title: Resection of a Submucosal Tumor-Like Superficial Carcinoma in Middle Thoracic Esophagus Concomitant with Mucosal Adenocarcinoma and Submucosal Squamous Cell Carcinoma: A Case Report and Review of Literature.
abstract: A 67-year-old man was pointed out mucosal irregularity on health check-up and was referred to our institution. Diagnostic examinations were performed and an aggregated type 0-IIa lesion having 3 small protrusions was recognized in the middle thoracic esophagus. Endoscopic biopsy led to diagnosis of esophageal cancer concomitant with adenocarcinoma and squamous cell carcinoma. Thoracic esophagectomy with 3-fields lymph node dissection was performed via a right thoracoabdominal approach and reconstructed with stomach roll. Three submucosal tumors like small protrusions were recognized in resected specimen. One of them was well differentiated tubular adenocarcinoma which occupied in mucosal layer. The other two were moderately differentiated squamous cell carcinoma. They existed very near but no connection was recognized by serial section. The adenocarcinoma existing in middle esophagus is very rare. Almost all of them were submucosal or advanced cancers. When we searched with the ICHUSHI database (a domestic medical literature database service provided by the NPO Japan Medical Abstracts Society) and the PubMed database, there was no report of mucosal adenocarcinoma occurred in middle thoracic esophagus in the past 10 years. Then this report was thought to be the first report of mucosal adenocarcinoma in middle thoracic esophagus in the world.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. soichiro@is.icc.u-tokai.ac.jp.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Nobue
authors.initials: N
authors.lastname: Kumaki
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Soji
authors.initials: S
authors.lastname: Ozawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Shimada
authors.forename: Osamu
authors.initials: O
authors.lastname: Chino
authors.forename: Akihito
authors.initials: A
authors.lastname: Kazuno
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tamayama
authors.forename: Izumi
authors.initials: I
authors.lastname: Sakai
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004945:Esophagoscopy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D009378:Neoplasms, Multiple Primary; D019651:Plastic Surgery Procedures / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil