Early-Stage Esophageal Squamous Cell Carcinoma Adjacent to Cirrhosis-Related Varices: A Case Report

早期食道鱗狀上皮細胞癌合併鄰近之肝硬化所引起的食道靜脈曲張

王聿農(Yu-Nong Wang) ； 劉岱瑋(Dai-Wei Liu) ； 夏錫生(Hsi-Sheng Chsia) ； 許文林(Wen-Lin Hsu)

《放射治療與腫瘤學》 15卷2期 (2008/06) Pp. 161-166

https://doi.org/10.6316/TRO/200815(2)161

摘要

文獻報告上關於未經治療之食道靜脈曲張合併已存在之食道癌的紀錄相當少。大部分的報告多以探討經內視鏡注射硬化劑療法是否導致後續的食道癌為主題。以放射線治療食道癌是否會引起照野內的食道靜脈曲張之結構變化而造成大量出血的討論也鮮少被提及。我們在此報告一位在做內視鏡尋找上消化道出血原因時，意外發現表淺食道癌及鄰近之食道靜脈曲張的病人。根據我們所整理的文獻，食道癌及食道靜脈曲張可分開治療而不致相互影響。文中並介紹多種對表淺食道癌及食道靜脈曲張的治療方式。這位病人在接受放射線治療前先接受食道靜脈曲張的環套結紮。他順利完成療程後，追蹤至今未有食道癌復發及治療所引起的合併症。

關鍵字

食道靜脈曲張 ； 食道癌 ； 放射治療

並列摘要

The presence of cirrhosis-related esophageal varices combined with pre-existed esophageal cancer is rarely documented. Most studies concerned about the possibility that endoscopic injection sclerotherapy (EIS) induces a secondary esophageal cancer. Whether radiotherapy complicates varices bleeding or rupture is seldom mentioned. We present a case of early esophageal cancer accidentally found by panendoscope (PES) for upper gastrointestinal bleeding survey. The tumor was adjacent to one of the esophageal varices. According to the case reports we summarized, varices and the esophageal cancer can be managed separately. Varices can be treated by ligation, sclerotherapy, or photodynamic therapy (PDT). The early esophageal cancer can be treated by PDT, endoscopic resection, radiotherapy, or esophagectomy. In this case, varices ligation was performed prior to radiotherapy. The treatment course finished smoothly. He had kept regular follow-up at our OPD

並列關鍵字

Esophageal varices ； Esophageal cancer ； Radiotherapy