頭頸部癌と食道癌の同時性・異時性重複癌の発生頻度は高いとされており，頭頸部および食道の定期的な検査は必須と言える．そのことが早期の癌の発見につながり，低侵襲な治療が可能となる．

　The patient was a 66-year-old male addicted to heavy smoking and drinking. We detected synchronous double cancer of the esophagus and stomach, so we performed lower esophagectomy and total gastrectomy. Two years after this operation, an early cancer of the buccal mucosa was detected and was operated on. In addition, we detected superficial cancer of the residual esophagus and performed endoscopic mucosal resection. Since this episode, multiple and metachronous superficial cancer of the residual esophagus has been detected three times. We performed endoscopic mucosal resection for these lesions. He probably had some risk factor of multiple and metachronous cancers. This case shows the importance of periodic endoscopic follow-up for patients with head and neck cancers. Early detection of multiple and metachronous cancers enables patients to be cured with minimal invasive therapy.