We report a rare case of advanced carcinoma and a second primary carcinoma
of the esophagus, both of which were successfully cured by chemotherapy and
operation at different times. In 1991, a 38-year-old Japanese man was diag
nosed with advanced esophageal cancer, which was unresectable because of th
e bronchial invasion of the tumor. He was given chemotherapy with cisplatin
(CDDP), combined with radiotherapy. During a 4-year follow-up, neither reg
rowth of the primary tumor nor distant metastasis occurred. In 1995, esopha
goscopy demonstrated a lugol-unstained region located 3cm distal from the a
rea of radiation to the primary lesion shown by esophagography. Histologica
l examination of a biopsy specimen showed the mucosa to be normal. Neverthe
less, yearly surveillance by endoscopy and histological examinations showed
that the mucosa of the esophagus gradually began to demonstrate mild dyspl
asia, followed by severe dysplasia; in 1998, a diagnosis of squamous cell c
arcinoma was made. Esophagectomy with lymph node dissection was performed.
Microscopic examination revealed that there had been pathologic complete re
sponse for the original advanced esophageal cancer.