Endoscope-assisted thoracoscopic technique for esophageal bronchogenic cyst which presented elevated CA125.
A 26-year-old male was admitted to our hospital with a complaint of mild dysphagia. Preoperative examinations revealed a cystic lesion at the lower esophagus, thought to be a bronchogenic cyst. The patient underwent successful thoracoscopic tumor extirpation, assisted by endoscopy, without undergoing major thoracotomy. Thoracoscopic surgery is recommended for this entity, but the muscle layer is often injured. Endoscopic ultrasonography was very useful, as it could detect damage to the proper muscle layer of the esophagus near the tumor. Thus, we could predict preoperatively that the defect in the muscle layer, which must be closed, would be caused by the surgery. Additionally, endoscopy easily facilitated the detection of the regional defect and the border of the proper muscle layer, and also could be used as a stent during wall suturing. This technique enabled us to avoid postoperative stenosis of the esophagus. Furthermore, our case presented a high level of CA125. The preoperative serum CA125 value was 93.8 U/ml and intratumoral CA125 concentration was 1,690,000 U/ml. Serum CA125 decreased to 16.5 U/ml after surgery. In this paper, we present a new strategy of the treatment for bronchogenic cyst and a review the literature.
Akutsu
Yasunori
Y
Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. yakutsu@faculty.chiba-u.jp
Matsubara
Hisahiro
H
Hayashi
Hideki
H
Okazumi
Shinichi
S
Aoki
Taito
T
Kozu
Teruo
T
Ochiai
Takenori
T
D000328:Adult; D001994:Bronchogenic Cyst / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D018394:CA-125 Antigen / Q000097:blood*; D004934:Esophageal Cyst / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008297:Male; D013906:Thoracoscopy; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D018394:CA-125 Antigen