Two cases of early esophageal carcinoma
Onizuka, S.; Ito, M.; Sekine, I.; Yamaguchi, S.; Shinozaki, T.; Hayashi, T.
Nagasaki Igakkai Zasshi 67(4): 26, 277-279
1992
Accession: 009682961
Two cases of early esophageal cancer were reported. Case 1: A 65-year-old man received further examination for appetite loss. Esophagogram and endoscopic findings revealed a small flat lesion (0 - IIb) on the middle intrathoracic esophagus (Im). "Pull through" esophagectomy without thoracotomy was performed. The resected specimen has a flat geographic lesion, 8 times 6 mm in size and non-staining lesion by Lugol staining method. Histopathological findings demonstrated moderately differentiated squamous cell carcinoma invading the muscularis mucosa (mm), with no involvement of vessels and lymphatics and no regional lymph nodes metastases. Case 2: 67-year-old man received an endoscopic examination because of dysphagia. A polypoid lesion of 4.0 times 5.0 cm in size was found by endoscopy and radical operation was performed. Macroscopical study revealed not only polypoid lesion (0 - I p) detected by endoscopy but also flat lesion (0 - II b) close to the polypoid lesion. Pathological findings showed moderately differentiated squamous cell carcinoma, invading the muscularis mucosa (mm) in the lesion of 0 - I p and the epithelium (ep) in the lesion of 0 - II b. Early esophageal cancer more than 4.0 cm in size, which is 0 - I type and confined to the mucosa, is rare. Lugol staining method in routine endoscopic examination is a useful technique that contributes in the detection of "mm" cancer and also to improve the survival rate of the patients with esophageal cancer. "Pull through" esophagectomy technique may be indicated for small early esophageal cancer that is limited to mm with no lymph nodes metastasis.