A Resected Case of Esophageal Cancer with Right Aortic Arch

Tomohiko Setoguchi, Kinji Kamiya and Hiroyuki Konno

Second Department of Surgery, Hamamatsu University School of Medicine

We report a case of thoracoabdominal esophageal cancer with a right aortic arch. A 61-year-old man seen elsewhere for dysphagia in September 2006 was found in endoscopic examination to have Type 3 esophageal cancer of the abdominal esophagus. Routine chest X ray showed that he had a right aortic arch and an upper GI series showed an irregular ulcerative lesion in the abdominal esophagus. Computed Tomography (CT) showed esophageal wall thickening but no lymph node metastasis. Angiography and three-dimensional CT showed the right aortic arch with an aberrant left subclavian artery classified as type IIIB aortic arch anomaly based on the Edwards' classification. The patient underwent subtotal esophagectomy and three regional lymphadenectomies through left thracotomy. We saw no lymph node metastasis during surgery and did not conduct additional lymph node dissection in midline sternotomy. We found 3-dimensional CT and angiography to be very useful in determining the anatomical relationship between vessels, the esophagus, and recurrent laryngeal nerves.

Key words
esophageal cancer, right aortic arch, surgery

Reprint requests
Tomohiko Setoguchi Second Department of Surgery, Hamamatsu University School of Medicine
1-20-1 Handayama, Higashiku, Hamamatsu, 431-3192 JAPAN

Accepted
September 24, 2008

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