[症例報告]アカラシア術後30年目に発生した食道癌の1例

概要

論文の詳細を見る
A case of esophageal carcinoma occurring 30 years after an operation for achalasia in a 77-year-old female is reported. Her past history revealed that she had been operated for esophageal achalasia at the age of 47 years. She became aware of a mild dysphagia in January, 1993, and a serial upper gastrointestinal barium examination at a local hospital showed a diffuse, tortuous dilatation of the esophagus (achalasia, sigmoid type) , and an ulcerative and localized tumor of the upper intrathoracic esophagus. She was referred to the University Hospital on January 18, and was diagnosed as having esophageal carcinoma associated with achalasia. A transthoracic esophagectomy was carried out. On histopathologic examination, the tumor was moderately differentiated squamous cell carcinoma with scattered areas of moderate dysplasia in the middle and lower intrathoracic esophagus. Almost all of the ganglion cells of Auerbach's plexus were degenerated or disappeared throughout the esophagus. Since achalasia is a high risk condition for carcinoma of the esophagus, and only fairly advanced or large tumors could develop their own symptoms in the dilated esophagus, patients with achalasia should be carefully examined at least once a year with endoscopy to detect carcinoma in the earlier stage.
琉球医学会,Ryukyu Medical Associationの論文