根治手術後急速な転帰をとった食道小細胞癌の1例
進行食道小細胞癌に対して術前化学療法を行い，down stagingののち根治手術をしえたものの，術後急速に肝転移が出現し術後46日で死亡した症例を経験した．症例は66歳，男性．右反回神経リンパ節転移を伴った食道癌の診断で術前化学療法を施行後，食道癌根治術を行った．術後の病理検査で食道小細胞癌と診断された．術後1カ月ごろより肝転移，骨転移が出現，その後状態が急速に増悪し術後46日で肝不全のため死亡した．食道小細胞癌は，一般的に悪性度が高く予後は不良であるため，本症例のように臨床的に明らかにリンパ節転移のある進行癌症例についての手術療法は特に慎重であるべきと考えられた．...
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| Published in | 日本臨床外科学会雑誌 Vol. 69; no. 5; pp. 1053 - 1057 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床外科学会
2008
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-2843 1882-5133 |
| DOI | 10.3919/jjsa.69.1053 |
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| Abstract | 進行食道小細胞癌に対して術前化学療法を行い，down stagingののち根治手術をしえたものの，術後急速に肝転移が出現し術後46日で死亡した症例を経験した．症例は66歳，男性．右反回神経リンパ節転移を伴った食道癌の診断で術前化学療法を施行後，食道癌根治術を行った．術後の病理検査で食道小細胞癌と診断された．術後1カ月ごろより肝転移，骨転移が出現，その後状態が急速に増悪し術後46日で肝不全のため死亡した．食道小細胞癌は，一般的に悪性度が高く予後は不良であるため，本症例のように臨床的に明らかにリンパ節転移のある進行癌症例についての手術療法は特に慎重であるべきと考えられた． |
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| AbstractList | 進行食道小細胞癌に対して術前化学療法を行い，down stagingののち根治手術をしえたものの，術後急速に肝転移が出現し術後46日で死亡した症例を経験した．症例は66歳，男性．右反回神経リンパ節転移を伴った食道癌の診断で術前化学療法を施行後，食道癌根治術を行った．術後の病理検査で食道小細胞癌と診断された．術後1カ月ごろより肝転移，骨転移が出現，その後状態が急速に増悪し術後46日で肝不全のため死亡した．食道小細胞癌は，一般的に悪性度が高く予後は不良であるため，本症例のように臨床的に明らかにリンパ節転移のある進行癌症例についての手術療法は特に慎重であるべきと考えられた． |
| Author | 西村, 透 金田, 邦彦 和田, 隆宏 千堂, 宏義 中村, 吉貴 |
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| References | 1) McKeown F : Oat cell carcinoma of the esophagus. J Pathol Bacteriol 64 : 889-891, 1952 5) Nishimaki T, Suzuki T, Fukuda T, et al : Primary small cell carcinoma of the esophagus with ectopic gastrin production : Report of a case and review of the literature. Dig Dis Sci 38 : 767-771, 1993 6) Brenner B, Tang LH, Klimstra DS, et al : Small-cell carcinomas of the gastrointestinal tract. A review J Clin Oncol 22 : 2730-2739, 2004 13) Hosokawa A, Shimada Y, Matsumura Y, et al : Small cell carcinoma of the esophagus. Analysis of 14 cases and literature review. Hepato-gastroenterology 52 : 1738-1741, 2005 3) Huncharek M, Muscat J : Small cell carcinoma of the esophagus. The Massachusetts General Hospital experience. 1978 to 1993. Chest 107 : 179-181, 1995 12) 渡辺茂樹，宇田川郁夫，石田康生:カルボプラチン，エトポシドを用いた化学放射線療法にて長期生存中の食道小細胞癌の1例．日消誌 101:1217-1220，2004 2) Nichols GL, Kelsem DP : Small cell carcinoma of the esophagus. The memorial hospital experience 1970 to 1987. Cancer 64 : 1531-1533, 1989 17) Yau KK, Siu WT, Wong DCT, et al : Non-operative management of small cell carcinoma of esophagus. Dis Esophagus 20 : 487-490, 2007 16) Brenner B, Shah MA, Gonen M, et al : Small-cell carcinoma of the gastrointestinal tract : a retrospective study of 64 cases. Br J Cancer 90 : 1720-1726, 2004 11) 後藤利博，渡部宏嗣，川上高幸他:イリノテカンとシスプラチンの併用化学療法が著効した進行食道小細胞癌の1例．日消誌 104:1204-1211，2007 15) 杉浦功一，小澤壯治，北川雄光他:食道小細胞癌の1切除例と文献報告例の検討．日消外会誌 37:123-129，2004 18) Ku GY, Minsky BD, Rusch VW, et al : Small-cell carcinoma of the esophagus and gastroesophageal junction : review of the Memorial Sloan-Kettering experience. Ann Oncol 19 : 533-537, 2008 10) 辻江正徳，柴田信博，野村 孝他:化学療法にて完全緩解が得られ23ヵ月生存したStageIV b食道癌の1例 癌と化療 30:271-275，2003 7) Kelsen DP, Weston E, Kurtz R, et al : Small-cell carcinoma of the esophagus. Treatment by chemotherapy alone. Cancer 45 : 1558-1561, 1980 8) Medgyesy DC, Wolff RA, Putnam JB, et al : Small cell carcinoma of the esophagus. The university of Texas M.D. Anderson cancer center experience and literature review. Cancer 88 : 262-267, 2000 9) Law SYK, Fok M, Lam KY, et al : Small cell carcinoma of the esophagus. Cancer 73 : 2894-2899, 1994 19) Torii K, Kawabe J, Hayashi T, et al : A case of small cell carcinoma of the esophagus detected incidentally by FDG-PET. Ann Nucl Med 18 : 699-702, 2004 4) Casas F, Ferrer F, Farrus B, et al : Primary small cell carcinoma of the esophagus. A review of the literature with emphasis on therapy and prognosis. Cancer 80 : 1366-1372, 1997 14) Bennouna J, Bardet E, Deguiral P, et al : Small cell carcinoma of the esophagus. Analysis of 10 cases and review of the published data. Am J Cin Oncol 23 : 455-459, 2000 |
