2020 Volume 53 Issue 2 Pages 131-138
A 69-year-old woman, with a diagnosis of poorly differentiated squamous cell carcinoma of thoracic esophagus (T3N2M0, Stage III, UICC 7th), underwent right thoracic esophagectomy with three-field lymphadenectomy following neoadjuvant chemotherapy. At 9 months after esophagectomy, she underwent definitive chemo-radiotherapy for a recurrence of mediastinal lymph nodes. In the follow-up course, abdominal CT scan at 2 years and 2 months after esophagectomy revealed an enhanced mass in the left adrenal region, diagnosed as adrenal metastasis. The tumor shrank noticeably owning to a continuous chemotherapy; however, showed a regrowth after interruption of chemotherapy. PET/CT scan showed high accumulation of FDG in the left adrenal region, with no other obvious accumulations including the mediastinum. Surgical resection for the left adrenal gland was performed at 4 years after esophagectomy. She was periodically followed up without any additional treatment, and survived for 10 years after esophagectomy and 6 years after the last surgery without any recurrence of disease. Although the prognosis of hematogenous recurrences after radical esophagectomy is considered to be poor, this case suggests a benefit of surgical resection for a solitary metastasis of esophageal carcinoma.
