A Case of Esophageal Cancer with Superior Mediastinal Lymph Nodes Recurrence Developed More Than 9 Years after Radical Resection

Abstract

A 70-year-old man who was diagnosed with cancer of the mesopharynx as a result of close exploration for pharyngeal pain and odynophagia was also pointed out having a 2-cm tumor shadow at the dorsal aspect of the trachea by CT scanning of the neck, chest and abdomen. A CT-guided needle biopsy provided a diagnosis of recurrence of cancer of the thoracic esophagus for which a radical resection had been done at the age of 60. PET-CT scan revealed abnormally high uptake of FDG to the tumor, but any findings suggestive of metastases to other sites were absent. We diagnosed the case as cancer of the mesopharynx and local recurrence of esophageal cancer and performed radiation therapy alone to the lesions including the affected mesopharynx area at the total dose of 60 Gy/30Fr. In 6 months after the irradiation, the tumor at the dorsal aspect of the trachea disappeared, and thereafter no enlargement of the tumor occurred, a complete cure being achieved. When 2 years had elapsed after the irradiation, thickening of the pharyngeal wall was identified and recurrence of the mesopharyngeal cancer was diagnosed. Three months later, the patient died. As it is rare that esophageal cancer recurs more than 5 years after radical operation, we present our case with some bibliographical comments.