tailieunhanh - Báo cáo khoa học: "The diagnostic challenge of mediastinal sarcoidosis accompanying esophageal cancer"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The diagnostic challenge of mediastinal sarcoidosis accompanying esophageal cancer | Schauer and Theisen World Journal of Surgical Oncology 2010 8 15 http content 8 1 15 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access The diagnostic challenge of mediastinal sarcoidosis accompanying esophageal cancer Matthias Schauer1 Joerg Theisen2 Abstract The primary staging of an oesophageal cancer can be difficult if accompanied by sarcoidosis. In these patients endosonography CT and PET may not be sufficient for staging purposes concerning lymph node and distant metastases. In these special cases operative biopsies of enlarged lymph nodes and unclear pulmonary nodules have to be obtained. In connection with the radiographic examinations the histopathological results of the biopsies contribute to further precise staging and help to decide on a curative versus a palliative therapy concept. Background The incidence of sarcoidosis averages 1 in the western world 1 . A risk analysis of cancer from cohorts of Swedish patients with sarcoidosis showed that the overall relative risk for cancer development is increased especially the risk for cancer of the lung stomach small intestine liver and skin 2 . The coincidence of sarcoidosis and oesophageal cancer is a rare event. Up until now five such cases were mentioned in the international literature 2 . The documented cases describe the limitations of the possible staging procedures in patients with a thoracic neoplasia accompanied by sarcoidosis. Moreover a feasible approach towards these cases is being proposed. Case presentation In the year 2007 283 patients with an adenocarcinoma of the gastro oesophageal junction AEG or an oesophageal cancer were admitted to our hospital. Two patients aged 55 and 66 presented with an oesophageal cancer a thoracic lymphadenopathy and sarcoidosis in their past medical history. The 55-year-old female patient with an adenocarcinoma of the cardia was referred to our hospital after neoadjuvant chemotherapy with cisplatin and 5-FU in Montenegro for a second .