[Experimental and clinical study for spread of cardiac cancer to the diaphragm]

We investigated the route of lymphogenous metastasis of cardiac cancer to the diaphragm, making a model of cardiac cancer using VX2 tumor of rabbit. Metastasis ratio of each lymph node in the experimental model indicated a correlation with clinical cases. Histological investigation of the diaphragm indicated floating of VX2 cancer cells in the lymph vessels in the diaphragm in 4 of 20 cases (20%). After, injection of CH44 at the oral side of the tumor, the presence of CH44 in the lymph vessels in the diaphragm were seen in 6 of 16 cases (37.5%). Clinically, the left diaphragm was excised as wide as possible in 22 cases of cardiac cancer with esophageal invasion by left thoraco abdominal approach. Histologically, embolic of the tumor or floating tumor cells in the lymph vessels in the diaphragm were seen in 6 of 22 cases (27.3%). These results revealed that carcinoma proliferating in the cardia can apparently spread to the diaphragm more extensively than has been previous believed.