再発性早期胃管癌に合併した下咽頭梨状陥凹癌の1例

A case of pyriform sinus cancer with recurrent early stage gastric tube cancer in the reconstructed gastric tube

はじめに

　近年，内視鏡機器が発達し，narrow band imaging（NBI）により病巣をbrownish areaとして認識することで，より早期の咽頭癌の発見が増えてきている^1）。また，食道癌の治療成績の向上に伴い胃管癌の検出が認められるようになったが，胃管癌の経過観察中に下咽頭癌が同時に発見された報告は少ない。

　今回われわれは，食道癌術後に再発を繰り返す胃管癌の経過観察中に下咽頭梨状陥凹癌が発生し，当院消化器内科と同時手術を施行した1例を経験したので，文献的考察を加えて報告する。

　We treated a case of pyriform sinus cancer with recurrent early stage gastric tube cancer in the reconstructed gastric tube. A 75-year-old man presented with no subjective symptoms.

　Since the total thoracic esophagectomy and the gastric tube reconstruction 10 years ago, the patient frequently had recurrence of cancer in the gastric tube, and treated.

　In this time, recurrence of gastric cancer and hypopharyngeal cancer were found simultaneously. Therefore, the endoscopic laryngopharyngeal surgery and the endoscopic submucosal laceration were performed in our hospital.

　The gastric acid reflux after the esophageal cancer reconstruction can be a new risk factor for hypopharyngeal cancer.