Lu Qijue, Shi Bowen, Hong Jiang, Chen Hezhong, Li Chunguang
Department of Thoracic Surgery, Changhai Hospital, The Second Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China.
J Cardiothorac Surg. 2020 Mar 26;15(1):52. doi: 10.1186/s13019-020-01092-4.
Esophageal squamous cell carcinoma with tumor thrombus in the arch of the azygos vein has not been reported to date. Neoadjuvant chemotherapy can decrease the stage in patients with advanced preoperative tumor staging, regaining surgical opportunities and significantly prolonging progression-free survival and overall survival. Herein, we present a case of esophageal squamous cell carcinoma accompanied by tumor thrombus in the arch of the azygos vein, and the patient underwent radical surgery after neoadjuvant chemotherapy.
A 63-year-old male with esophageal squamous cell carcinoma was found to have tumor thrombus formation in the arch of the azygos vein. Four courses of neoadjuvant chemotherapy with the TP regimen (paclitaxel plus nedaplatin) were given. Reexamination revealed a significant reduction in tumor and tumor thrombus volume. Therefore, McKeown radical resection for esophageal cancer and removal of the tumor thrombus in the arch of the azygos vein were performed. Postoperative pathology suggested complete remission of the esophageal tumor and the presence of small focal cancer tissues in the arch of the azygos vein.
We report a case of esophageal squamous cell carcinoma with tumor thrombus formation in the azygos vein. We conducted radical resection after 4 rounds of neoadjuvant chemotherapy, and the pathological results revealed complete remission of the tumor. We report our experience addressing this rare case, and we hope to find the underlying mechanism of tumor thrombus formation and whether it has any effects on prognosis in our future study.
迄今为止，尚未见有关奇静脉弓内有肿瘤血栓形成的食管鳞状细胞癌的报道。新辅助化疗可降低术前肿瘤分期较晚患者的分期，使其重新获得手术机会，并显著延长无进展生存期和总生存期。在此，我们报告一例伴有奇静脉弓内肿瘤血栓形成的食管鳞状细胞癌病例，该患者在新辅助化疗后接受了根治性手术。
一名63岁的食管鳞状细胞癌男性患者被发现奇静脉弓内有肿瘤血栓形成。给予了4个疗程的TP方案（紫杉醇加奈达铂）新辅助化疗。复查显示肿瘤和肿瘤血栓体积显著缩小。因此，对该患者实施了食管癌McKeown根治性切除术，并切除了奇静脉弓内的肿瘤血栓。术后病理提示食管肿瘤完全缓解，奇静脉弓内存在小灶性癌组织。
我们报告了一例奇静脉内有肿瘤血栓形成的食管鳞状细胞癌病例。我们在4轮新辅助化疗后进行了根治性切除，病理结果显示肿瘤完全缓解。我们报告了处理这一罕见病例的经验，并希望在未来的研究中找到肿瘤血栓形成的潜在机制及其对预后是否有任何影响。
