A Case of Esophageal Carcinoma with Hyperamylasemia after Recurrence in Postoperative Course

Toshiyuki Suganuma¹⁾²⁾, Kazuo Hase²⁾, Atsushi Shikina²⁾, Suefumi Aozasa²⁾, Katsuyuki Utsunomiya²⁾, Keiichi Fujino²⁾, Kazushige Okada²⁾, Tomoki Tsuda²⁾ and Hiroteru Takeo³⁾

Department of Surgery, Japan Self Defense Force Yokosuka Hospital¹⁾
Department of Surgery, Japan Self Defense Forces Central Hospital²⁾
Department of Pathology, Japan Self Defense Forces Central Hospital³⁾

We report a case of esophageal carcinoma with hyperamylasemia after postoperative recurrence detected at the recurrent site by immunohistochemical study. A 49-year-old-male, admitted to our hospital for dysphasia and epigastralgia, was diagnosed with lower thoracic esophageal carcinoma determined histologically to be poorly differentiated squamous cell carcinoma. He was treated with neoadjuvant chemotherapy and underwent transthoracic esophagectomy. Lymph node metastasis to the right supraclavicular region occurred 3 months into the postoperative course and he underwent dissection of right-side neck lymphnodes. Eight months into the postoperative course, abdominal CT showed multiple metastases to the liver and serum amylase increased to 1,447 U/L, which was predominantly salivary-type amylase. He died due to liver failure in spite of systemic chemotherapy. Immunohistochemical study with anti-alphaamylase antibody showed positive staining of metastatic tumor cells in the lymph nodes at the right supraclavicular region, but the primary lesion was negative. These findings indicate an extremely rare case of amylase-producing esophageal carcinoma. This is the first case of amylase-producing esophageal carcinoma.

Key words
amylase-producing tumor, esophageal carcinoma, salivary-type amylase

Reprint requests
Toshiyuki Suganuma Department of Surgery, Japan Self Defense Force Yokosuka Hospital
1766-1 Tauraminato-machi, Yokosuka-city, 237-0071 JAPAN

Accepted
February 25, 2004

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