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ID 48966
JaLCDOI
フルテキストURL
Thumnail 66_5_417.pdf 6.94 MB
著者
Horio, Takuya Departments of Surgery, National Defense Medical College
Ogata, Sho Departments of Pathology and Laboratory Medicine, National Defense Medical College
Tsujimoto, Hironori Departments of Surgery, National Defense Medical College
Akase, Takayoshi Departments of Surgery, National Defense Medical College
Takahata, Risa Departments of Surgery, National Defense Medical College
Yaguchi, Yoshihisa Departments of Surgery, National Defense Medical College
Maehara, Tadaaki Departments of Surgery, National Defense Medical College
Hase, Kazuo Departments of Surgery, National Defense Medical College
抄録
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.
キーワード
esophageal cancer
intrathoracic paraaortic lymph node
solitary metastasis
Amo Type
Case Report
発行日
2012-10
出版物タイトル
Acta Medica Okayama
66巻
5号
出版者
Okayama University Medical School
開始ページ
417
終了ページ
421
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
著作権者
CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Sience KeyUT