Coexistence of Carcinoid Tumor and Adenocarcinoma within the Esophageal Diverticulum Complicated with Empyema Thoracis-A Case Report

食道憩室、食道類癌及腺癌併發食道肋膜瘻口及膿胸－病例報告

許聯輝(Lien-Hui Hsu) ； 柯獻欽(Shian-Chin Ko) ； 鄭高珍(Kau-Chen Cheng) ； 馮瑤(Yao Fong) ； 張晉民(Jinn-Ming Chang) ； 林靖南(Ching-Nan Lin) ； 謝俊民(Jiunn-Min Hsieh)

《胸腔醫學》 20卷5期 (2005/10) Pp. 463-470

https://doi.org/10.29806/TM.200510.0015

摘要

食道憩室合併食道類癌及腺癌是一種臨床非常罕見的疾病。大部分之食道憩室及食道癌症初期通常無臨床症狀，若出現症狀則以吞嚥困難為最常見。因食道憩室破裂造成食道氣管瘻口並以呼吸症狀及膿胸形態表現更屬罕見。
我們報告一位五十一歲男性病人有長期咳嗽及聲音沙啞併發咳血、胸痛及發燒而住院。經食道攝影、上消化道內視鏡及胸部電腦斷層約未診斷出食道憩室合併癌症之疾病，後藉由手術及病理切片才確立診斷。據我們所知，此為第一例食道憩室合併食道類癌及腺癌和食道氣管瘻口併發膿胸之個案，須加以鑑別診斷。

關鍵字

食道憩室 ； 食道類癌 ； 食道腺癌 ； 食道肋膜瘻口 ； 膿胸

並列摘要

Patients with an esophageal diverticulum are usually asymptomatic, the most common symptom is dysphagia. However, perforation of the esophageal diverticulum can cause acute mediastinitis and empyema thoracis.
We present a 51-year-old man who suffered from a chronic cough and hoarseness. He presented to the hospital complaining of hemoptysis, chest pain and fever. Empyema thoracis developed during admission. An upper gastrointestinal (UGI) series and panendoscopy suggested an esophageal tumor, but neither endoscopic nor percutaneous biopsies could lead to a definite diagnosis. The patient finally underwent thoracotomy, and the pathologic report showed esophageal carcinoid tumor and adenocarcinoma. The coexistence of esophageal carcinoid tumor and adenocarcinoma is very rare. To our knowledge, this is the first report of esophageal carcinoid tumor and adenocarcinoma arising from an esophageal diverticulum and complicated with empyema thoracis.

並列關鍵字

esophageal diverticulum ； esophageal carcinoid ； esophageal adenocarcinoma ； esophagoplerual fistula ； empyema thoracis