食道癌原発転移性心臓腫瘍

Metastatic Cardiac Tumor in the Left Atrium from Esophageal Cancer

転移性心臓腫瘍は無症状であることが多く，生存期間中に発見されることは少ない．しかしながら担癌患者の剖検例で8.4～10.6％に認められるとも報告されており，まれではないが食道癌からの転移報告例は非常に少ない1，2）．われわれは食道癌に由来する転移性左房内腫瘍に対し，外科的切除と冷凍凝固を併用することにより局所再発を予防しえた2例を経験したので報告する．

Metastatic cardiac lesions are clinically silent and are usually found a necropsy. The most common primary tumor resulting in cardiac metastases is carcinoma of the lung, with there being only a few reports of metastases from esophageal cancer. We report two cases of metastatic cardiac tumors in the left atrium from esophageal cancer and perform a review of the literature.

Case 1：A 62-year-old woman underwent esophagectomy and adjuvant chemotherapy. No other metastases were observed.

Case 2：A 49-year-old man also underwent esophagectomy and adjuvant chemotherapy for lymph node and liver metastases. In both patients, the left atrial tumors were detected on recent follow-up computed tomography.

Left atrial tumors often cause cerebral emboli with neurological sequelae. Therefore, surgical resection and cryo-ablation for the prevention of local recurrence were performed on the metastatic tumors.

Local recurrence was not observed after the surgery in both patients. Although chemotherapy is usually the most beneficial treatment for metastatic cardiac lesions, left atrial tumor should be treated with surgical resection because of the high risk of cerebral emboli. We suggest that surgical resection with cryo-ablation may prevent local recurrence.