24 April 2024 : Case report
[In Press] A Rare Case of Ileocecal Lymph Node Recurrence After Surgery in Siewert’s Classification Type I Esophagogastric Junction Adenocarcinoma
Unusual clinical course
Takaatsu Bessho1ADEF, Yasuyuki Miura1BDEF, Satoshi Yajima1EF, Satoru Kagami1DF, Takayuki Suzuki1DF, Tomoaki Kaneko1DF, Kazunori Okubo1DF, Mitsunori Ushigome1DF, Akiharu Kurihara1DF, Naobumi Tochigi2DF, Hideaki Shimada1DF, Kimihiko Funahashi1ABCDEFDOI: 10.12659/AJCR.943080
Am J Case Rep In Press; DOI: 10.12659/AJCR.943080
Available online: 2024-04-24, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
BACKGROUND
Although recurrence after surgery for esophagogastric junction (EGJ) adenocarcinoma frequently develops in the mediastinal and para-aortic lymph nodes (LN), distant LN recurrence in the mesocolon is rare. We report a rare case of ileocecal LN metastasis in the ascending mesocolon after radical surgery for an EGJ adenocarcinoma.
CASE REPORT
We performed subtotal esophagectomy with mediastinal and para-gastric LN dissection in a patient with an advanced EGJ adenocarcinoma. Clinicopathologically, the patient was diagnosed with type I EGJ adenocarcinoma based on Siewert’s classification (pathological T3N1M0). One year after surgery, computed tomography showed enlarged lymph nodes around the ileocolic artery, and further examination was performed. Although positron emission tomography-computed tomography showed that the lesion had moderate uptake of fluorodeoxyglucose, we did not find the reason for the enlarged lymph nodes. Finally, laparoscopic ileocecal resection was performed for diagnostic and therapeutic purposes. Clinicopathological tests revealed that the specimen was a moderately differentiated adenocarcinoma, which was strongly suspected to be a metastasis of the EGJ adenocarcinoma.
CONCLUSIONS
We encountered a rare case of EGJ adenocarcinoma that spread to the ileocecal LN in the ascending mesocolon. To the best of our knowledge, this is the first such report in the literature to date. Laparoscopic ileocecal resection for metastasis to the ascending mesocolon seems reasonable as a local control.
Keywords: Esophagectomy; Adenocarcinoma; Mesocolon; Lymph Nodes; Laparoscopy
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