Synchronous Double Cancers of Intraepithelial Esophageal Squamous Cell Carcinoma and Small Hepatocellular Carcinoma in a Patient with B Hepatitis and Alcoholism: Report of a Case

食道上皮內鱗狀細胞癌及小型肝細胞癌之同時性重複癌於一酗酒之B型肝炎：一病例報告

林其斌(Chi-Pin Lin) ； 鄭錦翔(Jin-Shiung Cheng) ； 黎國洪(Kwok-Hung Lai) ； 羅錦河(Gin-Ho Lo) ； 張晃宙(Huang-Chou Chang) ； 潘慧本(Huay-Ben Pan) ； 曾暉華(Hui-Hwa Tseng)

《中華民國消化系醫學雜誌》 18卷4期 (2001/12) Pp. 277-283

https://doi.org/10.6557/GJTb.200112_18(4).0006

摘要

合併食道癌及肝癌在文獻上並不多見，晚期肝細胞癌及食道鱗狀上皮癌即使以最先進的手術治療，預後也非常不好。早期食道鱗狀上皮內癌，發現時，幾乎均無淋巴腺轉移，五年存活率可達百分之一百；而小於三公分之小型肝細胞癌，絕大多數均可選擇接受較有療效之療法，如手術切除、局部注射治療、及肝動脈栓塞術。我們報告一位四十八歲男性患者，具酗酒和慢性B型肝炎病史，以酒精戒斷症候由他院轉入本院精神科，因先前懷疑有Mallory-Weiss症，故接受胃鏡及上腹部超音波檢查，意外發現小型肝細胞癌及食道鱗狀上皮內癌。小型肝細胞癌於該次入院以局部冰醋酸注射治療，腫瘤完全消除；而食道鱗狀上皮癌部份於兩個月後肝功能較正常時，接受次全食道切除及重建手術。病患術後於門診追蹤迄今計二十二個月，情況良好。

關鍵字

上皮內食道癌 ； 肝細胞癌 ； 重複癌

並列摘要

Synchronous double primary cancer of esophageal carcinoma and hepatocellular carcinoma is rare from the literature review. The incidence of intraepithelial squamous cell carcinoma of esophagus is also rare. Advanced HCC and esophageal carcinoma still have a dismal result despite modern management and suigical techniques. Small hepatocellular carcinoma and intraepithelial squamous cell carcinoma without lymph node metastasis usually show good prognosis. We report a 48-year-old male with chronic hepatitis B and alcoholism who developed alcohol withdrawal syndrome and Mallory-Weiss syndrome. Small hepatocellular carcinoma and intraepithelial squamous cell carcinoma of esophagus were found during hospitalization. Small hepatocellular carcinoma was first treated by percutaneous acetic acid injection and the intraepithelial squamous cell carcinoma of esophagus was managed by subtotal esophagectomy and reconstruction with gastric tube 2 months later. The patients felt essentially well up to 22 months after operation.

並列關鍵字

intraepithelial esophageal carcinoma ； hepatocellular carcinoma ； double cancers