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Ivor-Lewis Esophagectomy for Mucinous Adenocarcinoma: 1

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Five months prior to the present admission a 47-year-old man presented with melena, dull mid-epigastric pressure and a 35-pound weight loss over a 3-month period. He underwent esophagogastroscopy with biopsy at that time which showed mucinous adenocarcinoma on a background of Barrett’s esophagitis at the esophagogastric junction (see esophagogastrectomy and transhiatal esophagectomy.)     

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Ivor-Lewis Esophagectomy for Mucinous Adenocarcinoma: 2

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CT scan showed numerous lymph nodes anterior to the esophagus, the largest measuring 1.4 cm. In addition, there was a 1x3 cm mass in the gastrohepatic ligament and a large collection of lymph nodes just inferior to the stomach. There was minimal adenopathy in the porta hepatis. There was 10 cm of diffuse thickening from mid-esophagus down the gastroesophageal (GE) junction where there was focal gastric wall thickening and a suggestion of a lobular mass projecting into the lumen. Also a large hypodense lesion in the right lobe of the liver was noted and read as a probable hemangioma.   

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Ivor-Lewis Esophagectomy for Mucinous Adenocarcinoma: 3

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Workup showed increased uptake at the site of the cancer on PET scan with no evidence of metastatic disease.       

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This page was last modified on 4/17/2007.