Coexistence of esophageal superficial carcinoma and multiple leiomyomas:A case report  

作　　者：Takeshi Iwaya Chihaya Maesawa Noriyuki Uesugi Toshimoto Kimura Kenichiro Ikeda Yusuke Kimura Shingo Mitomo Kaoru Ishida Nobuhiro Sato Go Wakabayashi 

机构地区：[1]Departments of Surgery Ⅰ,Iwate Medical University School of Medicine,Uchimaru 19-1,Morioka 020-8505,Japan [2]Departments of Pathology,Iwate Medical University School of Medicine,Uchimaru 19-1,Morioka 020-8505,Japan [3]Division of Pathology,Central Clinical Laboratory,Iwate Medical University School of Medicine,Uchimaru 19-1,Morioka 020-8505,Japan [4]Critical Care Medicine,Iwate Medical University School of Medicine,Uchimaru 19-1,Morioka 020-8505,Japan

出　　处：《World Journal of Gastroenterology》2006年第28期4588-4592,共5页世界胃肠病学杂志（英文版）

摘　　要：Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.平滑肌瘤是食管的最普通的良性瘤。他们通常作为单个损害或作为二或三个小瘤发生。仅仅包括超过 10 个小瘤的食道的多重平滑肌瘤的二个案例以前被报导了。而且，有食道的有鳞的房间癌覆闷死粘膜下层肿瘤的很少报告。我们描述作为有表面的食道的癌症与二或三个平滑肌瘤小瘤共存被诊断的一个 71 岁的人。在外科期间， 10 或一直不外科手术前地是明显的更多的小瘤在整个食管在粘膜下层和肌层是摸得出的。当食道的癌症的内部转移被怀疑，我们认为另外的淋巴是腺切除术，但是因为病人的严重血缺氧，不得不排除这种选择。显微镜检查表明所有小瘤是平滑肌瘤(20 损害，在直径的多达 3 厘米) ，并且癌房间的那侵略被限制到粘膜下层层 overlying 一个相对大的平滑肌瘤。这是与众多的独居的平滑肌瘤共存的表面的食道的癌症的第一份报告。多重极小的平滑肌瘤经常也在一个癌损害罐头的底作为内部转移，和一个平滑肌瘤被误诊作为肿瘤侵略被误诊。现在的案例证明那精确诊断与共存为病人的管理被要求表面的食道的癌症和多重平滑肌瘤。

关 键 词：Multiple leiomyomas Squamous cell carcinoma ESOPHAGUS COEXISTENCE 

分 类 号：R735.1[医药卫生—肿瘤]