[Esophageal carcinoma with right aortic arch associated with a vascular ring--a case report]

A 56-year-old man with cancer of the mid-thoracic portion of the esophagus and who had a right aortic arch associated with a vascular ring, underwent esophagectomy and mediastinal lymphadenectomy successfully. A routine chest roentgenogram had revealed the right aortic arch. The entire thoracic esophagus was excised via a left thoracotomy, and the left subclavian artery, which originated from a diverticulum of the right descending aorta was located on the left side of the esophagus, ascending from its posterior aspect. The left subclavian artery and the left arterial duct formed a vascular ring which was interrupted by dividing the arterial duct. Histologically, the resected specimen showed poorly differentiated squamous cell carcinoma of the protruding type, and was classified as stage IV, a2, ly(+), V(-) and na(+). Successful mediastinal lymphadenectomy requires that the surgeon pay careful attention to vascular abnormalities, as well as the pathways of the vagal and recurrent nerves.