PMC6145360_01
Endoscopy biopsy (A) suggested esophageal squamous cell carcinoma; postoperative pathology (B) demonstrated moderately differentiated esophageal squamous cell carcinoma invading the full thickness of the esophageal wall.
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Endoscopy biopsy suggested ESCC 28-35 cm away from incisors (Figure 1A and B) and computed tomography (CT) indicated that there was a space-occupying lesion at the lower esophagus (Figure 2). The full thickness of the esophageal wall was invaded, with dimensions of 5 x 2 x 1.3 cm, and metastasis was observed in esophageal lymph nodes (3/7; Figure 1B) but not observed in the resection margin.
The initial thoracic CT indicated that the middle thickening esophageal wall was markedly enhanced. Plain scan (A); arterial phase (B); venous phase (C).. Note: Red arrows represent the lymph node.. Abbreviation: CT, Computed tomography.
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Endoscopy biopsy suggested ESCC 28-35 cm away from incisors (Figure 1A and B) and computed tomography (CT) indicated that there was a space-occupying lesion at the lower esophagus (Figure 2).
Cervical CT showed no lymphadenopathy before surgery (A); CT showed a significantly enlarged lymph node in the left neck which prompted PD after first-line chemotherapy (B); CT revealed the left cervical lymph node was not reduced after radiotherapy and irinotecan treatment (C); CT examination showed the swollen lymph nodes significantly narrowed and the border was not clear, suggesting that the patient achieved PR (D).. Note: Red arrows represent the lymph node.. Abbreviations: CT, Computed tomography; PD, disease progression; PR, partial response.
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Until May 1, 2017, a lump could be touched in the patient's left neck, shown as left cervical lymph node metastasis by CT (Figure 3A and B). Since CT revealed that the left cervical lymph node was not narrowed, the treatment was terminated (Figure 3C). After treatment with apatinib for 1.4 months, CT examination showed cervical lymph node was decreased, without tumor recurrence or metastasis in other sites (Figure 3D).
The treatment schedule of the patient.. Abbreviations: CT, computed tomography; RT, radiotherapy; CPT-11, irinotecan.
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There was no sign of progression in the patient's conditions until we reported this case and now the PFS was 7.5 months (until March 10, 2018). The treatment schedule is given in Figure 4.