[A case of superficial carcinoma in a diverticulum of the thoracic esophagus].

An upper gastrointestina(l GI) series revealed a diverticulum in the anterior wall of the middle thoracic esophagus of a 72-year-old man. Endoscopy revealed a type 0-IIc lesion in the esophageal diverticulum. The margin of the lesion was unclear. Biopsy proved that it was squamous cell carcinoma. Endoscopic ultrasonography showed that the deepest layer of the tumor was the lamina propria mucosae (cT1a-LPM) and that the underlying muscularis propria was thinning. No distant metastasis or regional lymph node metastasis was detected. Diverticulectomy or endoscopic submucosal dissection (ESD) was out of indication due to the unclear margin and thin muscularis propria. We conducted mediastinoscopy-assisted esophagectomy. The pathological diagnosis of the resected specimen was moderately differentiated squamous cell carcinoma with invasion to the lamina propria mucosae (pT1a-LPM). Pathological examination proved the thinning of the underlying muscularis propria in the diverticulum. The patient is alive without recurrence at 6 months after surgery.

[A case study of pulmonary and pancreatic metastasis from primary renal cell carcinoma more than ten years after nephrectomy].

A 73-year-old man, who had a left nephrectomy for renal cell carcinoma at the age of 58, visited our hospital for the treatment of 2 right lung tumors. Both tumors were resected. Immunopathology showed that one of these was a metastatic tumor from renal cell carcinoma, and the other was a primary lung adenocarcinoma. Four years later, a follows-up computed tomography showed a hypervascular nodule in the body of the pancreas. Distal pancreatectomy and spleenectomy were performed, and histopathological analysis revealed that the tumor was a metastasis from renal cell carcinoma. Three months after surgery, multiple liver metastases were discovered, and molecular-targeted therapy was started. If a distant metastasis from renal cell carcinoma can be resected completely, it has been reported that a good long-term prognosis can be expected. Therefore, postoperative long-term follow-up after resection of the renal cell carcinoma is essential, and if possible, the resection of metastasis should be considered.