病人,男,59岁。吞咽困难6年,加重半年。体格检查,病人消瘦,贫血(Hb 85g/l),余未见异常。食管造影:膈以上食管高度扩张,钡剂涂布不均,呈雪片状,贲门处狭窄呈鸟嘴状,粘膜无破坏,酷似“贲门失驰缓征”(图1)。食管镜检查:距门齿18cm食管左前壁一新生物突入腔内,并延续至贲门口,活检仅见鳞状上皮。 经左胸和左颈切口探查:食管腔内一巨大长条柱状肿瘤,质地中等偏硬,表面光滑,富含细小血管,前外侧长出多个葡萄大小同质地结节。肿瘤25cm×8cm×3cm大小,重380g(图2)。基底宽大,位于食管上段左前壁,并向上延伸至下咽部。食管粘膜正常,贲门无狭 Patient, male, 59 years old. Difficulty swallowing for 6 years, an increase of six months. Physical examination, patient weight loss, anemia (Hb 85g/l), no exception. Esophageal radiography: The upper esophagus is dilated, the esophagus is highly dilated, the elixir is unevenly coated, and it is snow-flaky. The stenosis at the cardia is burrow-shaped, and the mucous membrane is not damaged. It resembles the “stagnation of the fontanelle” (Figure 1). Esophagoscopy: A new creature from the left anterior wall of the esophagus protruded into the cavity 18 cm from the incisors, and continued into the estuary. The biopsy showed only squamous epithelium. The left chest and left neck incision exploration: a large columnar tumor in the lumen of the esophagus, texture is moderately hard, smooth surface, rich in small blood vessels, the anterolateral growth of a number of grapes the size of the same texture nodules. The tumor was 25 cm x 8 cm x 3 cm in size and weighed 380 g (Figure 2). The base is wide, located in the left anterior wall of the upper esophagus and extends upward to the hypopharynx. Normal esophageal mucosa, no stench