内容紹介
Summary
Herein, we report a case of lymph node recurrence 7 years after curative esophagectomy for T1a(LPM)upper thoracic esophageal cancer. A 70's man underwent radical esophagectomy by using video-assisted thoracic surgery and hand-assisted laparoscopic surgery(VATS and HALS)with gastric tube reconstruction via a posterior mediastinal route for upper thoracic esophageal cancer cT1bN0M0, cStageⅠ in August 2010. The pathological diagnosis was pT1a(LPM), w/d, scc, ly0, v0, ie(+), inf β, pIM0, pPM0, pDM0, pRM0, pN0, pM0, pStage 0. Moreover, he was followed-up without treatment after surgery. In November 2017, 7 years after esophagectomy, follow-up CT revealed left supraclavicular lymph node swelling. FDG-PET revealed high uptake of FDG, and lymph node recurrence was suspected. In January 2018, we performed lymph node biopsy. We could not remove the lymph node completely, because the lt common carotid artery and lt jugular vein were associated with the metastatic lymph node. The pathological diagnosis was squamous cell carcinoma. Chemoradiation therapy was performed after surgery, and patient recovery was uneventful.
要旨
食道癌根治手術後の再発は28～47%,その約85%が2年以内の早期に認められ,再発診断時からの生存期間中央値は5～10か月と極めて不良である。一方,壁深達度T1a(MM),T1b(SM1)の症例でのリンパ節転移は10～20%であることが知られており多くは手術治療が行われるが,T1a(LPM)ではリンパ節転移の頻度は極めてまれである。今回われわれは,pT1a(LPM)の食道癌根治術後7年という長期経過後に左鎖骨上リンパ節(No. 104L)に再発したまれな症例を経験したので文献的考察を加えて報告する。
目次
Herein, we report a case of lymph node recurrence 7 years after curative esophagectomy for T1a(LPM)upper thoracic esophageal cancer. A 70's man underwent radical esophagectomy by using video-assisted thoracic surgery and hand-assisted laparoscopic surgery(VATS and HALS)with gastric tube reconstruction via a posterior mediastinal route for upper thoracic esophageal cancer cT1bN0M0, cStageⅠ in August 2010. The pathological diagnosis was pT1a(LPM), w/d, scc, ly0, v0, ie(+), inf β, pIM0, pPM0, pDM0, pRM0, pN0, pM0, pStage 0. Moreover, he was followed-up without treatment after surgery. In November 2017, 7 years after esophagectomy, follow-up CT revealed left supraclavicular lymph node swelling. FDG-PET revealed high uptake of FDG, and lymph node recurrence was suspected. In January 2018, we performed lymph node biopsy. We could not remove the lymph node completely, because the lt common carotid artery and lt jugular vein were associated with the metastatic lymph node. The pathological diagnosis was squamous cell carcinoma. Chemoradiation therapy was performed after surgery, and patient recovery was uneventful.
要旨
食道癌根治手術後の再発は28～47%,その約85%が2年以内の早期に認められ,再発診断時からの生存期間中央値は5～10か月と極めて不良である。一方,壁深達度T1a(MM),T1b(SM1)の症例でのリンパ節転移は10～20%であることが知られており多くは手術治療が行われるが,T1a(LPM)ではリンパ節転移の頻度は極めてまれである。今回われわれは,pT1a(LPM)の食道癌根治術後7年という長期経過後に左鎖骨上リンパ節(No. 104L)に再発したまれな症例を経験したので文献的考察を加えて報告する。