title: Pyogenic liver abscess caused by direct invasion of esophageal squamous cell carcinoma to the liver: report of a case.
abstract: We report a case of esophageal squamous cell carcinoma (ESCC) directly invading the liver and causing a pyogenic liver abscess. The patient was a 66-year-old man who presented with dysphagia. Esophagography, endoscopic study, and computed tomography (CT) showed a mass lesion in the lower third of the esophagus. A high fever developed on hospital day 17 and another CT scan revealed a liver abscess, 50 × 45 mm, in the left lateral lobe of the liver. Although imaging demonstrated a liver abscess continuous with the tumor, we performed percutaneous transhepatic drainage, followed thereafter by distal esophagectomy and total gastrectomy with a left lateral segmental resection of the liver. The pathological findings confirmed a diagnosis of ESCC with direct invasion (T4N1M0, stage IVa in the TNM classification). The patient had an uneventful postoperative recovery. Microscopic examination of the resected specimen revealed the expansive growth of tumor cells into the hepatocellular tissues. To our knowledge, this is the first report of the direct invasion of esophageal cancer to the liver causing a pyogenic liver abscess; however, it should be borne in mind when a patient with esophageal cancer becomes febrile.
authors.affiliation: Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Akagi
authors.forename: Masao
authors.initials: M
authors.lastname: Miyashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Makino
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nomura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Okawa
authors.forename: Nobutoshi
authors.initials: N
authors.lastname: Hagiwara
authors.forename: Junji
authors.initials: J
authors.lastname: Ueda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamada
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Yokoi
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000473:pathology*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D008297:Male; D010462:Peptostreptococcus / Q000302:isolation & purification*