Salvage Surgery for Thoracic Esophageal Cancer with Right Aortic Arch after Chemoradiotherapy: A Case Report

Hidetoshi Kumano, Yoshinori Hosoya, Toru Zuiki, Masanobu Hyoudou, Yoshikazu Yasuda, Hideo Nagai, Kiyonori Nakazawa¹⁾ and Hirotoshi Kawada²⁾

Department of Surgery, Department of Radiology¹⁾ and Department of Pathology²⁾, Jichi Medical University

We report a case of esophageal cancer involving the right aortic arch (RAA). A 57-year-old man with dysphagia diagnosed with esophageal squamous cell carcinoma on endoscopic and computed tomographic examination was diagnosed clinically with T3N1M0 Stage III carcinoma. He underwent chemoradiotherapy (radiotherapy, 60 Gy; concurrent chemotherapy, 3 courses of low-dose cisplatin plus 5-fluorouracil). The tumor and local metastatic lymph nodes shrank temporarily, but local regrowth was detected 6 months after treatment, necessitating thoracic esophagectomy with a gastric pull-up maneuver through a left thoracotomy. Regrowth of tumor cells, i.e, carcinosarcoma, was diagnosed histopathologically. His postoperative course was uneventful. Esophageal cancer and salvage surgery were challenging in this patient with RAA. This is, to our knowledge, the first report of the successful treatment of both conditions.

Key words
esophageal cancer, salvage surgery, right aortic artery

Reprint requests
Hidetoshi Kumano Department of Surgery, Jichi Medical University
3311-1 Yakushiji, Shimotsuke, 329-0498 JAPAN

Accepted
April 23, 2008

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