Surgical Treatment of Metastasis to the Ascending Colon after Resection of Esophageal Cancer

Abstract

An 80-year-old man underwent thoracoscopic esophagectomy for advanced esophageal cancer (poorly-differentiated squamous cell carcinoma with severe lymphatic and venous invasion ; pT3 pN4 M0 pStage IVa). Adjuvant chemotherapy was not employed considering his great age. Six months later, he complained of right lower quadrant pain and a hard tumor was palpated in the same area. Total colonoscopy revealed a type 3 lesion encircling two-thirds of the circumference of the ascending colon, and abdominal computed tomography (CT) scan showed wall thickening in the ascending colon with some lymph node swelling. The histological diagnosis was poorly-differentiated squamous cell carcinoma. CT scan did not show ascites, distant organ metastasis or local recurrence in the mediastinum. We performed right hemicolectomy with D3 lymphadenectomy based upon the diagnosis of metastatic colon carcinoma from esophageal cancer. Intraoperative findings showed no liver metastasis and peritoneal dissemination and intraoperative peritoneal cytology was negative. The most probable mode of colon metastasis was lymphogenic or hematogenous. Herein, we report a rare case of ascending colon metastasis derived from esophageal squamous cell carcinoma. Resection for metastatic colon cancer may be useful to prevent various symptoms associated with an increase in the tumor size.