title: [A Case of Esophageal Carcinoma with an Aberrant Right Subclavian Artery].
abstract: We report a rare case of esophageal carcinoma with an aberrant right subclavian artery. A 67-year-old woman was admitted to our hospital because of a sense of discomfort during swallowing. A detailed gastrointestinal examination revealed advanced carcinoma of the middle thoracic esophagus. Preoperative CT also revealed an aberrant right subclavian artery (AR SA). After the second course of neoadjuvant chemotherapy (FP therapy), we conducted a transthoracic esophagectomy with a 3-field lymphadenectomy. The right recurrent nerve was not identified at the right subclavian artery during mediastinal dissection, but the non-recurrent inferior laryngeal nerve (NRILN) was identified as going directly from the vagal nerve to the larynx during the neck lymphadenectomy. The thoracic duct ran between the esophagus and the azygos vein, terminating at the right venous angle. We were able to perform a #106recL lymphadenectomy as usual. She continues to do well without signs of recurrence 1 year later. Though ARSA is a relatively rare congenital anomaly, it must be identified preoperatively, and anatomical anomalies such as NRILN must be taken into consideration, in order that the operation can be performed safely.
authors.affiliation: Dept. of Digestive Surgery, Tsushimi Hospital.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Tokunou
authors.forename: Tatsuhito
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kamei
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Seiichirou
authors.initials: S
authors.lastname: Ando
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018376:Cardiovascular Abnormalities / Q000150:complications / Q000601:surgery*; D003680:Deglutition Disorders / Q000150:complications / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D013348:Subclavian Artery / Q000002:abnormalities* / Q000601:surgery