内容紹介
Summary
This is a case of a 72-year-old woman who presented without any major complaint. An anemia was indicated during follow-up for diabetes at the internal medicine unit and an upper gastrointestinal endoscopy(GS)was performed. A type 2 tumor was detected in the middle thoracic esophagus and biopsy revealed a squamous cell carcinoma. A tumor was detected in the middle thoracic esophagus by cervical thoracoabdominal computed tomography(CT)scan and no invasion of surrounding organs was noted. The lymph node 104R had enlarged significantly but no distant metastasis was observed. The patient was diagnosed with advanced esophageal cancer, Mt, type 2, cT2N2M0, stageⅡ. For preoperative chemotherapy, CDDP plus 5-FU(FP)therapy was administered. Lung metastasis was found on CT examination and surgical resection was not indicated. Hence, 4 courses of docetaxel plus CDDP plus 5-FU(DCF)therapy were administered. Following treatment, lung and lymph node metastases disappeared on the image. However, the main tumor remained at the GS. Radiotherapy was administered as a local additional treatment. Thereafter, GS showed mucous membrane redness and white spots of the lesion. Biopsy from the same site showed no malignant findings. The patient has remained malignancy-free since 18 months.
要旨
症例は72歳,女性。主訴はなし。近医で糖尿病の経過観察中に貧血を指摘され,上部消化管内視鏡検査を施行した。胸部中部食道に2型病変を認め,生検で中分化扁平上皮癌と診断された。造影CT検査で胸部中部食道に腫瘍を認め,周囲臓器への浸潤はなかった。104Rリンパ節が有意に腫大していたが,遠隔転移は認めなかった。以上から,進行食道癌,Mt,type 2,cT2N2M0,stageⅡと診断された。術前化学療法としてFP療法を施行した。評価の造影CT検査で肺転移を認め,外科的切除の適応外となり,DCF療法を4コース施行した。化学療法施行後,肺転移巣およびリンパ節転移巣は画像上消失した。GSでは主病変に腫瘍遺残を認めた。局所病変への追加治療として放射線治療を施行した。放射線治療後にGSを施行し,粘膜の発赤と白苔を認め,同部位からの生検では悪性所見は認めなかった。現在,外来にて18か月無再発生存で経過観察中である。
目次
This is a case of a 72-year-old woman who presented without any major complaint. An anemia was indicated during follow-up for diabetes at the internal medicine unit and an upper gastrointestinal endoscopy(GS)was performed. A type 2 tumor was detected in the middle thoracic esophagus and biopsy revealed a squamous cell carcinoma. A tumor was detected in the middle thoracic esophagus by cervical thoracoabdominal computed tomography(CT)scan and no invasion of surrounding organs was noted. The lymph node 104R had enlarged significantly but no distant metastasis was observed. The patient was diagnosed with advanced esophageal cancer, Mt, type 2, cT2N2M0, stageⅡ. For preoperative chemotherapy, CDDP plus 5-FU(FP)therapy was administered. Lung metastasis was found on CT examination and surgical resection was not indicated. Hence, 4 courses of docetaxel plus CDDP plus 5-FU(DCF)therapy were administered. Following treatment, lung and lymph node metastases disappeared on the image. However, the main tumor remained at the GS. Radiotherapy was administered as a local additional treatment. Thereafter, GS showed mucous membrane redness and white spots of the lesion. Biopsy from the same site showed no malignant findings. The patient has remained malignancy-free since 18 months.
要旨
症例は72歳,女性。主訴はなし。近医で糖尿病の経過観察中に貧血を指摘され,上部消化管内視鏡検査を施行した。胸部中部食道に2型病変を認め,生検で中分化扁平上皮癌と診断された。造影CT検査で胸部中部食道に腫瘍を認め,周囲臓器への浸潤はなかった。104Rリンパ節が有意に腫大していたが,遠隔転移は認めなかった。以上から,進行食道癌,Mt,type 2,cT2N2M0,stageⅡと診断された。術前化学療法としてFP療法を施行した。評価の造影CT検査で肺転移を認め,外科的切除の適応外となり,DCF療法を4コース施行した。化学療法施行後,肺転移巣およびリンパ節転移巣は画像上消失した。GSでは主病変に腫瘍遺残を認めた。局所病変への追加治療として放射線治療を施行した。放射線治療後にGSを施行し,粘膜の発赤と白苔を認め,同部位からの生検では悪性所見は認めなかった。現在,外来にて18か月無再発生存で経過観察中である。