内容紹介
A Case of Advanced Esophageal Cancer and Tongue Cancer Treated with Induction DCF Chemotherapy Followed by Radical Surgery
Summary
A man in his 60s was admitted for the treatment of advanced cervical esophageal cancer with metastasis to the lymph nodes and advanced tongue cancer with metastasis to the lymph nodes. Esophageal cancer was suspected to have invaded the trachea. The tongue cancer was located on the left side and had invaded beyond the median line of the tongue. Both cancers were pathologically diagnosed as squamous cell carcinomas. Therefore, it was determined that pharyngo-laryngo-esophagectomy and total glossectomy were required prior to the treatment. However, after 2 courses of docetaxel/cisplatin/5-FU combined induction chemotherapy, both cancers remarkably decreased; consequently, an esophagectomy to preserve laryngeal function and partial glossectomy could be performed simultaneously. The patient is well without recurrence 1 year post-surgery.
要旨
症例は60歳台,男性。2か月前からの舌腫大にて近医を受診し,紹介受診となった。舌口腔MRIでは,舌左側に正中を越え口腔底に浸潤する腫瘍と左顎下リンパ節腫大を認めた。上部消化管内視鏡検査にて頸部食道に1型腫瘍,胸部下部食道にヨード不染帯を認め,造影CT検査では右反回神経周囲リンパ節腫大と気管膜様部浸潤が疑われた。生検結果は舌,食道ともに扁平上皮癌であった。食道癌,CeUt,cType 1,cT4(気管)N1M0,cStageⅣa,同時性多発食道癌,舌癌(T4aN1M0,StageⅣa)と診断した。導入化学療法としてDCF療法を2コース施行し,食道癌,舌癌ともに腫瘍縮小効果を認め,同時手術を施行した。手術は右開胸開腹食道亜全摘術,後縦隔経路,頸部食道胃管再建,3領域リンパ節郭清,左舌可動部半側切除術,頸部郭清,舌形成術を行った。現在,術後経過1年となるが無再発生存中である。
目次
Summary
A man in his 60s was admitted for the treatment of advanced cervical esophageal cancer with metastasis to the lymph nodes and advanced tongue cancer with metastasis to the lymph nodes. Esophageal cancer was suspected to have invaded the trachea. The tongue cancer was located on the left side and had invaded beyond the median line of the tongue. Both cancers were pathologically diagnosed as squamous cell carcinomas. Therefore, it was determined that pharyngo-laryngo-esophagectomy and total glossectomy were required prior to the treatment. However, after 2 courses of docetaxel/cisplatin/5-FU combined induction chemotherapy, both cancers remarkably decreased; consequently, an esophagectomy to preserve laryngeal function and partial glossectomy could be performed simultaneously. The patient is well without recurrence 1 year post-surgery.
要旨
症例は60歳台,男性。2か月前からの舌腫大にて近医を受診し,紹介受診となった。舌口腔MRIでは,舌左側に正中を越え口腔底に浸潤する腫瘍と左顎下リンパ節腫大を認めた。上部消化管内視鏡検査にて頸部食道に1型腫瘍,胸部下部食道にヨード不染帯を認め,造影CT検査では右反回神経周囲リンパ節腫大と気管膜様部浸潤が疑われた。生検結果は舌,食道ともに扁平上皮癌であった。食道癌,CeUt,cType 1,cT4(気管)N1M0,cStageⅣa,同時性多発食道癌,舌癌(T4aN1M0,StageⅣa)と診断した。導入化学療法としてDCF療法を2コース施行し,食道癌,舌癌ともに腫瘍縮小効果を認め,同時手術を施行した。手術は右開胸開腹食道亜全摘術,後縦隔経路,頸部食道胃管再建,3領域リンパ節郭清,左舌可動部半側切除術,頸部郭清,舌形成術を行った。現在,術後経過1年となるが無再発生存中である。