[Long-Term Survival of Patient Having Advanced Esophageal Cancer with Cirrhosis after Overcoming Anastomotic Leakage, Purulent Osteomyelitis, Cervical Lymph Node Recurrence, and Systemic Edema-A Surgical Case].

Abstract

We report the surgical case of advanced esophageal cancer with cirrhosis in a patient who has been cancer-free for 6 years after overcoming anastomotic leakage, purulent osteomyelitis, cervical lymph node recurrence, and systemic edema. A 69-year-old woman visited our hospital and presented with the complaint of a food sticking sensation. Endoscopic findings showed a type 3 tumor in the middle thoracic esophagus. Esophagectomy was subsequently performed. Histopathological findings revealed poorly differentiated squamous cell carcinoma, Mt, 17×15 mm, type 3, pT3, pIM0, pPM0, pDM0, pRM0, pN2(7/18), pStage Ⅲ, and liver cirrhosis(F4, A1-2). Postoperative suture failure was observed; however, it conservatively improved in approximately 2 months. The patient had lower back pain since approximately 6 weeks after the surgery, and she was diagnosed with purulent spondylitis and was administered antibiotics. The patient was subsequently discharged 67 days after the surgery. One course of 5-FU+CDDP was administered as postoperative adjuvant chemotherapy. However, renal function deteriorated, and chemotherapy was discontinued. Four months after the surgery, cervical echography revealed recurrence in the left cervical lymph node, and docetaxel(DTX)was administered. Five DTX doses were administered, because of which the left cervical lymph nodes markedly shrunk. Moreover, the sixth dose of DTX resulted in febrile neutropenia and a large amount of abdominal pleural effusion. Consequently, the patient was hospitalized. Tolvaptan treatment was extremely effective, and the thoracic ascites disappeared. Esophageal cancer has not recurred, and the patient is being observed at an outpatient clinic 6 years after the surgery.

• Authors: Shigeru Fujisaki, Motoi Takashina, Ryouichi Tomita, Kenichi Sakurai, Tadatoshi Takayama
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 49 Issue 1 Pg. 91-93 (Jan 2022) ISSN: 0385-0684 [Print] Japan
• PMID: 35046372 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Anastomotic Leak
• Carcinoma, Squamous Cell (surgery)
• Edema (pathology)
• Esophageal Neoplasms (complications, drug therapy, surgery)
• Esophagectomy
• Female
• Humans
• Liver Cirrhosis
• Lymph Node Excision
• Lymph Nodes (pathology)
• Lymphatic Metastasis (pathology)
• Osteomyelitis (pathology)