1986 Volume 28 Issue 6 Pages 1281-1286_1
We have recently experienced two cases of minute esophageal carcinoma detected and totally excised by panendoscopy. The first case was a 74-year-old man who was found elsewhere to find an esophageal diverticulum on UGI series and a small flat lesion near the divesticulum by subsequent endoscopy performed by chance during hospitalization for pneumonia. Endoscopic dye method using a 3% Lugol solution revealed a tiny unstained area where carcinoma in situ (about 0.3 cm in size) was confirmed in one of two biopsied specimens. The second case was a 63-year-old man who was referred to us for further examination of the stomach. Panendoscopy revealed a small irregular red-spot in the middle esophagus where one of four biopsied specimens obtained made a diagnosis of moderately differentiat-ed squamous cell carcinoma. Since two more biopsied specimens repeatedly taken from the same area unstained with 3% Lugol solution again revealed squamous cell carcinoma, surgical operation was performed. An irregular erosion of 0.6×0.45 cm in size was demonstrated macroscopically on the resected specimen. However, no cancer cells were found with only regenerating epithelium in the resected specimens of two cases despite thorough pathological examination. UGI series could not demonstrate any abnormalities in both cases. The authors would emphasize that careful observation of the esophagus at the time of panendoscopy is indispensable in detecting such a minute carcinoma of the esophagus.
