title: [Surgically resected local recurrence after endoscopic submucosal dissection of esophageal cancer--a case report].
abstract: We report a case of surgically resected esophageal cancer which was locally recurred after endoscopic submucosal dissection. A 66-year-old man was admitted to our hospital because of further examination and a treatment of superficial esophageal cancer. A type 0-IIb+IIa cancer occupying the whole circumference of the lumen of the middle to lower esophagus was revealed. The depth of the invasion was judged to be T1a-EP or LPM by endoscopic ultrasonography, and no metastasis to other organs or lymph nodes was detected. Endoscopic submucosal dissection (ESD) was performed. However, macroscopic residual cancer didn't seem to exist. Pathological diagnosis was squamous cell carcinoma, moderately differentiated, the depth of tumor invasion was T1a-LPM. The presence of the residual cancer of the horizontal cut margin could not be judged because en bloc resection could not be achieved. After that, endoscopic balloon dilatation of the esophageal stenosis was performed repeatedly for about one year. Then, he was diagnosed as the local recurrence of the squamous cell carcinoma of the esophagus. Thoraco-abdominal esophagectomy reconstructed by stomach tube via a retrosternal route was undergone. The final stage of the lesion was judged T3N1M0 (Stage III, UICC) by the histological examination from the resected specimen. After the operation, he is receiving adjuvant chemotherapy and alive without recurrence. When endoscopic resection of the esophageal cancer is performed to the lesion, which relatively indicated to endoscopic resection or outside the guideline criteria for endoscopic resection, it is important that we choose the appropriate treatment protocol obtaining an informed consent from the patient sufficiently.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Kentarou
authors.initials: K
authors.lastname: Suchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okamura
authors.forename: Seiji
authors.initials: S
authors.lastname: Umehara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Momoko
authors.initials: M
authors.lastname: Todo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Shojiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Chouhei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sonoyama
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012086:Reoperation