Metachronous Multiple Thoracic Esophageal Cancers with Sarcoid Reaction—Report of a Case—

Key Points

• To discuss a case of metachronous esophageal cancer with a sarcoid reaction complicating diagnosis and treatment.
• Performed endoscopic submucosal dissection for initial early esophageal cancer.
• Conducted CT and PET scans revealing lymph node enlargement.
• Diagnosed sarcoidosis from biopsy with no clinical symptoms.
• Identified new superficial esophageal cancer via upper gastrointestinal endoscopy.
• Performed radical resection and pathological examination of lymph nodes.
• Final diagnosis included esophageal cancer with lymph node metastasis (Stage IIA).
• Lymph nodes showed non-caseating granulomas, confirming sarcoid reaction.
• Diagnosis delayed due to sarcoidosis, complicating treatment planning.
• Considered preoperative chemotherapy for similar cT1b staged cases due to lymph node concerns.