title: Sudden death from metastatic esophageal cancer to the ventricular septum.
abstract: A 67-year-old man was admitted to our hospital due to esophageal cancer. Cancer existed at the lower esophagus and subtotal esophagectomy and lymphadenectomy was performed. The postoperative course was uneventful. Pathological findings revealed moderately differentiated squamous cell carcinoma that metastasized to the abdominal lymph nodes which include the paraaortic lymph nodes. He complained of anorexia three months after the operation and was found to have multiple liver and mediastinal lymph node metastases. He was admitted for chemotherapy. Before starting chemotherapy, he suddenly died without any sign of hemorrhage or respiratory disorder. Autopsy showed metastatic lesions to the heart and mediastinal lymph nodes, liver, thoracic vertebrae, kidney, adrenal gland and heart. Metastatic nodules in the heart were on the ventricular septum where the conducting system exists. No direct invasion from the pericardium was observed. Blockade of the conducting system of the heart was considered to have caused the severe arrhythmia and sudden cardiac arrest.
authors.affiliation: Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifuku-cho, Okayama 700-8511, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kataoka
authors.forename: Kaori
authors.initials: K
authors.lastname: Shigemitsu
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tanabe
authors.forename: Toshinori
authors.initials: T
authors.lastname: Ohara
authors.forename: Takaomi
authors.initials: T
authors.lastname: Takahata
authors.forename: Soichiro
authors.initials: S
authors.lastname: Nose
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology* / Q000556:secondary*; D003645:Death, Sudden; D004938:Esophageal Neoplasms / Q000473:pathology*; D006323:Heart Arrest / Q000209:etiology; D006338:Heart Neoplasms / Q000150:complications / Q000556:secondary*; D006346:Heart Septum; D006801:Humans; D008297:Male