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Curative Two-Stage Resection for Synchronous Triple Cancers of the Esophagus, Colon, and Liver: Report of a Case

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Curative Two-Stage Resection for Synchronous Triple Cancers of the Esophagus, Colon, and Liver: Report of a Case

Yuji Akiyama et al. Int J Surg Case Rep.

Abstract

Introduction: Cases of synchronous triple cancers of the esophagus and other organs curatively resected are rare.

Presentation of case: A 73-year-old man was admitted to our hospital with bloody feces. He was diagnosed with synchronous triple cancers of the esophagus, colon, and liver. We selected a two-stage operation to safely achieve curative resection for all three cancers. The first stage of the operation comprised a laparoscopy-assisted sigmoidectomy and partial liver resection via open surgery. The patient was discharged without complications. Thirty days later, he was readmitted and thoracoscopic esophagectomy was performed. Although pneumonia-induced pulmonary aspiration occurred as a postoperative complication, it was treated conservatively. The patient was discharged on postoperative day 24.

Discussion: Esophagectomy is a highly invasive procedure; thus, simultaneous surgery for plural organs, including the esophagus, may induce life-threatening, severe complications. Two-stage surgery is useful in reducing surgical stress in high-risk patients. For synchronous multiple cancers, the planning of two-stage surgery should be considered for each cancer to maintain organ function and reduce the stress and difficulty of each stage.

Conclusion: We successfully treated synchronous triple cancers, including esophageal cancer, by a two-stage operation.

Keywords: Esophageal cancer; Synchronous triple cancers; Two-stage operation.

Figures

Fig. 1
Fig. 1
(a) Barium enema showed two tumors as defects in the sigmoid colon (arrows). (b) Surgical specimen of the sigmoid colon (arrows). (c) Pathological specimen from the sigmoid colon showed a moderately differentiated adenocarcinoma.
Fig. 2
Fig. 2
(a) Esophagogastroscopy revealed a superficial elevated lesion with a surrounding Lugol-voiding lesion from 27 cm to 30 cm below the incisor. (b) Surgical specimen of the esophagus. (c) Pathological examination of a specimen from the esophagus showed poorly differentiated squamous cell carcinoma.
Fig. 3
Fig. 3
(a) A CT scan during hepatic arteriography showed a 7 cm, high-density area on S4 and S8. (b) Surgical specimen of the liver. (c) Pathological examination of a specimen from the liver showed moderately differentiated HCC.

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