3年5か月逆追跡した食道癌の1例

Retrospective Study of Esophageal Cancer, Report of a Case Followed-up for Three Years and Five Months

要旨　患者は57歳，男性．3年3か月前に，下咽頭癌で手術．その手術の2か月前に第1回のX線検査をした．retrospectiveにみると，下部食道に陥凹性の病変を疑わせる所見がみられた．しかし，その後，約3年間にわたり3回のX線検査が行われたが，特に所見は指摘できなかった．ところが，嚥下困難を訴えてきたため，第5回のX線検査をしたところ，下部食道に約9cmにわたる全周性の食道癌を発見した．このような見逃し症例をなくすためには，X線装置や造影剤を改良すると共に，造影剤がよく付着し，適度に伸展した二重造影像を撮影することが必要である．

　A 57-year-old man complaining of dysphagia was operated on for hypopharyngeal cancer, often barium study of the esophagus revealed an annular carcinoma in the lower esophagus (Fig. 5).

　Three years and three months prior to the final diagnosis the first barium study had been performed and, speaking retrospectively, it can be said that, at that time, there were findings suggestive of a depressed type cancer in the lower esophagus (Fig. 1 a, b).

　During the next three years, barium studies were repeated three times but no abnormal findings were able to be pointed out in the x-ray films (Figs. 2-4).

　The diagnosis of cancer in this case was made only in the later stage of its development. To ensure that early diagnosis can be made, it is necessary to improve x-ray apparatus and barium suspension quality. It is also necessary to take double contrast radiographs of the esophagus properly distended, and well coated with barium.