[Two cases of lymph node recurrence after endoscopic mucosal resection of esophageal cancer]

Here, we reported two cases of lymph node recurrence after endoscopic mucosal resection of esophageal cancer. Case 1: A patient was a 49-year-old man. Endoscopic mucosal resection (EMR) was performed to the 0-IIc type esophageal cancer in October 2005. The pathological findings were moderately differentiated squamous cell carcinoma, pT1b-SM3, ly0, and v0. Therefore, additional therapy of definitive chemoradiation was conducted. However, he complained a difficulty in swallowing in June 2007 and computed tomography (CT) revealed a lymph node measuring 4 cm in diameter at the right side of cardia ( #1). Therefore, a radical operation to the lymph node recurrence was performed in August 2007. Pathological findings revealed metastases of cancer were not only in #1 LN but also in #8a. Unfortunately, the patient died on the 37th day after the operation due to a respiratory failure and anastomotic leakage. Case 2: A patient was a 68-year-old man. EMR was performed to the 0-IIa type esophageal cancer in August 2006. The pathological findings were poorly differentiated squamous cell carcinoma, pT1a-MM, ly0, v0. Therefore, adjuvant chemotherapy was added. However, in February 2009, a follow-up CT showed a metastatic lymph node measuring 2 cm in diameter at the right side of cardia (#1) and a radical operation was performed in June 2009. Pathological findings revealed the metastatic lymph nodes were at the right side of cardia (#1) and middle thoracic paraesophagus (#108).