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Esophageal cancer associated with right aortic arch: a case study
Takeshi Shimakawa1, Yoshihiko Naritaka, Yoshihisa Wagatuma
1Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo 116-8567, Japan. simakasu@dnh.twmu.ac.jp
Anticancer Research
|November 11, 2006
Summary
Surgical resection of esophageal cancer in patients with a right aortic arch is rare. This case study details the successful treatment of a 73-year-old man with Type IIIB right aortic arch and lower thoracic esophageal cancer.
Area of Science:
- Cardiovascular Surgery
- Surgical Oncology
- Medical Imaging
Background:
- Right aortic arch is a rare congenital vascular anomaly.
- Surgical resection of esophageal cancer in patients with this anomaly is extremely uncommon.
- Type IIIB, the most common form of right aortic arch, presents unique surgical challenges.
Observation:
- A 73-year-old man with Type 2 esophageal cancer in the lower thoracic esophagus was diagnosed with a Type IIIB right aortic arch and aberrant subclavian artery via upper GI series, endoscopy, and chest CT.
- The patient underwent surgical resection of the middle and lower intrathoracic esophagus through a left thoracoabdominal incision.
Findings:
- The surgical approach for esophageal cancer in the presence of a right aortic arch requires careful consideration of anatomical variations.
- A left thoracotomy, a common method for esophageal resection, may limit visualization of the right recurrent laryngeal nerve.
Implications:
- This case highlights the importance of pre-operative imaging to identify aortic arch anomalies before esophageal cancer surgery.
- Modified surgical techniques or additional incisions, such as a midline sternotomy, may be necessary to ensure adequate visualization and safe resection of the recurrent laryngeal nerve.
- Further research into optimal surgical strategies for esophageal cancer with right aortic arch is warranted.
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