TWO CASES OF SYNCHRONOUS DOUBLE CANCER OF THE ESOPHAGUS AND KIDNEY

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  • 食道癌と腎細胞癌の同時性重複癌の2例

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Abstract

Two cases of synchronous doble cancer of the esophagus and kidney treated surgically are reported.<br> Case 1: A 73-year-old man presented with dysphagia. An ulcerative cancer lesion with stricture was found in the upper thoracic esophagus. CT scan aiming for preoperative staging revealed a right renal lesion, which was diagnosed as renal cancer. Because of past history of right thoracoplasty for pulmonary tuberculosis and severe restrictive pulmonary disfunction, surgical treatment was performed on a two-step approach. Esophagectomy with mediastinal and cervical lymphadenectomy and cervical esophagocutaneostomy was performed first. Twenty one days after the first operation, a right nephrectomy with reconstruction using stomach through antesternal route was performed. Histologically, the esophageal lesion was well differentiated squamous cell carcinoma, a 3 (upper lobe of the right lung), n2, ly2, v2, stage 4 and renal lesion was clear cell carcinoma, pT2, pN0, pM0, stage 2, grade 2. Six months after the first operation, he died of recurrence of esophageal cancer in the upper mediastinal lymph node.<br> Case 2: A 71-year-old man presented with dysphagia. An ulcerative cancer lesion of 2cm in length was detected in the middle thoracic esophagus. CT scan aiming for preoperative staging revealed a left renal lesion, which was diagnosed as renal cancer. Because the patient had no cardiopulmonary nor renal disfunction, an esophagectomy with extended lymphadenectomy, reconstruction using stomach through posterior mediastinum and left nephrectomy was performed simultaneously. Histologically, the esophageal lesion was well differentiated squamous cell carcinoma, mp, n0, ly0, v0, stage 1 and the renal lesion was clear cell carcinoma, pT3, pN0, pM0, stage 3. grade 2. He is at good condition without any evidences of recurrence at 8 months after the surgery.<br> Among the malignancies accompanied with esophageal cancer, head and neck cancer and gastric cancer are commonly seen. Synchronous double cancer of the esophagus and kidney in rare. To obtain good outcome, radical resection for both lesions are essential. The preoperative evaluation of the patient condition for such a radical operation is important to avoid unnecessary risks.

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