Abstract
The patient was an 82-year-old woman who underwent definitive chemoradiotherapy (dCRT) for middle thoracic esophageal cancer which achieved a complete response (CR) in June 2005. In July 2012, seven years later, CT showed a 25×38mm metastatic lymph node in the right side of the neck. We diagnosed it as recurrence of esophageal cancer after dCRT.
Since no other lesions were identified, she underwent salvage surgery of right supraclavicular metastatic lymph node dissection in August 2012. The venous angle was found to be involved in the cervical lymph node metastasis. The clavicle was removed to achieve good exposure of the venous angle and the venous angle with the metastatic lymph node was resected by ligating and cutting the internal jugular, subclavian and innominate veins. The pathological diagnosis was squamous cell carcinoma. Six months after the operation, metastasis to the right supraclavicular lymph node occurred. Radiotherapy (RT) at 60Gy for the neck achieved a CR. However, 7 months after RT, she had a relapse to the right axillary lymph node and underwent RT at 60Gy for the axillary area, resulting in a CR. She has been in good condition without any evidence of recurrence as of 14 months after disappearance of the right axillary lymph node metastasis.
