A 53 year old man complained of dysphagia, cough and sputum since October 1958. These symptoms became more marked in the following year. In the middle of this January, he noticed that even liquid did not go down. An esophagoscopic examination revealed a tumor at the level corresponding to the bifurcation of the trachea. The biopsy removed showed cancroid.
On 3rd of February, exploratory thoraeotomy was performed and it was found that complete extirpation of the growth was impossible and gastrostomy was performed.
On 12th of February, hard, elastic and cauliflower-like mass appeared on the left margin of the tongue.
On 24th of February, a bronchoscopic examination showed a tumor at the tracheal bifurcation and the pathological examination of both this part and the tongue proved cancroid.
A tumor at the tracheal bifurcation was the extension of the oesophageal tumor and x-ray study with contrast media showed the existence of tracheo-oesophageal fistula.
The cancer of the tongue might be considered to be haematogenous metastasis from the trachea or duplicated cancer.
The size of the tongue cancer was decreased and hardly recognized by the treatment of CO needles, but the complication in the lung due to tracheo-oesophageal fistula became manifest and the patient grew weaker and died on April 1st.
The autopsy showed oesophageal cancer of 10 cm length at the height of the tracheal bifurcation and had infiltrated into the inner part of trachea forming a fistula.
Pathological examination showed it to be cancroid.
Metastasis were found at the submucosa of the stomach, lymph nodes around the stomach, left hilus of the lung and left margin of the tongue.
The histologic pictures of the oesophagus, bronchus, and the tongue; and the x-ray photograph of the lung are herewith attached.
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