A case of esophageal carcinoma with hyperamylasemia after recurrence in postoperative course

Abstract

We report a case of esophageal carcinoma with hyperamylasemia after postoperative recurrence detected at the recurrent site by immunohistochemical study. A 49-year-old-male, admitted to our hospital for dysphasia and epigastralgia, was diagnosed with lower thoracic esophageal carcinoma determined histologically to be poorly differentiated squamous cell carcinoma. He was treated with neoadjuvant chemotherapy and underwent transthoracic esophagectomy. Lymph node metastasis to the right supraclavicular region occurred 3 months into the postoperative course and he underwent dissection of right-side neck lymphnodes. Eight months into the postoperative course, abdominal CT showed multiple metastases to the liver and serum amylase increased to 1,447U/L, which was predominantly salivary-type amylase. He died due to liver failure in spite of systemic chemotherapy. Immunohistochemical study with anti-alphaamylase antibody showed positive staining of metastatic tumor cells in the lymph nodes at the right supraclavicular region, but the primary lesion was negative. These findings indicate an extremely rare case of amylase-producing esophageal carcinoma. This is the first case of amylase-producing esophageal carcinoma.