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Japanese Journal of Clinical Oncology 2006 36(5):333; doi:10.1093/jjco/hyl037
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© 2006 Foundation for Promotion of Cancer Research

Image of the Month

A Case of Esophageal Cancer with a Lusorian Artery

Hisayuki Matsushita and Hiroyasu Igaki

Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan

A 55-year-old man with esophageal cancer was referred to our hospital. Esophagoscopy showed an advanced esophageal cancer, measuring 2.4 cm in diameter, in the lower thoracic esophagus (T3N0M0) and also extramural pulsating compression of the posterior wall in the upper esophagus (Fig. 1A). Dynamic computed tomography (CT) scan showed an aberrant right subclavian artery arising from the distal aortic arch, behind the upper esophagus, which is called a ‘lusorian’ artery (Fig. 1B). Endoscopic ultrasonography also showed the right subclavian artery crossing between the esophagus and the supine (Fig. 1C).


Figure 1
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  		Figure 1. AA, Aortic Arch; ES, Esophagus, black arrow head, subclavian artery; white arrow, esophagus; black arrow, vagal nerve.

 
Transthroacic esophagectomy with three-field lymph node dissection was performed successfully. The right subclavian artery ran between the spine and the esophagus, and the right recurrent laryngeal nerve was absent (Fig. 1D).

The ‘lusorian’ artery is a very rare anomaly found in 0.4% of populations, caused by an abnormal involution of the fourth right aortic arch embryonically. In cases with lusorian artery, the right recurrent laryngeal nerve is absent, which should be of clinical importance during surgery. (Please note that a colour version of Figure 1 is available as supplementary data at http://www.jjco.oxfordjournals.org)


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This Article
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