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ID 48966
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Author
Horio, Takuya
Ogata, Sho
Tsujimoto, Hironori
Akase, Takayoshi
Takahata, Risa
Yaguchi, Yoshihisa
Maehara, Tadaaki
Hase, Kazuo
Abstract
Esophageal cancers usually exhibit lymph-node metastases. Although a solitary lymph-node metastasis is occasionally found, the involvement of an intrathoracic paraaortic node is rare. We present here an intrathoracic mid-esophageal cancer case in which an accompanying solitary retroaortic mass was found within the posterior mediastinum by integrated positron emission tomography/computed tomography. For diagnosis, thoracoscopic resection of the mass was performed from a left thoracic approach, and histology revealed it to be a squamous cell carcinoma metastasized from the esophageal cancer. Upon radical esophagectomy after neoadjuvant therapy as a T3N1M0 Stage IIIa (AJCC/UICC) cancer, the esophageal cancer was found to have invaded unexpectedly deeply in the vicinity of the descending aorta. Another lymph node within the paraaortic region was also involved (T4N1M0 Stage IIIc). The present case and other cases we review here inform our understanding of metastasis to intrathoracic paraaortic nodes as follows:1) its existence may indicate extensive lymph-node metastasis or direct tumor invasion nearby, and 2) it may be accompanied by other lymph-node involvements in this region, even if it appears solitary upon preoperative investigation. Thus, for radical esophagectomy, sufficient lymph-node dissection is required, even at locations not reached by the usual right thoracic approach. Definitive chemoradiotherapy may be a better choice for preoperatively recognized T3 esophageal cancer when the cancer is accompanied by paraaortic lymph node metastasis.
Keywords
esophageal cancer
intrathoracic paraaortic lymph node
solitary metastasis
Amo Type
Case Report
Published Date
2012-10
Publication Title
Acta Medica Okayama
Volume
volume66
Issue
issue5
Publisher
Okayama University Medical School
Start Page
417
End Page
421
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2012 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID
Web of Science KeyUT