Esophageal Cancer Presenting as Upper Airway Obstruction in a 75-year-old Man with Chronic Obstructive Pulmonary Disease

食道癌表現為上呼吸道阻塞在一位七十五歲有慢性阻塞性肺疾病男性病患

李敏思(Min-Si Li) ； 賴炳村(Ping-Tsun Lai) ； 張凱惟(Kai-Wei Chang)

《童綜合醫學雜誌》 13卷2期 (2019/12) Pp. 112-115

https://doi.org/10.3966/207135922019121302009

摘要

Esophageal cancer typically presents as dysphagia and weight loss but can also present as upper airway obstruction, which is a medical emergency. Here we present a case of a 75-year-old man with a history of chronic obstructive pulmonary disease refractory to medical treatment. Central airway obstruction was suspected. Computerized tomography of the chest showed an upper tracheal tumor. Bronchoscopy showed no endoluminal lesion but with airway obstruction from external compression. Upper gastrointestinal endoscopy showed a submucosal mass over the upper esophagus with lumen stenosis. Pathology showed squamous cell carcinoma of the esophagus. Endotracheal intubation was performed, and tracheostomy was done to bypass stenotic lesion. Chemotherapy was attempted due to the high risk of surgery.

關鍵字

esophageal cancer ； upper airway obstruction ； chronic obstructive pulmonary disease

並列摘要

食道癌常見的症狀包括吞嚥困難與體重減輕,少數表現為上呼吸道阻塞,而且是急症。我們提出一例75歲男性病患因呼吸困難，痰多，被診斷慢性阻塞性肺病急性發作，對藥物治療無效。進一步電腦斷層掃描撿查發現疑似氣管腫瘤，支氣管鏡卻沒發現氣管腫瘤但有支氣管壓迫性阻塞。進一步胃鏡撿查發現粘膜下腫瘤病理報告為鱗狀上皮癌。病患有接受氣管內插管。後續做氣管造口術及化療。

並列關鍵字

食道癌 ； 上呼吸道阻塞 ； 慢性阻塞性肺病 ； 氣管造口術