Abstract
A 62-year-old man was diagnosed with superficial esophageal cancer on upper endoscopy during health screening. Endoscopic examination with iodine staining and narrow-band imaging revealed three superficial erosive lesions in the middle and lower thoracic esophagus. The depth of tumor invasion was diagnosed as shallow invasion into the submucosal layer on endoscopic ultrasonography. Since enhanced computed tomography showed a markedly swollen lymph node at the right cardia, with higher F-deoxyglucose uptake on F-deoxyglucose positron emission tomography, lymph node metastasis was suspected. Then esophagectomy with lymph node dissection was performed, and histopathologic examination of the resected specimen revealed metastasis of squamous cell carcinoma in the huge lymph node along the celiac artery. In superficial esophageal cancer with a distinct depressed lesion, horizontal extension, and especially with erosive esophagitis, the possibility of lymph node metastases should be kept in mind even the depth of tumor invasion was lamina propria mucosa.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Natsugoe S, Matsumoto M, Okumura H, Ikeda M, Ishigami S, Owaki T, Takao S, Aikou T. Prognostic factors in patients with submucosal esophageal cancer. J Gastrointest. 2004;8:631–5.
Eguchi T, Nakanishi Y, Shimoda T, Iwasaki M, Igaki H, Tachimori Y, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 2006;19:475–80.
Japanese Society for Esophageal Disease. Guide lines for the clinical and pathologic studies on carcinoma of the esophagus. 10th ed.; 2008.
Kumagai Y, Toi M, Kawada K, Kawano T. Angiogenesis in superficial esophageal squamous cell carcinoma: magnifying endoscopic observation and molecular analysis. Dig Endosc. 2010;22:259–67.
Kodama M, Kakegawa T. Treatment of superficial cancer of the esophagus: a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan. Surgery. 1998;123:432–9.
Ando N, Ozawa S, Kitagawa Y, Shinozawa Y, Kitajima M. Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg. 2000;232:225–32.
Takahashi Y, Takeno S, Watanabe S, Kamei M, Ono K, Yamashita S, et al. Superficial esophageal squamous cell carcinoma with bulky gastric hiatus lymph node metastasis: a case report. Dig Endosc. 2009;21:262–5.
Hatakeyama T, Shiozaki A, Fujiwara H, Ichikawa D, Okamoto K, Komatsu S, et al. A case of a superficial carcinoma of the esophagus with isolated lymph node metastasis around the abdominal aorta. Surg Today. 2012;42:676–80.
Prenzel KL, Bollshweiler E, Schröder W, Mönig SP, Drebber U, Vallboehmer D, et al. Prognostic relevance of skip metastases in esophageal cancer. Ann Thorac Surg. 2010;90:1662–80.
Patti MG, Gantert W, Way LW. Surgery of the esophagus. Anatomy and physiology. Surg Clin N Am. 1997;77:959–70.
Nishimura T, Sayama J, Ueda H, Sugawara K, Takano R, Sagawa J, et al. Lymph flow and lymph node metastasis in esophageal cancer. Surg Today. 1995;25:307–17.
Natsugoe S, Matsumoto M, Okumura H, Nakashima S, Higashi H, Uenosono Y, Ehi K, Ishigami S, Takao S, Aikou T. Initial metastatic, including micrometastatic, sites of lymph nodes in esophageal squamous cell carcinoma. J Surg Oncol. 2005;89(1):6–11.
Natsugoe S, Nakashima S, Kijima F, Shimada M, Kusano C, Yoshinaka H, Baba M, Tkao S, Aikou T. Analysis of macroscopic appearance and p53 expression in superficial esophageal carcinoma. Hepatogastroenterology. 1999;46(28):2398–404.
Flamen P, Lerut A, Van Cutsem E, De Wever W, Peeters M, Stroobants S, et al. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000;181:3202–10.
Kita Y, Okumura H, Uchikado Y, Sasaki K, Omoto I, Matsumoto M, et al. Clinical significance of 18F-fluorodeoxyglucose positron emission tomography in superficial esophageal squamous cell carcinoma. Ann Surg Oncol. 2013;20:1646–52.
Ethical Statement
This article does not contain any studies with human or animal subjects performed by any authors.
Conflict of interest
There are no financial or other relations that could lead to a conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tanoue, K., Okumura, H., Uchikado, Y. et al. A case of superficial esophageal squamous cell carcinoma invading the lamina propria mucosa with a metastatic lymph node along the celiac artery. Esophagus 12, 263–266 (2015). https://doi.org/10.1007/s10388-014-0425-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10388-014-0425-9