同时性食管多原发癌及碰撞癌一例并文献复习

摘要

目的：探讨同时性食管多原发癌及碰撞癌的病理形态及临床特点。方法：通过分析笔者所在医院诊治的1例同时性食管多原发癌及碰撞癌(鳞状细胞癌和纤维肉瘤)的临床表现、影像学检查、内窥镜检查，以及病理大体及镜下形态特点，并结合文献复习。结果：本例为食管中下段有两个不相连的隆起溃疡型的鳞状细胞癌瘤灶及1个带蒂息肉状向腔内生长的纤维肉瘤，鳞癌呈浸润性生长，浸润食管壁全层，并发生局部区域淋巴结转移，纤维肉瘤未见浸润和转移。结论：同时性食管多原发癌是非常少见的恶性肿瘤，再合并发生纤维肉瘤(碰撞癌)就更为罕见，术前影像学、内窥镜检查及同时行活检病理检查有助于诊断，但容易发生漏诊。%Objective:To investigate the pathological and clinical characteristics of multiple primary carcinoma and collision carcinoma of esophagus. Methods:One case of simultaneity multiple primary carcinomas and collision carcinoma of esophagus(squamous cell carcinoma and fibrosarcoma) was studied on the literature review,including clinical manifestations,imaging tests,endoscopy,and the pathological gross and microscopic morphology characteristics. Results:In this case,esophageal lower segment two not connected to uplift ulcers squamous cell carcinoid tumor and a pedunculated polypoid growth to the cavity fibrosarcoma,squamous cell carcinoma showed infiltrative growth,infiltration of the esophageal wall full-thickness and partial region lymph node metastasis,the fibrosarcoma no invasion and metastasis.Conclusion:Simultaneity multiple primary carcinomas are very rare malignant tumor of the esophagus,and then merge the occurrence of the fibrosarcoma(collision carcinoma) is even more rare,preoperative imaging,endoscopy and biopsy simultaneously contribute to the diagnosis, but prone missed.