肝細胞癌切除１３年後に根治切除術を行った胸部食道癌の１例

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  • Radically resected esophageal cancer 13 years after a hepatic resection for hepatocellular carcinoma. Report of a case.

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This paper presents a rare case of metachronous double cancer of the liver and esophagus, in which esophageal cancer was radically resected 13 years after a hepatic anterior segmentectomy for hepatocellular carcinoma (HCC). A 71-year-old man, who had a history of undergoing a hepatic anterior segmentectomy for HCC 13 years earlier, was admitted to the hospital because of dysphasia. Barium swallow study and an endoscopy revealed well defined ulcerative type of moderately differentiated squamous cell carcinoma 4cm in diameter in the middle third of the esophagus. Esophagectomy was performed on August 30, 2000. Because the patient was associated with liver disfunction and hepatitis c virus infection, a laparotomy was preceded. As the liver damage was mild, an esophagectomy with lymph node dissection (D2) and a posterior mediastinal reconstruction using the stomach were performed. Histologically the esophageal cancer was in Stage IV a, with a curability of pB. The postoperative course was uneventful. The patient is in a good condition without any signs of recurrence. In the patients with double cancer involving HCC, histologic stage of the HCC often becomes the determinant prognostic factor. However, when HCC can be treated curatively like in this case, the second cancer should be treated curatively, if the patient's liver function permits it.

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