MEDIX, God. 15 Br. 82  •  Pregledni članak  •  Gastroenterologija / Onkologija HR ENG

Tumori jednjakaTumours of the oesophagus

Aleksandar Včev, Ivana Begić, Dario Nakić, Melanija Ražov-Radas, Ivo Klarin, Jogen Patrk, Eugenija Basioli-Kasap

Benigni i maligni tumori jednjaka relativno su rijetki. Više od 90% svih tumora jednjaka čine adenokarcinomi, planocelularni karcinomi ili leiomiomi. Ostali primarni tumori jednjaka izrazito su rijetki i uglavnom su mezenhimalnog porijekla. Ezofagoskopija s biopsijama tumorskog tkiva za patohistološku dijagnostiku metoda je izbora u dijagnostici tumora epitelnog porijekla. Endoskopski ultrazvuk s mogućnošću citološke punkcije glavna je dijagnostička metoda u otkrivanju tumora mezenhimalnog porijekla. Određivanje stadija bolesti bitno je za prognozu i terapiju malignoma jednjaka. Ezofagektomija se radi u 0., I., II. i III. stadiju bolesti. Tumorske lezije ograničene na sluznicu mogu se tretirati endoskopskom resekcijom sluznice jednjaka. U IV. stadiju bolesti koriste se palijativne endoskopske metode (dilatacija, ablacija, stentiranje) za uklanjanje simptoma, znakova i komplikacija malignoma jednjaka

Ključne riječi:
dijagnostika tumora jednjaka; liječenje tumora jednjaka; tumori jednjaka

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Benign and malignant oesophageal tumours are uncommon. More than 90% of all oesophageal tumours are adenocarcinomas, squamous cell carcinomas or leiomyomas. Other primary tumours are extremely rare and mainly mesenchymal. The method of choice for pathohistological diagnosis of oesophageal tumours of mucosal origin is endoscopic tumour biopsy. Diagnosis and detection of mesenchymal tumours are greatly enhanced by endoscopic oesophageal ultrasonography (EUS), which has become essential in the evaluation of benign and malignant oesophageal disease. EUS does not provide a histologic diagnosis, although tissue sampling is possible using transendoscopic fine needle aspiration. Staging of oesophageal cancer is highly important for prognosis and optimal treatment plan. Oesophagectomy is an appropriate treatment method in patients with stage 0, I, II, or III. Chemoradiation is a therapeutic option for patients with stages II and III. Endoscopic mucosal resection may be considered an appropriate first step in the treatment of patients with mucosa-limited lesions. Palliative endoscopic therapy (dilation, tumour ablation, or oesophageal stenting) is used for the treatment of the symptoms, signs and complications of oesophageal cancer.

Key words:
esophageal neoplasms; esophageal neoplasms, diagnosis; esophageal neoplasms, therapy