Abstract
It is important to evaluate multiple primary cancers when treating head and neck cancers. If double cancer is found, the treatment strategy must be determined considering not only lesions but also the background and general condition of the patient. Herein, we report a case of laryngeal cancer accompanying esophageal cancer treated with combined surgery.
The patient was a 72-year-old male who was diagnosed with spinocerebellar degeneration. He was
referred to our hospital with a suspected tumor of the left vocal cord. We made a diagnosis of laryngeal cancer （cT3N2cM0） based on histology and image examination. Furthermore, upper gastrointestinal endoscopy
revealed thoracic esophageal cancer （Mt, Pw, 0-Ⅱc, T1b-SM）. We planned total pharyngolaryngoesophagectomy and reconstruction using the gastric tube at first, but this would have been a burden to this patient because he had obstructive pulmonary disease and neurodegenerative disease, so we performed laryngectomy and transhiatal esophagectomy.
At first, right-side neck dissection and laryngectomy were performed keeping as much pharyngeal mucosa as possible. After the pharyngeal mucosa was closed, the cervical esophagus was amputated and the thoracic esophagus was removed. Then, the gastric tube was elevated and anastomosed to preserve the cervical esophagus. In order to avoid sutural leakage, we put the thyroid on the pharyngeal suture. Blood flow in the preserved pharyngeal mucosa and elevated gastric tube was good and microvascular anastomosis was not needed. Ingestion was started 13 days after the surgery, and sutural leakage did not occur. He has no recurrence or metastasis after treatment.
