A case of intraepithelial carcinoma of the esophagus found by endoscopic examination for the follow-up of duodenal ulcer.

UCHIDA Yuzo, TOMONARI Kazuhide, SHIGEMITSU Osamu, HADAMA Tetsuo, SHIBATA Okihiko, SHIRABE Joji, MATSUMOTO Kozo, YOKOYAMA Shigeo, FURUSAW Takeshi

doi:10.11280/gee1973b.28.3118

A 60-year-old male had been under medication for his duodenal ulcer for 4 years and examined endoscopically 4 times a year. He visited our clinic this time complaining epigastralgia. Endoscopic examination revealed a nail-size hyperemic lesion 38 cm deep from the incisors. This lesion was not stained by Lugol staining method. Histology of the biopsy specimens taken from this lesion revealed squamous cell carcinoma. Therefore, the intrathoracic esophagus was removed followed by dissection of the lymph nodes. In the resected esophagus, there was found a lesion of superficial flat type, 2.5 by 2.0 cm in size, with unclear margin and slightly uneven mucosal surface. The esophageal mucous membrane of this lesion could not be stained by Lugol staining method. Histological specimens from this lesion demonstrated poorly differentiated squamous cell carcinoma with the intact basement membrane in the epithelial layer. In order to find esophageal cancer in the stage of intraepithelial carcinoma, it is obligatory to carry out screening tests of the upper digestive organs, not only for those who complain swallowing disturbance, but also for those who have other digestive disturbances, even if they fail to complain. And endoscopic examination is the first choice among many screening tests. In addition, endoscopic test using Lugol staining method and brushing cytology with capsule are also valuable in detection of intraepithelial cancer of the esophagus.

A case of intraepithelial carcinoma of the esophagus found by endoscopic examination for the follow-up of duodenal ulcer.

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