Abstract
A 59-year-old man under treatment fir hepatitis B, liver cirrhosis, esophageal varices arldhepatocellular carcinoma was submitted to endoscopic variceal ligation(EVL)for esophageal varices in the other hospital. During the follow-up, a superficial esophageal carcinoma was detected and the patient was referred to Tokai University hospital for further examination and treatment. Initial endoscopic examination revealed a slightly depressed lesion type 0-IIc at the louver thoracic to abdominal esophagus. The lesion vvas diagnosed to be an early stagscarcinoma limited to the muscularis mucosae (depth m3), measuring 3cm in sire, occupying onehalf of the circumference. An ulcer scar after EVL was noted on the lesion. He was assignedto no therapy because the treatment seemed too risky due to liver failure and esophageal varices adjacent to the carcinoma. The turnor progressed to a type 0-Ip+IIc invading tosubmucosa(depth sm3)in three months, and then to a type 1p+0-IIc advanced cancer extendinginto muscularis propria five months after the initial exarnination. The tumor becarne a type 2 lesion in six months, and then a type 3 lesion extending further into adventitia in eight months. Finally, the patient died for liver failure eight months after the initial endoscopic exarnination.
