Metastasis to the Upper Mediastinal Lymph Nodes and Lung after EMR of sm1 Esophageal Cancer, Report of a Case Hideo Shimada 1 , Osamu Chino 1 , Hikaru Tanaka 1 , Takafumi Kise 1 1Department of Surgery, School of Medicine, Tokai University Keyword: 食道表在癌 , 内視鏡的粘膜切除術 , MR , リンパ節再発 , 肺転移 pp.93-98
Published Date 2002/1/25
DOI https://doi.org/10.11477/mf.1403103412
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 We report a case of metastasis to the upper mediastinal lymph nodes and lung after endoscopic mucosal resection (EMR) of esophageal cancer. A 68-year-old male patient presented a 0-Ⅱc lesion on the middle thoracic esophagus. It was found by endoscopic screening. The patient underwent EMR for this lesion thought to be m3 in depth, by endoscopy, without any lymph node metastases noticed by radiological examinations. Pathology of the resected lesion revealed a moderately differentiated squamous cell carcinoma reaching the sm1 at the subtle area with mild lymphatic invasion (ly1) . Discussion with the patient resulted in there being no additional resection. The patient was followed up for 3 years and 11 months, when he complained of cervical lymph node swelling and recurrence was detected by CT. It was mediastinal lymph node metastasis and lung metastasis. Chemotherapy was conducted without any effect. Autopsy revealed that those metastases were derived from the primary lesion, and no residual lesion in the esophagus or double cancer in other organs was detected.

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