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消化道癌 - 一个诊断挑战
Vishu Jain1, Peeyush Varshney1, Divya Aggarwal2
1Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Ochsner journal
|September 15, 2023
概括
食道癌,一种罕见的癌症,由于其混合细胞类型,诊断可能具有挑战性. 这一案例凸显了错误诊断和不良预后的潜力,即使对食道癌进行了积极的治疗.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
背景情况:
- 食道癌是一种罕见的食道恶性瘤,包括表皮和介质细胞元素.
- 它通常影响中和下食道,占食道癌症的0.5%至2.8%.
研究的目的:
- 报告一例食道癌肉瘤,其中主要是肉瘤组成部分.
- 讨论与这种罕见的食道瘤相关的诊断挑战和预后.
主要方法:
- 一个54岁的男性的病例报告,患有渐进性消化障碍.
- 诊断工作包括食道胃道透镜和成像.
- 手术切除 (McKeown食道切除术) 随后进行辅助化疗 (碳白和帕克利塔塞尔).
主要成果:
- 手术前的活检显示了性肌肉瘤,但最终的病理学发现了轻微的侵入性状细胞癌组成部分.
- 免疫组织化学检测显示每个成分都有不同的标记物 (肉瘤性:维门,h-卡尔德斯蒙,光滑肌肉动蛋白;表皮性:泛细胞激素,p40).
- 患者在治疗后4个月的宫淋巴结中出现了复发,并在2个月后死亡.
结论:
- 食道癌肉瘤很容易被忽略,特别是当肉瘤成分占主导地位时,即使有免疫组织化学反应.
- 这些瘤与预后不佳以及早期复发的高风险有关.
- 包括手术和辅助化疗在内的积极治疗可能无法预防这些病例的复发.
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