Surgical treatment of synchronous hepatocellular and esophageal carcinoma: case report and review of literature.

Simultaneous presentation of hepatocellular carcinoma and esophageal carcinoma is rare. Few cases have been reported as surgically curable. We treated a caucasian man of 68 years who presented a voluminous hepatocellular carcinoma in the right lobe of the liver and a superficial squamous cell carcinoma of the middle third of the esophagus. Both tumors seemed curable with surgery. We adopted a treatment consisting of two steps: 1) curative hepatic right trisegmentectomy; 2) three months later transhiatal esophagectomy. Two units of blood were transfused for both operations. Simultaneous hepatectomy and esophagectomy have been published in seven cases. We opted for resecting the tumors in two distinct procedures to lower the operative risk. Because of the large size of the hepatocellular carcinoma and the small size of the esophageal carcinoma, hepatectomy was performed first. The delay between the two interventions did not compromise the prognosis that is actually dependent of the hepatocellular carcinoma.