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Kenneth A. Kesler
Zane T. Hammoud
Karen M. Rieger
John W. Brown
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Right arrow Esophagus - cancer

J Thorac Cardiovasc Surg 2006;131:497-498
© 2006 The American Association for Thoracic Surgery

Brief Communication

Long-term survival after excision of a solitary esophageal cancer brain metastasis

Kenneth A. Kesler, MD a , * , Zane T. Hammoud, MD a , Paul R. Helft, MD b , Karen M. Rieger, MD a , Michael B. Pritz, MD, PhD c , John W. Brown, MD a

a Indiana University School of Medicine, Department of Surgery, Thoracic Division, Indianapolis, Ind
b Indiana University School of Medicine, Department of Medicine, Medical Oncology Division, Indianapolis, Ind
c Indiana University School of Medicine, Department of Neurosurgery, Indianapolis, Ind

Received for publication September 9, 2005; accepted for publication September 28, 2005.

* Address for reprints: Kenneth A. Kesler, MD, Indiana University Dept of Surgery, Thoracic Division, Barnhill Dr EM 212, Indianapolis, IN 46202 (Email: kkesler@iupui.edu).

The first 20% of the full text of this article appears below.

Locally advanced esophageal cancer remains a disease with a low long-term cure rate, despite combined modality therapy, because of the frequent presence of occult metastatic disease. Metastatic disease to the central nervous system (CNS) is unusual, with a reported incidence of between 0.4% and 5.1%. 1 Go Patients with esophageal cancer who do present with CNS metastases after initial treatment represent a clinical dilemma. Although several treatment strategies using radiotherapy, surgical intervention, or both for CNS metastases exist, a poor prognosis is anticipated. We report long-term survival in a patient treated for a locally advanced adenocarcinoma of the esophagus and subsequently for a CNS metastasis.

Clinical Summary

The patient presented in June 1999 as a 53-year-old healthy white male with dysphagia and a 27-pound weight loss. Endoscopy identified a mass in the distal esophagus from 35 to 39 cm. A biopsy was positive for poorly differentiated adenocarcinoma. No evidence of metastatic disease by means of computed tomographic (CT) scans of the chest and abdomen was found. Transesophageal ultrasonography demonstrated a transmural neoplasm with a cytologically positive celiac lymph node equating to stage IVa disease. He was treated . . . [Full Text of this Article]






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