PMC5726877_01
Esophagoscopy prior to treatment, showing superficial esophageal tumors (a) 25 cm and (b) 30 cm from the incisors. (c) A 70-mm-long protruding lesion on the right wall of the esophagus, 36-43 cm from the incisors. (d) After docetaxel, CDDP, and 5-FU (DCF) therapy, and chemoradiotherapy (CRT), these lesions disappeared, and the outcome was rated as a complete response (CR).
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Upper gastrointestinal endoscopy showed geographic esophageal 0-IIc lesions at 25 cm and 30 cm from the incisors; moreover, a type-2 lesion was observed 35-40 cm from the incisors (Fig. 1a-c). The results of endoscopy indicated that a CR had been maintained (Fig. 1d).
(a) Computed tomography (CT) showed a 65 mm swollen lymph node invading the pancreas (*) and stomach at the lesser curvature of the stomach (indicated by an arrow). (b) Positron emission tomography (PET)-CT showing fluorodeoxyglucose (FDG) uptake by the lymph node. (c) After DCF and CRT, the invasion to the stomach and pancreas was unclear, (d) but the lymph node displays FDG uptake.
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There was a possibility of lymph node infiltration into the pancreas at the lesser curvature lymph node (Fig. 2a). Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increased FDG uptake in the primary lesion and the lymph node along the left gastric artery (Fig. 2b). At 206 days after completion of CRT, a relapse in the lymph nodes along the lesser curvature, with a possibility of infiltration into the gastric wall and pancreas, was observed on CT and PET images (Fig. 2c and d).
Macroscopic findings of the resected esophagus.
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Therefore, a diagnosis of lower intrathoracic esophageal cancer ypT0N1 (1/7) M0 (Fig. 3) was made.