A case of endocrine cell carcinoma of the esophagus with gastric adenocarcinoma successfully treated by chemotherapy

症例は70歳代,男性.約1ヵ月前より嚥下困難を認め,近医を受診.上部消化管内視鏡検査で胸部上部~下部食道に管腔のほぼ全周を占める3型腫瘍と胃角部小弯に5cm大の0-IIc型腫瘍を認めた.生検で食道内分泌細胞癌,胃低分化型腺癌と診断.3領域の多発リンパ節転移と多発肝転移を伴っていた.切除不能と判断しCPT-11+CDDP併用療法を開始.食道病変,胃病変および転移巣は縮小したが,腎機能障害を認めた.そのため,CPT-11+CBDCA併用療法に変更し治療を継続したところ,腫瘍はさらに縮小した.診断から9ヵ月後の現在,増悪なく経過中である.食道内分泌細胞癌は比較的まれな疾患であり,胃腺癌の合併も非常にまれである.有効な化学療法は確立されていないが,今回肺小細胞癌に準じた化学療法を行うことにより良好な結果が得られたため報告する.

A 70s-year-old man visited a nearby hospital with the complaint of a difficulty in swallowing lasted for approximately one month. Upper gastrointestinal endoscopic examination revealed tumorous lesion in the esophagus and stomach. We diagnosed endocrine cell carcinoma of the esophagus and gastric poorly differentiated adenocarcinoma with multiple metastasis in lymph nodes and the liver. Chemotherapy using CPT-11 and CDDP were successfully performed, then the regimen was changed to CPT-11 and CBDCA because of renal dysfunction. Now, from the diagnosis 9 months later, the chemotherapy still continues without exacerbation of the cancer. Endocrine cell carcinoma of the esophagus with gastric adenocarcinoma is a very rare disease and has no treatment guideline. In this case, we selected chemotherapy same as lung small cell carcinoma that performed successfully.

食道内分泌細胞癌

胃腺癌

遠隔転移

化学療法