頸部食道に発生した巨大な脂肪腫の1例

A case of giant lipoma in cervical esophagus

Ⅰ．はじめに

　食道腫瘍は他の消化管と比べて良性腫瘍の頻度が低い^1）。食道良性腫瘍の大部分は平滑筋腫であり，これに対して食道脂肪腫は稀な疾患でわが国での報告例も少ない^2）。治療は，発生部位，腫瘍の大きさ，茎の太さなどにより選択される。一般的には内視鏡的切除が治療の第1選択であるが，それが困難な場合は，外切開による摘出術が行われることもある。今回われわれは，硬性食道直達鏡下に摘出しえた巨大な頸部食道脂肪腫の1例を経験したので，若干の文献的考察を加えて報告する。

　A 70-year-old man presented with a foreign body sensation on deglutition for 30 years. An esophageal tumor was found in upper digestive tract endoscopy performed by a previous physician, and the patient was referred to our department. Endoscopic examination, barium contrast X-ray, and esophageal ultrasonography revealed a soft smooth-surfaced pedunculated tumor arising from the cervical esophagus and extending to the middle thoracic esophagus. The tumor showed a low X-ray absorbance with CT value of-63HU. Under the diagnosis of esophageal lipoma, he underwent resection of the tumor through a rigid esophagoscope with the assistance of flexible endoscope and laparoscopic electrocautery. The tumor was successfully resected, and the postoperative course was uneventful. We stress that this surgical technique is useful for safe and minimally-invasive resection of such esophageal tumors.