Abstract
A 52-year-old man complaining of appetite loss and abdominal distention was admitted to our hospital because of advanced carcinoma in the lower thoracic esophagus and a solitary giant tumor about 75mm in diameter around the lesser curvature of the stomach. Abdominal angiography showed displacement and narrowing of the splenic artery and vein due to the tumor. The most likely diagnosis was advanced esophageal cancer with solitary giant lymph node metastasis at the lesser curvature of the stomach. Right thoraco-laparotomic subtotal esophagectomy and resection of the giant abdominal tumor were performed by Appleby's procedure, followed by reconstruction of the esophagus using a gastric tube. The pathological diagnosis was poorly differentiated squamous cell carcinoma (type3, t3, ly1, v0, n2, 3.4×2.3 cm in diameter) with an abdominal lymph node metastasis about 90 mm in diameter. Eight days after the operation, major leakage of the anastomosis in the thoracic and right-sided pyothorax occurred. But the postoperative complications subsided eventually by conservative treatment with thoracic and gastrointestinal drainage. There has been no evidence of recurrence for 7 years after the operation. We report this case and a review of the relevant literature.
