Successfully treated advanced esophageal cancer with left axillary lymph node metastasis and synchronous right breast cancer: a case report

Akiyama, Yuji; Iwaya, Takeshi; Shioi, Yoshihiro; Endo, Fumitaka; Ishida, Kazushige; Kashiwaba, Masahiro; Otsuka, Koki; Nitta, Hiroyuki; Koeda, Keisuke; Morita, Masaru; Kimura, Yusuke; Sasaki, Akira

doi:10.1186/s40792-015-0102-9

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…A similar finding was reported in patients with lung cancers[ 4 5 ] and also in a case report of a patient with synchronous double cancers of the esophagus with left ALNM and a right breast primary, prompting the author's to suggest a second theory of a possible direct lymphatic spread to the axillary lymph nodes bypassing the supraclavicular lymph nodes. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Understanding the association of axillary lymph node metastasis in esophageal cancers

Krishnamurthy

2018

Indian J Nucl Med

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Lymph node metastasis is widely believed to be one of the most powerful prognostic factors influencing the outcomes of many solid cancers, including esophageal cancers. The left supraclavicular node, famously described as the Virchow's node, is occasionally involved in patients with advanced gastrointestinal cancers. Virchow node involvement is considered “nonregional” in all the gastrointestinal cancers, except in esophageal cancers. On the other hand, axillary lymph node metastases (ALNMs) are considered “nonregional” in all gastrointestinal cancers, including esophageal cancers. Exceptionally, some experts share a contrarian view and consider ALNM and supraclavicular lymph node metastasis to represent a contiguous regional dissemination of esophageal cancer. The clinical presentation of ALNM in the vast majority of the patients with esophageal cancers has been reported to be metachronous. Synchronous presentation is exceedingly rare, and our patient is possibly the second case to be reported in the English language literature. The increasing role of 18F-fluorodeoxyglucose positron emission tomography computed tomography scans in aiding the staging workup in patients with esophageal cancers and ultimately influencing the choice of management in such rare scenarios is further discussed.

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Section: Discussionmentioning

confidence: 99%

Understanding the association of axillary lymph node metastasis in esophageal cancers

Krishnamurthy

2018

Indian J Nucl Med

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“…A clear delineation is described with improved quality of life measures despite the terminality of the primary cancer. Concurrently, 14 studies noted statistically significant survival rates in individuals who underwent palliative mastectomy [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Of these aggregates, three studies noted no difference in patient survival outcome and concluded with conflicting data [25][26][27].…”

Section: Literature Reviewmentioning

confidence: 99%

Palliative Modified Radical Mastectomy to Improve Quality of Life by Decreasing Disease Burden: A Case Report

Rostami¹,

Ladd²,

Stewart³

et al. 2021

Asp Biomed Clin Case Rep

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In cases of advanced pathology, palliative medicine is able to confer a great deal of relief to the patient. In the same light, surgical intervention is able to provide increased quality of life in cases of extensive disease burden, providing palliation where curative measures cannot be achieved. In the case study therein, a patient presents with metastatic breast cancer with a localized fungating mass contributing to severe local and systemic symptomatology. In this setting, invasive management of her disease allowed for clinical improvement of the patient when medical management alone was not sufficient. The patient quickly demonstrated recovery of her symptoms in the post-operative phase when the local disease was resected. The utilization of invasive measures, as seen in this case, further proves the importance of multidisciplinary palliative care where surgical measures are included in patient care.

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“…In addition, most cases of double primary cancer are metachronous, and there are few cases in which both cancers were treated simultaneously. Surgery was chosen for all of these cases [4,5], and there were no cases in which treatment other than surgery was chosen because of multiple metastases or advanced cancer.…”

Section: Introductionmentioning

confidence: 99%

Double primary recurrent human epidermal growth factor receptor 2-positive breast cancer and esophageal cancer that responded well to chemotherapy

et al. 2018

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Double primary breast and esophageal cancer have been no reported cases in which treatment methods other than surgery were selected because of multiple metastasis or advanced cancer. The patient was a 52-year-old woman who had received left pectoral muscle-preserving mastectomy and axillary lymph node dissection (level 2) 7 years prior, following the diagnosis of left breast cancer. The postoperative diagnosis was pT2 N3a M0 stage IIIC and luminal human epidermal growth factor receptor 2 (HER2) phenotype. After the surgery, six courses of triple chemotherapy with 5-fluorouracil (5-FU), epirubicin, and cyclophosphamide and four courses of docetaxel (DTX) were administered, and letrozole was administered for 5 years. Seven years after the surgery, swelling of her left axillary, supra-, and subclavicular lymph nodes, and sternum osteolysis were observed on computed tomography (CT). Radioisotope uptake was observed in the esophagus on positron emission tomography. An esophageal cancer was observed in the upper thoracic esophagus on esophagogastroscopy. The patient was administered a local treatment for esophageal cancer and systemic chemotherapy for both cancers. As a primary therapy, double chemotherapy with 5-FU and cisplatin (FP) (two courses) + radiotherapy on the esophagus and left supraclavicular lymph nodes (total target dose of radiotherapy was 60 Gy /30 fractions) was performed with the concomitant use of trastuzumab and zoledronate. Marked shrinkage [complete response (CR)] of the esophageal cancer was observed on esophagogastroscopy and shrinkage (partial response) of the left axillary and supra-and subclavicular lymph nodes were observed on CT. The secondary treatment included pertuzumab + trastuzumab + DTX. Bilateral pleural effusions were observed in the eighth course; therefore, DTX was withdrawn and the treatment was continued with only the molecularly targeted drugs. Two years have passed since the initiation of treatment. The individual lymph node metastatic foci have disappeared or markedly shrunk (CR) on CT scans and the sternal metastases have remained hard without change. In addition, CR for esophageal cancer has been maintained. We report a case of double primary recurrent HER2-positive breast cancer and esophageal cancer that responded well to radiotherapy and chemotherapy.

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Successfully treated advanced esophageal cancer with left axillary lymph node metastasis and synchronous right breast cancer: a case report

Cited by 5 publications

References 19 publications

Understanding the association of axillary lymph node metastasis in esophageal cancers

Understanding the association of axillary lymph node metastasis in esophageal cancers

Palliative Modified Radical Mastectomy to Improve Quality of Life by Decreasing Disease Burden: A Case Report

Double primary recurrent human epidermal growth factor receptor 2-positive breast cancer and esophageal cancer that responded well to chemotherapy

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