| References_xml | – reference: 14) Bennouna J, Bardet E, Deguiral P, et al : Small cell carcinoma of the esophagus. Analysis of 10 cases and review of the published data. Am J Cin Oncol 23 : 455-459, 2000 – reference: 1) McKeown F : Oat cell carcinoma of the esophagus. J Pathol Bacteriol 64 : 889-891, 1952 – reference: 4) Casas F, Ferrer F, Farrus B, et al : Primary small cell carcinoma of the esophagus. A review of the literature with emphasis on therapy and prognosis. Cancer 80 : 1366-1372, 1997 – reference: 6) Brenner B, Tang LH, Klimstra DS, et al : Small-cell carcinomas of the gastrointestinal tract. A review J Clin Oncol 22 : 2730-2739, 2004 – reference: 13) Hosokawa A, Shimada Y, Matsumura Y, et al : Small cell carcinoma of the esophagus. Analysis of 14 cases and literature review. Hepato-gastroenterology 52 : 1738-1741, 2005 – reference: 16) Brenner B, Shah MA, Gonen M, et al : Small-cell carcinoma of the gastrointestinal tract : a retrospective study of 64 cases. Br J Cancer 90 : 1720-1726, 2004 – reference: 2) Nichols GL, Kelsem DP : Small cell carcinoma of the esophagus. The memorial hospital experience 1970 to 1987. Cancer 64 : 1531-1533, 1989 – reference: 8) Medgyesy DC, Wolff RA, Putnam JB, et al : Small cell carcinoma of the esophagus. The university of Texas M.D. Anderson cancer center experience and literature review. Cancer 88 : 262-267, 2000 – reference: 5) Nishimaki T, Suzuki T, Fukuda T, et al : Primary small cell carcinoma of the esophagus with ectopic gastrin production : Report of a case and review of the literature. Dig Dis Sci 38 : 767-771, 1993 – reference: 9) Law SYK, Fok M, Lam KY, et al : Small cell carcinoma of the esophagus. Cancer 73 : 2894-2899, 1994 – reference: 17) Yau KK, Siu WT, Wong DCT, et al : Non-operative management of small cell carcinoma of esophagus. Dis Esophagus 20 : 487-490, 2007 – reference: 3) Huncharek M, Muscat J : Small cell carcinoma of the esophagus. The Massachusetts General Hospital experience. 1978 to 1993. Chest 107 : 179-181, 1995 – reference: 7) Kelsen DP, Weston E, Kurtz R, et al : Small-cell carcinoma of the esophagus. Treatment by chemotherapy alone. Cancer 45 : 1558-1561, 1980 – reference: 11) 後藤利博，渡部宏嗣，川上高幸他:イリノテカンとシスプラチンの併用化学療法が著効した進行食道小細胞癌の1例．日消誌 104:1204-1211，2007 – reference: 10) 辻江正徳，柴田信博，野村 孝他:化学療法にて完全緩解が得られ23ヵ月生存したStageIV b食道癌の1例 癌と化療 30:271-275，2003 – reference: 12) 渡辺茂樹，宇田川郁夫，石田康生:カルボプラチン，エトポシドを用いた化学放射線療法にて長期生存中の食道小細胞癌の1例．日消誌 101:1217-1220，2004 – reference: 18) Ku GY, Minsky BD, Rusch VW, et al : Small-cell carcinoma of the esophagus and gastroesophageal junction : review of the Memorial Sloan-Kettering experience. Ann Oncol 19 : 533-537, 2008 – reference: 19) Torii K, Kawabe J, Hayashi T, et al : A case of small cell carcinoma of the esophagus detected incidentally by FDG-PET. Ann Nucl Med 18 : 699-702, 2004 – reference: 15) 杉浦功一，小澤壯治，北川雄光他:食道小細胞癌の1切除例と文献報告例の検討．日消外会誌 37:123-129，2004 |
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| Title | 根治手術後急速な転帰をとった食道小細胞癌の1例 |
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