A Case of Early Cancer of the Stomach Tube Posteriormediastinally Reconstructed after Pharyngolaryngoesophagectomy for Hypopharyngeal Cancer

Hironori Tsujimoto, Takashi Ichikura, Shoetsu Tamakuma

First Department of Surgery, National Defense Medical College

A 59-year-old man who had a familial cancer accumulation (father, elder brother and younger brother with stomach cancer and elder sister with uterine cancer) underwent total pharyngo-laryngoesophagectomy, modified radical neck dissection, tracheostomy and a reconstruction with the stomach tube through the posteriormediastinal route for hypopharyngeal cancer. One year later, a gastrointestinal endoscopic examination revealed an elevated lesion in the reconstructed stomach tube. The biopsy specimen showed well-differentiated adenocarcinoma. Segmental resection of the stomach tube preserving the right gastroepiploic vessels were performed with a reconstruction using the transverse colon, since he had severe renal dysfunction and the tumor was located on the counter side of the vessels. Pathologic examination showed well-differentiated adenocarcinoma, involving the submucosal layer without any lymph node metastasis. He is alive and well, as of 1 year after the second operation. This surgical procedure may be recommended especially for patients with a surgical risk of mortality and morbidity.

Key words
hypopharyngeal cancer, cancer in the reconstructed stomach tube, segmental resection of the reconstructed stomach tube

Reprint requests
Hironori Tsujimoto First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
November 13, 1996

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