内容紹介
Summary
A 56-year-old man was diagnosed with advanced adenocarcinoma of the esophagogastric junction. He received 1 course of neoadjuvant chemotherapy with S-1. After neoadjuvant chemotherapy, the primary tumor showed a remarkable decrease in size. Subtotal esophagectomy, D2 lymph node dissection, and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed that most of the cancer cells had been destroyed, with a part where adenocarcinoma mucosa was seen. We successfully treated a case of advanced adenocarcinoma of the esophagogastric junction, with neoadjuvant S-1 chemotherapy and surgical resection.
要旨
症例は56歳,男性。検診にて,腹部食道壁の不整を指摘され,精査で食道胃接合部癌[Siewert TypeⅠ,cT2,N0M0,StageⅡ(食道癌取扱い規約第10版に準じる)]と診断した。術前化学療法(S-1 100 mg,2週間内服,3週間休薬。1コース施行)を施行し,著明な縮小を認めた。右開胸開腹食道亜全摘出術+高位胸腔内食道胃管吻合,2領域リンパ節郭清を施行した。病理組織学的所見: adenocarcinoma of the esophagogastric junction,post chemotherapy,E=G,ypT1a(m),pN0(0/13),ly0,v0,Grade 2。術後経過良好で外来経過観察中である。食道胃接合部腺癌に対するS-1による術前化学療法は簡便であり,有用な治療法となり得ることが示唆された。
目次
A 56-year-old man was diagnosed with advanced adenocarcinoma of the esophagogastric junction. He received 1 course of neoadjuvant chemotherapy with S-1. After neoadjuvant chemotherapy, the primary tumor showed a remarkable decrease in size. Subtotal esophagectomy, D2 lymph node dissection, and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed that most of the cancer cells had been destroyed, with a part where adenocarcinoma mucosa was seen. We successfully treated a case of advanced adenocarcinoma of the esophagogastric junction, with neoadjuvant S-1 chemotherapy and surgical resection.
要旨
症例は56歳,男性。検診にて,腹部食道壁の不整を指摘され,精査で食道胃接合部癌[Siewert TypeⅠ,cT2,N0M0,StageⅡ(食道癌取扱い規約第10版に準じる)]と診断した。術前化学療法(S-1 100 mg,2週間内服,3週間休薬。1コース施行)を施行し,著明な縮小を認めた。右開胸開腹食道亜全摘出術+高位胸腔内食道胃管吻合,2領域リンパ節郭清を施行した。病理組織学的所見: adenocarcinoma of the esophagogastric junction,post chemotherapy,E=G,ypT1a(m),pN0(0/13),ly0,v0,Grade 2。術後経過良好で外来経過観察中である。食道胃接合部腺癌に対するS-1による術前化学療法は簡便であり,有用な治療法となり得ることが示唆された。