Three cases of recurrent metastasis in the mesenteric lymph node of free jejunal grafts

Abstract

We present three cases of recurrent metastasis in the mesenteric lymph node of free jejunal grafts after total hypopharyngolaryngectomy and free jejunum reconstruction （TPL） for hypopharyngeal cancer. Case 1 and Case 2 displayed recurrence at the resection margin after TPL and resection were performed. Several years later, since the metastatic lymph node was located in the mesentery, we carried out resection of the mesenteric lymph node. Case 3 was treated with chemoradiotherapy for mesenteric lymph node metastasis after TPL. Eight months later, the patient developed recurrent lymph node metastasis and underwent lymphadenectomy. Mesenteric lymph node metastasis of the reconstructed jejunum is rare, but interruption of blood flow to the reconstructed jejunum can result in ischemia and scar narrowing. Therefore, it was necessary to resect the mesenteric lymph node without damaging nutrient vessels.